Is it Time to Change Your Atopic Dermatitis Treatment?
When you have atopic dermatitis, a form of eczema, it can be easy to dismiss certain symptoms, such as dry, itchy skin, as your â€œnormal.â€ However, even if youâ€™re able to live with these symptoms, doing so can create a cascade of other health problems, including sleep issues, anxiety, and depression.
Thatâ€™s why, if you arenâ€™t satisfied with how your eczema symptoms are being controlled with your current medication regimen, itâ€™s important to reach out to your doctor, according to Melissa Piliang, MD, a dermatologist at the Cleveland Clinic in Cleveland, Ohio.
â€œBecause our bodies are unique, we all respond to different medications in different ways. On top of that, we have different personal preferences,â€ she says. It may take some trial and error, but there are several options for people to manage their atopic dermatitis, Dr. Piliang adds.
Signs Itâ€™s Time to Check on Your Atopic Dermatitis Treatment
Not sure if your current regimen is working as well as it should? Here are some of the most common signs that itâ€™s time for a check-in.
- Youâ€™re experiencing new or worsening symptoms of atopic dermatitis. â€œIf your eczema is under control â€” for example, your regular regimen of moisturizing your skin and using topical medications is working â€” you probably donâ€™t need to check in with your doctor, says Piliang. â€œBut if you suddenly develop areas where your medicines arenâ€™t working, you develop itching, or overall things get a lot worse, those are all the times when you should call your doctor,â€ she says. Even if your eczema has been largely under control, itâ€™s possible for it to change over time. Sometimes people come into contact with a new irritant or develop a new allergy that causes their disease to flare up again, which causes the medication to no longer work, according to Piliang. Outside stressors can affect your disease and cause flares, she says. â€œMaybe youâ€™re doing fine on your regimen and then say something happens â€” a recent example would be the COVID-19 pandemic â€” and your stress levels go through the roof. When that happens, your treatments may not work like they did before that,â€ she says.
- Youâ€™re tired of keeping up with your skin-care routine. It can take a lot of effort to keep your eczema symptoms at bay â€” so itâ€™s not surprising that you may, at times, be tempted to give up your skin-care regimen altogether. â€œSometimes people just get fed up with it,â€ Piliang says. Problem is, when people stop sticking to their routine, thatâ€™s when they tend to get a flare, she says. If youâ€™re getting tired of your skin-care treatment â€” for example, itâ€™s too time-consuming â€” talk to your doctor before you stop it. â€œWe can help,â€ she explains.
- You started a new treatment but canâ€™t cope with the worsening symptoms. Sometimes, a drug can take a few months before it starts working â€” and in the meantime, it might be hard to deal with the worsening symptoms, Piliang says. Itâ€™s always a good idea to ask your doctor how long it will take for the new medication to kick in, she says. This way, you can manage your symptoms as best as possible until then. If youâ€™re absolutely miserable and you have to wait longer than youâ€™d hoped â€” for example, the prescription is going to take two or three months before it starts helping you feel better â€” your doctor may be able to prescribe an additional, faster-working medication that will help ease your symptoms until the first one kicks in, Piliang says. â€œSometimes in a case like that weâ€™ll do a round of systemic steroids in the beginning to tamp down on the inflammation and give the medication time to work,â€ she adds.
- Your symptoms are interfering with your day-to-day plans. Eczema can really affect your quality of life,â€ says Piliang. â€œEspecially if you have moderate-to-severe eczema, it can impact school performance, work performance, and relationships with family and friends,â€ she adds. If you find yourself missing out on life activities, either in your work or personal life, because of your eczema symptoms, you should probably talk to your doctor about changing up your treatment.
- Your health insurance status changes. It happens all too often: You and your doctor have tried different medications and found the ones that work for you â€” and then your prescription drug coverage changes. When that happens, you may not know whether your insurance will continue covering your current medications. â€œIt can be really discouraging and frustrating,â€ Piliang says. However, if you talk to your doctor, they can send a letter to your insurance company explaining that youâ€™re being treated successfully with a certain type of medication â€” and hopefully, the coverage can continue, she says. â€œIt takes a lot of work on your doctorâ€™s part and on your part to get that to happen, but thatâ€™s something you can work on with your dermatologist,â€ she adds.
- The side effects of your medication are bothering you. The side of effects of eczema medications can include itching, stinging, and burning, among others. If side effects occur with the medication youâ€™re taking, they can be very bothersome, says Piliang. Plus, if youâ€™re using a topical medicine, you may not like how it feels on your skin. â€œSome of the ointments we use for eczema can be greasy; when you put it on, it gets all over your clothes and leave stains and so you donâ€™t want to use it,â€ says Piliang. If you donâ€™t want to use the medication, thatâ€™s a sign that you may want to try a different treatment.
- Your previously well-controlled symptoms are coming back, despite following your treatment. â€œIf your treatment stops working as well as it once did, thatâ€™s a time to come in,â€ Piliang notes. Sometimes people feel guilty when they have a flare, and that may keep them away from checking in with their provider, she adds.
What Are My Options When It Comes to Changing My Atopic Dermatitis Treatment?
Once youâ€™ve talked to your doctor about any concerns youâ€™re having with your atopic dermatitis/eczema treatment, there are a few options you can explore together. Your doctor may, for example:
- Tweak the dosage of your medication. Many people with eczema often start with topical treatments, and doctors can increase the strengths of those medications if needed, according to Piliang. â€œSometimes it may be just going to a stronger topical medication for flares,â€ she says.
- Recommend supplementing your current treatment plan with another drug. In some cases, if your symptoms are no longer well controlled, your doctor may step up therapy to a more aggressive treatment, says Piliang. â€œWe may add systemic medications,â€ such as biologics and JAK inhibitors, she adds.
- Recommend switching to a new treatment altogether. There are times when itâ€™s appropriate to switch treatments, according to Piliang. This can include situations in which your symptoms arenâ€™t well controlled or you may be experiencing unpleasant side effects with your current regimen.
- Ask you to do some trial and error to find the right treatment or combination of treatments. It can take some time to find the right eczema treatment for you â€” so you shouldnâ€™t feel bad about telling your doctor if a medication isnâ€™t working, says Piliang.
â€œIf there was one perfect treatment that worked for everybody in the same way, we wouldn't need all the different options that are available,â€ she says. â€œThere's no reason for you to suffer because your treatment isnâ€™t the right one for you.â€
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