Back in September, I shared the symptoms of Eczema and Atopic Dermatitis in this post. I got a lot of feedback from this community, many of you are interested in learning about treatments. So, I thought a follow-up post that outlines how to treat Eczema or Atopic Dermatitis in adults and children would be helpful. The timing couldn’t be more perfect than now because it’s winter, and people who suffer from Eczema or Atopic Dermatitis tend to deal with flare ups and worsened symptoms during the colder months of the year. I’m not a medical expert, so I need to share accurate medical information. My source for all of the information I’m providing is an informative conversation with Dr. Peter A. Lio, a Clinical Assistant Professor of Dermatology and Pediatrics at Northwestern University Feinberg School of Medicine and Founding Director, Chicago Integrative Eczema Center.
How to treat Eczema in adults and children.
There is a Therapeutic Ladder for treatment, and in this post, I will take you through each step of the ladder, which are all based on the Atopic Dermatitis’s severity. You start at the bottom with the simplest remedies for more mild cases, and if they don’t work, you move up the ladder to the next level.
Step one: Basic skincare
This is for anyone with atopic dermatitis.
When you start the therapy ladder, your first step is basic skincare. This will require you to use gentle oil-based skincare cleansers and moisturizers. These products must be preservative-free and moisturizing. One issue is that products that meet these requirements can sometimes be expensive, but they can be effective as a treatment for Atopic Dermatitis.
Identify and avoid irritants and allergens.
In addition to basic skincare, you should try to identify and avoid possible irritants and allergens. The most popular irritants and allergens are fragrances, fabrics like wool or coarse fabrics, a diet with certain foods like dairy products, or the weather (transitions or extremes).
Identifying the triggers can be challenging, so you should speak with your medical provider if you’re unable to find a solution on your own. They can do an allergy test to identify specific triggers.
Step Two: Corticosteroids
If step one doesn’t work, it’s time to move up the ladder to step two. The options in step two are best for mild or moderate atopic dermatitis. They can also be used in combination with systemic therapies for more severe disease or flares.
Corticosteroids or Topical steroids should be used on a short-term basis for treatment, primarily where basic skin care cannot provide relief for the patient. They’re also not recommended for treating sensitive areas like the diaper area and face.
If you’re uncomfortable with corticosteroid use, there are some corticosteroid-sparing therapies available that you can ask your medical provider about.
Step Three: Phototherapy and/or Systemic therapies
Step three is for patients with moderate-to-severe atopic dermatitis.
When the topical options of steps one and two aren’t effective, phototherapy may be a consideration. Phototherapy is done with the use of UV lights by a trained professional. However, it can be both time-consuming and expensive and not a fit for all patients.
Another step-three treatment option is systemic therapies. Systemic therapies can be nonspecific immunosuppressants, like systemic corticosteroids. While these can be effective, please consider that they can be responsible for rebound flares and multiple adverse effects if used over a long-term period.
Other immunosuppressant therapies that the FDA has not approved for this use may also be prescribed if nothing else works until this point, but they may require laboratory work.
New systemic agents are now available and approved by the FDA that target the causes of atopic dermatitis, including the factors that cause itch and inflammation. Dupilumab is approved for use in patients age six years and older to treat moderate-to-severe atopic dermatitis that cannot be controlled by topical therapies. Also, keep in mind that topical medications can be used to augment systemic therapies.
Eczema Action Plan
Treating a chronic condition, like atopic dermatitis, should be taken seriously, so a formal written plan or “Eczema Action Plan” should be given to you by your skin care provider and is a guide to your recommended management that you can refer to. Following this plan and the treatment instructions carefully are essential because it helps your medical provider determine what type of treatment would effectively treat your atopic dermatitis. Also, be sure to communicate with your skincare provider if treatments so they can work on changing your plan.
Eczema Treatment for children.
I know that many of you have children who suffer from Eczema. When it comes to finding the right treatment for them, it may be best to go to a pediatric dermatologist if that’s an option for your family. Your child’s pediatrician may not be comfortable treating up the ladder the way a pediatric dermatologist will.
I hope this information helps you manage Atopic Dermatitis for yourself or your child. The key is finding a healthcare provider who can be your partner through your treatment journey. A good clinician will ask you for your preferences to ensure you’re comfortable, communicate with you, and learn about your prior experiences so you can work together to create your eczema action plan.
Thank you so much for your feedback in the first Med-IQ survey with your Atopic Dermatitis experience. It would be greatly appreciated by Med-IQ if you can also complete this survey . As a thank you, you can win one of 10 $100 VISA gift cards.
Med-IQ is conducting an anonymous survey and would appreciate your input. The survey will take less than 10 minutes to complete. Survey responses are shared only in aggregate. Your responses to these survey questions will provide Med-IQ with important information about your experiences with atopic dermatitis, which will help us develop future educational initiatives. Once you’ve completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 10 $100 VISA gift cards. If you choose to enter, your email address will be used only to randomly draw the winners and notify them of their prize.