Eczema Treatment: Topical Medication, Light Therapy, Natural Remedies, and More
People with atopic dermatitis (the most common type of eczema) and other forms of the condition often go through symptom-free periods (remissions) followed by flare-ups, when symptoms become severe.
Eczema mainly causes dry, itchy skin, which inevitably causes people to scratch or rub the affected area.
This can result in inflammation, rashes, blisters, and skin that â€œweepsâ€ (oozes clear liquid), among other symptoms. Bacterial, viral, and fungal infections can also develop because eczema breaks down the skin barrier.
There is no cure for eczema â€” natural or otherwise. The goal of treatment is to reduce symptoms, heal the skin and prevent further damage, and prevent flare- ups.
Medication, moisturizers, and at-home skin-care routines are all part of an effective treatment plan. (1)
Corticosteroids for Treating Eczema Symptoms
You may have heard of cures for treating eczema naturally online, but the truth is that topical corticosteroids are the standard, go-to treatment for eczema flare-ups.
Applied directly to the affected areas of skin, these ointments, creams, or lotions may:
- Reduce inflammation
- Tame allergic reactions
- Ease irritation or soreness
- Reduce itching and the desire to scratch
Topical corticosteroids come in varying degrees of strength â€” with 1 the most powerful and 7 the weakest â€” and are most effective when applied within three minutes of showering. For example, Vanos (0.1 percent fluocinonide) cream is a â€œsuper potentâ€ class 1 medication, while over-the-counter hydrocortisone creams are a â€œleast potentâ€ class 7, according to the National Eczema Foundation. (2)
Topical corticosteroids should not be used as moisturizers and should only be applied to areas of the skin that are affected by eczema.
Over time, these drugs can thin the skin, cause changes in color, or result in stretch marks.
Rarely, topical corticosteroids can be absorbed into the skin and enter the blood stream, causing systemic side effects (those that affect the whole body). These more severe side effects may include:
- Eye problems (glaucoma and cataracts)
- Avascular necrosis (death of bone tissue due to loss of blood supply)
- Worsening diabetes
- Cushing syndrome (a condition with wide-ranging symptoms that are caused by too much of the hormone cortisol in the body)
- High blood pressure
- Blemishes (acne, pink bumps, and pus-filled follicles)
- Adrenal suppression
- Topical steroid addiction (2,3)
If topical corticosteroids arenâ€™t working, doctors may prescribe a systemic corticosteroid, taken by mouth or injected.
Doctors only recommend systemic corticosteroids for short periods of time, because these drugs can cause a number of serious side effects, including osteoporosis, hair loss, and gastrointestinal issues. (4,5)
Other Topical Medication for Eczema
Topical calcineurin inhibitors (TCIs) are another category of prescription medication for eczema that includes Protopic (tacrolimus) and Elidel (pimecrolimus). (2)
TCIs don't contain steroids. Instead, they control inflammation and reduce eczema flare-ups by suppressing the immune system.
Though TCIs don't cause the same side effects as topical corticosteroids, patients should only use them for short periods of time. A boxed warning (also known as a black box warning) alerts patients to the possible cancer risk associated with these drugs.
PDE4 inhibitors, a new class of topical drugs for eczema, work by blocking an enzyme called phosphodiesterase 4 (PDE4) from producing too much inflammation in the body. There is currently only one PDE4 inhibitor on the market: Eucrisa (crisaborole), which was approved by the U.S. Food and Drug Administration (FDA) in 2016. (2)
Oral Antihistamines for Eczema
Doctor may also recommend that patients take certain antihistamines for eczema â€” such as Benadryl (diphenhydramine), hydroxyzine, or Unisom (doxylamine succinate) â€” to make it easier to sleep through the night.
Antihistamines may help prevent nighttime scratching, which can further damage the skin and cause infections. (4)
Various protectant repair creams may also help ease eczema symptoms by restoring essential skin components, like ceramides, fatty acids, and cholesterol. (1)
What Triggers Eczema?
Numerous factors â€” from cold weather to dust and laundry detergent â€” can set off a flare. Be aware of these common culprits.
Other Treatments and Light Therapy for Severe Eczema
In especially severe eczema cases, doctors may prescribe an oral immunosuppressant, such as Neoral, Sandimmune or Restasis (cyclosporine), Trexall or Rasuvo (methotrexate), or CellCept (mycophenolate).
These drugs carry potentially serious side effects, such as an increased risk of developing dangerous infections and cancers.
If patients develop a skin infection that's affected by eczema, doctors will prescribe antibiotic, antiviral, or antifungal drugs to treat it, depending on the particular cause. (5)
Light therapy (phototherapy) using ultraviolet waves is a common treatment for people with moderate to severe atopic dermatitis.
Skin improvements donâ€™t occur immediately but instead become evident after one to two months of treatments several times a week, according to the National Eczema Association. Light therapy is effective for up to 70 percent of people with eczema.
Burns, increased skin aging, and a higher risk of skin cancer are potential side effects, particularly if the patient receives light therapy for a67' target='_blank' rel='noopener noreferrer' > long period of time. (6)
The side effects of dupilumab are generally mild and include pink eye, injection site reactions, and cold sores. (7,8)
Wet-wrap therapy is another option for severe eczema. Sometimes given in a hospital, this treatment involves applying topical medicines (corticosteroids) and moisturizers to affected areas, then sealing them with a wrap of wet gauze. (9)
Bacterial Treatments for Eczema
A potential new approach to treating eczema involves using â€œgoodâ€ bacteria to kill pathogenic (disease-causing) bacteria like Staphylococcus aureus, which are commonly found in large quantities on the skin of people with eczema and are known to cause symptom flare-ups.
Though such treatments are not yet available to the public, preliminary research is encouraging.
In one clinical trial, researchers at the National Institute of Allergy and Infectious Diseases found that 10 out of 15 study participants had a dramatic improvement in symptoms (itching and rash) and needed fewer topical corticosteroids after treatment with a spray containing Roseomonas mucosa, a naturally occurring beneficial bacteria. (10)
In another study in mice, scientists found promise in a topical cream containing Staphylococcus hominis, a beneficial bacteria species on the skin that produces proteins able to kill harmful S. aureus. The research is now moving through the clinical trial phase. (11,12)
Bacteria Therapy Shows Promise as Cheap, Effective Eczema Treatment
Tackling â€œbadâ€ germs with â€œgoodâ€ ones may be the answer to fending off eczema flares in children and adults. Hereâ€™s how it works.
Home Remedies for Eczema
In addition to seeking help from a doctor, people with eczema may be able to take a few steps on their own to reduce itching and the need for medication.
These measures include:
- Keeping fingernails short, and avoiding scratching the skin
- Moisturizing skin frequently with ointments (petroleum jelly), creams, and lotions that are free of alcohol, fragrances, and dyes
- Using a humidifier, particularly if the air is dry
- Avoiding skin irritants, such as wool or man-made fibers (wear soft cotton clothing instead), strong soaps and detergents, and situations or environments that cause sweating
- Avoiding airborne allergens, such as pollen, pet dander, and dust mites
When bathing, it's important to minimize time in the tub or shower and to use cool or lukewarm water. Use gentle body washes and cleansers, and avoid scrubbing or toweling off for too long.
Also be sure to apply a moisturizer immediately after drying off. (9)
Natural Remedies and Lifestyle Changes for Eczema Symptom Relief
While you canâ€™t cure eczema naturally, some people have used the following so- called natural or alternative therapies for eczema:
- Adding oatmeal, baking soda, or fragrant-free bath oils to bathwater (13)
- Getting a massage with essential oils, such as chamomile, chickweed, licorice, or thyme
- Managing stress through yoga, meditation, biofeedback, or mindfulness training (14)
Dietary Changes and Supplements for Eczema
For some people with atopic dermatitis, certain foods may cause allergic reactions that can lead to flare-ups.
Supplements for Atopic Dermatitis
Some patients report that certain dietary supplements offer some eczema relief, including:
- Fish oil
- Vitamin D
- Vitamin C
- Bromelain (an enzyme derived from pineapple)
But a review of the scientific literature found no convincing evidence that such supplements are effective. (16)
Talk with a doctor or dermatologist for more information about how diet might affect eczema.
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