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Your Guide to Treating Advanced Eczema

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4 Signs It’s Time to Try a Biologic for Severe Eczema

Medically Reviewed By William C. Lloyd III, MD, FACS
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If your current eczema treatment isn’t reducing symptoms, or it’s causing unwanted side effects, it may be time to consider a new approach. Talk with your doctor about available treatment options.

male doctor and patient

Eczema is one of the most common chronic inflammatory skin diseases. Also called atopic dermatitis (AD), eczema is caused by a combination of factors, including genetics, an overactive immune system, and environmental triggers like weather or stress. The resulting skin rash, itch, and pain is often treated with an anti-inflammatory corticosteroid skin cream. While these topicals are effective for many people, they may not work for everyone.

New medications called biologics are opening up new ways to find relief that weren’t available even just a year or two ago. If you’re having trouble managing your eczema, work with your doctor to find out whether or not biologics could help, especially if you’re familiar with these common experiences.

1. Your current eczema treatment isn’t relieving your symptoms. 

Anti-inflammatory corticosteroid creams can heal the skin and ease itching. They may be used alone or in combination with other topical medications that help to calm the overactive immune response. If itching and broken skin are severe, your doctor may recommend taking oral corticosteroids for a shorter amount of time. Oral steroids can’t be taken long term without the risk of serious side effects like high blood pressure and diabetes.

However, if the traditional approach doesn’t relieve your symptoms, a long-term systemic biologic medication that works on your whole body may be in order.

2. You have bothersome side effects with your current eczema treatment.

Side effects from using a corticosteroid cream are uncommon, but they can occur. Talk with your doctor if you experience any of the following changes to your skin:

  • acne
  • rosacea, a reddening of the skin
  • purpura, purple spots on the skin
  • skin atrophy (weakness)

3. Eczema is making you miserable.

Eczema symptoms can impact so many areas of your life. Do you have trouble sleeping? Feel too uncomfortable to exercise? Have difficulties with work or your social life? It’s worth a little time exploring different eczema treatment options with your doctor to feel healthier and happier. This is especially so if you’ve already tried stress busters like yoga, relaxation techniques, or talk therapy.

4. You can’t keep up with your skincare routine.

While it’s possible for some people to manage eczema symptoms with topicals and lifestyle changes like moisturizing, eating a healthy diet, and exercising, it can be a lot to keep track of, and some people might just get tired of the routine – or the pressure to get it right in order to keep eczema at bay. And that’s perfectly okay! If your regimen is beginning to feel too constricting, and perhaps only adding to triggers like stress, it might be time to consider trying a biologic to ease symptoms.

New biologic medication options are available or coming soon.

This is an exciting time for new eczema medications. The Food and Drug Administration (FDA) approved the first biologic for eczema in January 2021, dupilumab (Dupixent), which is given intravenously. Since then, two more biologics have been approved: upadacitinib (Rinvoq), taken in pill form, and tralokinumab (Adbry), given by injection. More than 20 additional biologic drugs are in the development stage.

Has science caught up with your symptoms? Make an appointment with your doctor to find out. You may even be able to contribute to the future of eczema treatment by participating in a clinical trial.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Feb 16
View All Your Guide to Treating Advanced Eczema Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Coondoo, A., et al. (2014). Side-effects of topical steroids: A long overdue revisit.
  2. Eczema Stats. (n.d).
  3. FDA approves new eczema drug Dupixent. (2017).
  4. Johnson, J. (2021). Biologics are changing the landscape of eczema treatment.
  5. Montes-Torres, A, et al. (2015). Biological treatments in atopic dermatitis.