Treatments for atopic dermatitis (eczema) aim to reduce inflammation, relieve itching and prevent future flare-ups. Over-the-counter (nonprescription) anti-itch creams and other self-care measures may help control mild atopic dermatitis.
Although atopic dermatitis is related to allergies, eliminating allergens is rarely helpful in clearing the condition. Occasionally, items that trap dust — such as feather pillows, down comforters, mattresses, carpeting and drapes — can worsen the condition. Allergy shots usually aren't successful in treating atopic dermatitis.
- Corticosteroid creams or ointments. Your doctor may recommend prescription corticosteroid creams or ointments to ease scaling and relieve itching. Some low-potency corticosteroid creams are available without a prescription, but you should always talk to your doctor before using any topical corticosteroid. Side effects of long-term or repeated use can include skin irritation or discoloration, thinning of the skin, infections, and stretch marks on the skin.
- Antibiotics. You may need antibiotics if you have a bacterial skin infection or an open sore or fissure caused by scratching. Your doctor may recommend taking antibiotics for a short time to treat an infection or for longer periods of time to reduce bacteria on your skin and to prevent recurrent infections.
- Oral antihistamines. If itching is severe, oral antihistamines may help. Diphenhydramine (Benadryl, others) can make you sleepy and may be helpful at bedtime. If your skin cracks open, your doctor may prescribe mildly astringent wet dressings to prevent infection.
- Oral or injected corticosteroids. For more severe cases, your doctor may prescribe oral corticosteroids, such as prednisone, or an intramuscular injection of corticosteroids to reduce inflammation and to control symptoms. These medications are effective, but can't be used long term because of potential serious side effects, which include cataracts, loss of bone mineral (osteoporosis), muscle weakness, decreased resistance to infection, high blood pressure and thinning of the skin.
- Immunomodulators. A class of medications called immunomodulators, such as tacrolimus (Protopic) and pimecrolimus (Elidel), affect the immune system and may help maintain normal skin texture and reduce flares of atopic dermatitis. This prescription-only medication is approved for children older than 2 and for adults. Due to possible concerns about the effect of these medications on the immune system when used for prolonged periods, the Food and Drug Administration recommends that Elidel and Protopic be used only when other treatments have failed or if someone can't tolerate other treatments.
Light therapy (phototherapy)
As the name suggests, this treatment uses natural or artificial light. The simplest and easiest form of phototherapy involves exposing your skin to controlled amounts of natural sunlight. Other forms of light therapy include the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light including the more recently available narrow band ultraviolet B (NBUVB) either alone or with medications.
Though effective, long-term light therapy has many harmful effects, including premature skin aging and an increased risk of skin cancer. For these reasons, it's important to consult your doctor before using light exposure as treatment for atopic dermatitis. Your doctor can advise you of possible advantages and disadvantages of light exposure in your specific situation.
Treatment for infantile eczema includes identifying and avoiding skin irritations, avoiding extreme temperatures, and lubricating your baby’s skin with bath oils, lotions, creams or ointments.
See your baby's doctor if these measures don't improve the rash or if the rash looks infected. Your baby may need a prescription medication to control his or her symptoms or to treat the infection. Your doctor may recommend an oral antihistamine to help lessen the itch and to cause drowsiness, which may be helpful for nighttime itching and discomfort.
Aug. 23, 2011
- Weston WL, et al. Epidemiology, clinical manifestations, and diagnosis of atopic dermatitis (eczema). http://www.uptodate.com/home/index.html. Accessed April 21, 2011.
- Weston WL, et al. Treatment of atopic dermatitis (eczema). http://www.uptodate.com/home/index.html. Accessed April 21, 2011.
- Eczema/atopic dermatitis. American Academy of Dermatology. http://www.aad.org/public/Publications/pamphlets/EczemaAtopicDermatitis.htm. Accessed May 3, 2011.
- What is atopic dermatitis? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/hi/topics/dermatitis/ffdermatitis.htm. Accessed May 3, 2011.
- Habif TP. Atopic dermatitis. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do? about=true&eid=4-u1.0-B978-0-7234-3541-9. X0001-6--TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed April 24, 2011.
- Zeppa L, et al. Atopic dermatitis in adults. Dermatitis. 2011;22:40.
- Atopic dermatitis: Possible complications. American Academy of Dermatology. http://www.skincarephysicians.com/eczemanet/complications.html. Accessed May 2, 2011.
- Spergel JM. Management of severe refractory atopic dermatitis (eczema). http://www.uptodate.com/home/index.html. Accessed April 21, 2011.
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