Eczema can be a frustrating skin condition, whether you get it a few times a year or deal with it every day. It's important to work closely with your doctor to make a plan that will help you control the itch and rash.
Eczema treatment has four main goals:
- Control the itch.
- Heal the skin.
- Prevent flares.
- Prevent infections.
The right treatment for you depends on your age, medical history, how bad your symptoms are, and other things. You’ll probably need to use a mix of remedies to get the best results. And there are things you should do on your own to keep your skin healthy and clear.
Here's your complete guide to eczema treatments.
Eczema meds can relieve your symptoms and help the skin heal when you take them as directed. The treatments may not have the same effects on everyone, though. So you and your doctor may need to try a few different options to see what works best for you. Treatment regimens may need to be changed occasionally when medications stop working as well as they once did.
Corticosteroid creams, solutions, gels, foams, and ointments. These treatments made with hydrocortisone steroids can quickly relieve itching and reduce inflammation. They come in different strengths, from mild over-the-counter (OTC) treatments to stronger prescription medicines.
OTC hydrocortisone is often the first thing doctors recommend to treat mild eczema. You may need different strengths of these steroids depending on where and how bad your rash is. For example, a doctor may prescribe a more potent one for thick, scaly skin. Side effects from these meds, such as thinning skin and stretch marks, are rare when you use them as directed.
NSAID ointment. There is now a new prescription non-steroidal, anti-inflammatory called crisaborole (Eucrisa) which can be used to treat mild to moderate forms of eczema. A twice a day application for patients 2 years old and older has been effective in reducing inflammation and helping the skin return to a normal appearance.
Barrier repair moisturizers. You can get these over the counter and by prescription. They help lock water into your skin, repair damage, and ease dryness, redness, and itching. Some products may have irritating fragrances or other ingredients, so ask your doctor or pharmacist which ones you should try or avoid.
Pimecrolimus and tacrolimus, medicines you rub on your skin, treat moderate-to-severe eczema for some people. They ease inflammation, but they aren't steroids. They may increase the risk of skin cancer and non-Hodgkin’s lymphoma, so the FDA issued a special warning for them. Talk to your doctor about these risks before you take the drugs.
Corticosteroid pills, liquids, or shots. These powerful drugs help relieve symptoms of severe or hard-to-treat eczema. Because of the risk for side effects such as skin damage and bone loss, you should take them only for a short time.
Drugs that turn down your immune system, including cyclosporine, methotrexate, and mycophenolate mofetil. They help keep your body's defenses from overreacting. You can take them as pills, liquids, or as a shot. They can help people with moderate-to-severe eczema when other treatments haven’t worked. Serious side effects include high blood pressure and kidney problems. You should take these medicines only for a short time to limit the risk for these problems.
Antibiotics. Scratching damages your skin, which allows bacteria to get under it and cause an infection. These medicines treat bacterial skin infections.
Antihistamines. When you take them at night, these drugs relieve itching and can help you sleep.
Ultraviolet (UV) light can help treat moderate-to-severe eczema. UV rays help keep the immune system from overreacting. But too much of it can age your skin and raise your risk for skin cancer. So doctors use the lowest possible dose and watch your skin carefully when you get this treatment.
There are two types of phototherapy:
UV light therapy. In a dermatologist’s office, your skin gets exposed to UVA rays, UVB rays, or a mix of both. Sometimes you’ll rub coal tar on your skin at the same time. You’ll have sessions two to five times a week, depending on the type of treatment you get.
PUVA therapy. With this type, you take psoralen, a prescription medication that makes the skin more sensitive to UVA light. It’s for people who haven’t gotten results from UV therapy alone.
Skin Care at Home
When you keep your skin healthy, you can prevent dryness, itching, redness, and maybe lessen the need for medication. Plus, it feels good to pamper yourself. Try these tips:
Bathe only in warm water. Hot water dries out skin. Wash with a gentle cleanser instead of soap. Don't use body scrubbers or washcloths, which can be irritating. Pat dry with a soft towel instead of rubbing, and be sure to leave your skin damp.
Apply moisturizers daily. Do it right after you bathe or wash your hands. Choose fragrance-free moisturizers that won't irritate you. Try using a thicker skin cream or ointment that has more oil at night, and wear cotton gloves or socks to lock in moisture. Gloves can also keep you from scratching in your sleep.
Avoid too much bathing and hand washing. It will dry out your skin. Steer clear of alcohol-based hand cleaners, too.
Limit your contact with skin irritants. Household cleaners, laundry detergents, perfumed soaps, bubble baths, cosmetics, and many other things can make eczema worse. Learn what irritates your skin so you can avoid it.
Choose cotton clothes that fit comfortably. Wool and synthetic fibers can be irritating. Also, be sure to wash new clothes before you wear them for the first time. Use fragrance-free laundry soap, and rinse your laundry thoroughly.
Avoid getting overheated. When you’re hot and sweaty, it can trigger itching and scratching. After a workout, rinse off right away in a warm shower.
Know your triggers. Many people with eczema react to allergens such as pollen, dust mites, animal dander, and mold.
Ease stress. It can be hard to find time to relax, but lowering your stress level will help you avoid symptom flare-ups.