How is eczema treated?
Pro Research Analysisby ![open sidebar](/icons/logo-full.svg)
Searched over 200M research papers
Consensus Meter
Eczema Treatment: A Comprehensive Overview
Eczema, also known as atopic dermatitis (AD), is a chronic inflammatory skin condition characterized by pruritus, sleep disturbances, and a significant impact on the quality of life. Effective management of eczema involves a multifaceted approach, incorporating both conventional and alternative treatments.
Topical Treatments for Eczema
Topical Corticosteroids and Calcineurin Inhibitors
Topical corticosteroids remain the cornerstone of eczema treatment, particularly for managing exacerbations. They are often used in combination with topical calcineurin inhibitors (TCIs) like tacrolimus and pimecrolimus, which are preferred for sensitive areas such as the face and neck . Proactive therapy, involving the twice-weekly application of these agents to previously affected areas, has been shown to reduce the frequency of flares.
Emollients and Moisturizers
Basic therapy for eczema includes the regular use of emollients and moisturizers to restore the epidermal barrier function. This is essential for maintaining skin hydration and preventing flare-ups .
Systemic Treatments for Severe Eczema
Immunosuppressive Agents
For moderate to severe cases of eczema, systemic immunosuppressive treatments such as cyclosporine, methotrexate, azathioprine, and mycophenolic acid are established options. These agents help in controlling inflammation and are particularly useful in refractory cases .
Biological Treatments
Biological agents targeting specific pathways in the immune system, such as dupilumab, have shown significant efficacy in reducing eczema symptoms. Dupilumab, in particular, has been highlighted as the most effective biological treatment for eczema, offering substantial improvements in both short-term and long-term outcomes.
Janus Kinase (JAK) Inhibitors
Oral JAK inhibitors, such as abrocitinib, have emerged as promising treatments for moderate to severe eczema. Clinical trials have demonstrated their efficacy in reducing pruritus and improving skin condition when used in combination with topical therapies.
Alternative and Complementary Therapies
Psychotherapeutic Interventions
Psychosocial factors play a crucial role in the management of eczema. Interventions such as cognitive behavioral therapy, mindfulness, and stress-reduction techniques have been shown to improve both eczema symptoms and associated psychological distress.
Chinese Herbal Medicine
Some patients seek alternative treatments like Chinese herbal medicine. While a few randomized controlled trials (RCTs) have shown potential benefits, more extensive research is needed to confirm their efficacy.
Adjunctive Treatments
Antimicrobial and Antiseptic Measures
Bacterial colonization, particularly with Staphylococcus aureus, can exacerbate eczema. Antimicrobial treatments, including systemic antibiotics for infected lesions and topical antiseptics like bleach baths, are recommended for managing high bacterial colonization.
Phototherapy
Ultraviolet (UV) phototherapy, including narrow-band UVB and PUVA, is another effective treatment for chronic hand eczema and other forms of eczema. It helps in reducing inflammation and controlling symptoms.
Conclusion
Eczema treatment requires a comprehensive approach that includes topical therapies, systemic treatments, and alternative interventions. The choice of treatment depends on the severity and chronicity of the disease, as well as individual patient factors. Ongoing research and clinical trials continue to expand the therapeutic options available, offering hope for better management of this challenging condition.
Sources and full results
Most relevant research papers on this topic