If you are one of the 31.6 million Americans that suffers from eczema (atopic dermatitis), then cold, dry winters are often synonymous with itchy, red skin. Eczema is an inflammatory skin condition that causes dry skin, itchy skin, rashes, scaly patches, blisters and skin infections. Loss of moisture within the skin is one of the most common triggers of eczema flares, and this can be made worse by temperature drops and by long hot showers.
The good news for patients suffering from eczema is that there are excellent treatments available, with several new medications that have become available over the last year. While there is still no cure, with proper treatment and skin care maintenance, eczema should be an occasional nuisance rather than something that reduces the quality of your everyday life.
Steroids: The Classic Eczema Treatment
Steroids have long been the mainstay of treatment for eczema. They are fast acting, safe when used properly, and very inexpensive. Eczema is caused by an inappropriate inflammatory reaction in the skin, and steroids are one of the main ways to reduce inflammation.
Most mild to moderate cases of eczema can be controlled with the occasional application of topical steroid creams. For more severe cases or eczema flares your doctor may prescribe brief courses of internal steroids, either with oral prednisone pills or long-acting steroid shots. Because overuse of topical steroids can gradually thin the skin, and systemic steroids carry long-term risks such as osteoporosis and glaucoma, a number of non-steroidal treatment options have been developed.
Non-Steroidal Treatments for Eczema
Non-steroidal creams include a few different categories of medications that suppress the inflammation of eczema without some of the chronic side effects we can see with long term steroid use. These include:
Protoic (tacrolimus) ointment and Elidel (pimicrolimus) cream, which have been around for over a decade.
Eucrisa (crisaborole) ointment is a newer steroid alternative.
These medications are typically used for chronic maintenance of stubborn eczema, especially in children, and for adults to use in sensitive areas such as the face and genitals. They do not work nearly as quickly as steroids and are more expensive.
New Treatment Options for Eczema
With the FDA approval of Dupixent in 2019, treatment of severe eczema entered the biologic era of medicine. Biologics are injected medications that block very specific communication pathways within the immune system to suppress inappropriate inflammation. Dupixent blocks the interleukin-4 and interleukin-13 receptors on immune cells. This therapy has revolutionized the treatment of severe eczema, giving us a treatment option that is highly targeted, has few serious side effects, and can offer life-altering relief from a debilitating, chronic condition.
With the recent FDA approval of Adbry, a more specific interleukin-13 blocker, we now have another safe, effective treatment for the treatment of our most severe eczema patients.
The newest treatment option for eczema is the JAK inhibitor class of medications. Similar to biologics, these medications block pro-inflammatory signaling within our immune cells, but instead of requiring shots, they are available as creams and pills.
Opzelura cream holds promise as a topical treatment that is as fast acting and as potent as a steroid cream, without the chronic risks. Rinvoq and Cibinqo are newly approved oral treatments that have the potential to offer remarkably fast and effective relief for even the most severe eczema patients.
While there is much to be excited about with these new treatment options, they are not for everyone. Newer medications can be very expensive and may have strict severity requirements that have to be met for insurance to cover them. Side effects from a lowered immune system, while rare, may be serious and include infections, malignancies, and blood clots.
Call us or book online today to learn whether new treatment options might help your skin!