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Your Guide to Treating Advanced Eczema

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Treating Your Atopic Dermatitis: How to Take Control

Medically Reviewed By William C. Lloyd III, MD, FACS
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The discomfort of atopic dermatitis, the most common form of eczema, can be tough to manage, and flares can make it feel like things are even more out of your control. However, there are lots of strategies you can employ to make life with eczema easier, whether it’s medications, therapies, lifestyle changes, or a combination of those tactics.

Smiling Woman Applying Moisturizing Cream At Home
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Atopic dermatitis, the most common form of eczema, is a chronic inflammatory skin condition that tends to develop during childhood but can persist through adulthood. It causes a variety of symptoms, such as dry, red skin and itching. You can even develop raw, swollen skin if you can’t resist the urge to scratch– and it can be hard to resist! Atopic dermatitis can cause so much discomfort that it can begin to interfere with your activities of daily living, as well as your ability to get a good night’s sleep. However, you don’t have to let your atopic dermatitis control you. Resolve to be proactive and tackle your symptoms so that you can manage them and feel better.

Controlling eczema with medication

The itching, the dryness, and the overall irritation getting you down? Fortunately, there is treatment available. Unless you have very mild eczema, you may find that you need some medication to help you manage your symptoms. Some options you can talk about with your doctor include:

  • topical creams, like topical corticosteroids or calcineurin inhibitors that you apply to the affected areas of your skin
  • oral medications, which may include any of several different types of immunosuppressant drugs, such as a steroid like prednisone or systemic meds like azathioprine, cyclosporine, methotrexate, or mycophenolate mofetil
  • newer biologic medications that block the root cause of inflammation, including dupilumab (Dupixent), upadacitinib (Rinvoq), and tralokinumab (Adbry)

Some research suggests that combination therapy is even more effective than a single type of treatment. So, if your doctor puts you on a biologic, it’s possible they may suggest also using topical corticosteroids and other creams in tandem with it.

Something to consider: some meds are not designed to be used long-term, so be sure to talk to your doctor about the best approach. Certain systemic oral medications carry the risk of serious side effects, and it’s important to weigh the cost-benefit ratio before going that route.

Other therapies for treating eczema

Medication can be very helpful for the dry, irritated skin of a person with atopic dermatitis. However, there are a few other types of therapies that might be worth exploring, too, including:

  • Light therapy: Phototherapy entails exposing your skin to ultraviolet light to reduce the inflammation. You’ll start with extremely short periods of exposure and gradually increase the amount of time. It’s not usually considered a first-line treatment, and it’s not for everyone, but if topical meds aren’t effective for you, it might be worth considering.
  • Wet wrap therapy: After bathing, you can try wet wrap therapy. Soak strips of cotton or gauze in water, and gently wrap them around the areas of affected skin. Then, put a dry layer on top to keep the moisture in, and put your clothes on. Let the wet wraps stay in place for a few hours before you remove them, as long as they stay moist.
  • Bleach baths: To prevent eczema flares, you can try a bleach bath. Add a half-cup of bleach to a 40-gallon tub of warm water and soak for about 10

Implementing lifestyle changes to improve eczema

A few basic lifestyle strategies can make a huge difference when it comes to living with atopic dermatitis. Consider these tips to control eczema and see if you notice some relief:

  • Moisturize, moisturize, moisturize: Did we mention that you should moisturize your skin as often as possible? Thick heavy creams tend to work best. Make sure you apply a thick layer after bathing, too.
  • Reconsider that hot shower: A shorter, more tepid shower is less likely to dry out your skin. If you choose to soak in the tub, make it quick — and stick with the lukewarm water.
  • Use gentle cleaning products: Scented detergents and soaps are known for irritating skin, as are harsh cleansers. Stick with gentle, unscented versions, since your skin doesn’t need any additional irritation.
  • Avoid allergens and other triggers: If you know that a certain allergen or even an environmental factor tends to set off an eczema flare, take care to avoid it.
  • Maintain a consistent temperature as much as possible: If you know that getting hot and sweaty irritates your skin and makes your eczema flare, let that knowledge guide you. You might want to stick to air-conditioned spaces as much as possible during the hot weather months.
  • Treat your skin with care: After bathing, gently pat your skin dry instead of rubbing it, which can irritate or even break open, fragile skin. Dress with care so as not to further irritate already irritated skin, as well.

Don’t give up.

Controlling eczema can be challenging. You may have to try a few different strategies to find a combination that works for you. Talk to your doctor about trying another medication if yours doesn’t seem to be working for you. And keep up the good habits that can reduce further irritation to your skin.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Feb 4
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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. Atopic dermatitis: Self-care. (n.d.). https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis/self-care
  2. Hawryluk, E. (2021). Topicals, oral medicines and phototherapy: An overview of eczema treatments. https://nationaleczema.org/eczema-medications-and-treatments/
  3. Prescription oral. (n.d). https://nationaleczema.org/eczema/treatment/immunosuppressants/
  4. Tameez Ud Din, A., et al. (2020). Dupilumab for atopic dermatitis: The silver bullet we have been searching for? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202577/
  5. Wet wrap therapy. (n.d.). https://nationaleczema.org/eczema/treatment/wet-wrap-therapy/