Common Eczema Treatments:

1. Moisturizers (Emollients)

   • Purpose: Keeping the skin moisturized is key in managing eczema, as dry skin often triggers flare-ups.
   • Recommendations:
     • Use fragrance-free, thick creams or ointments, as they help lock in moisture more effectively than lotions.
     • Apply moisturizers right after bathing to seal in moisture while the skin is still damp.
     • Look for products containing ingredients like petrolatum, glycerin, or ceramides.

2. Topical Steroids

   • Purpose: Steroid creams and ointments reduce inflammation and swelling during flare-ups.
   • Types:
     • Mild steroids: Hydrocortisone cream for mild flare-ups.
     • Moderate to potent steroids: Betamethasone or mometasone for more severe flare-ups.
   • Usage: Apply a thin layer only to the affected areas. Long-term use of potent steroids can cause thinning of the skin, so they should only be used as directed by a doctor.

3. Topical Calcineurin Inhibitors (TCIs)

   • Purpose: Non-steroidal medications like tacrolimus (Protopic) and pimecrolimus (Elidel) can be used to reduce inflammation, particularly in sensitive areas like the face or eyelids.
   • Advantages: Can be a good option for long-term management, as they don’t cause skin thinning like steroids.
   • Usage: Apply to affected areas twice a day. May cause a burning or stinging sensation upon application.

4. Oral Medications

   • Antihistamines: Oral antihistamines like diphenhydramine (Benadryl) or loratadine (Claritin) can help reduce itching, especially if eczema is related to allergic reactions or seasonal triggers.
   • Oral steroids: Prednisone may be prescribed for short-term use during severe flare-ups to reduce inflammation systemically.
   • Immunosuppressive Drugs: In severe cases, medications like methotrexate or azathioprine may be prescribed to suppress the immune response.

5. Biologic Medications

   • Dupilumab (Dupixent): A newer injectable biologic drug that targets specific pathways in the immune system to reduce inflammation. It’s typically prescribed for moderate-to-severe eczema that doesn’t respond well to topical treatments.
   • Usage: Given as an injection under the skin, usually once every two weeks after an initial loading dose.

6. Phototherapy (Light Therapy)

   • Purpose: Exposing the skin to ultraviolet (UV) light under medical supervision can help reduce symptoms of eczema.
   • Types:
     • UVB light therapy: The most commonly used form of phototherapy for eczema.
     • PUVA therapy: A combination of UVA light and a drug (psoralen) that makes the skin more sensitive to light, though this is less commonly used.
   • Considerations: Phototherapy usually requires multiple sessions and is best for those with moderate to severe eczema.

7. Wet Wrap Therapy

   • Purpose: This technique involves applying a thick layer of moisturizer or topical medication to the skin, followed by damp bandages or clothing, which helps soothe the skin, lock in moisture, and enhance the effectiveness of topical treatments.
   • How to Use: Apply moisturizer to the affected areas, then wrap the skin with damp cotton bandages or clothes. Cover with dry layers to keep the wrap in place overnight.

8. Lifestyle Changes & Home Care

   • Avoid Triggers: Identify and avoid triggers that worsen eczema flare-ups, such as certain foods, allergens, chemicals, extreme temperatures, or stress.
   • Gentle Skin Care:
     • Use mild, fragrance-free soaps and laundry detergents.
     • Take short, lukewarm baths (hot water can dry out the skin) and add colloidal oatmeal or baking soda to soothe irritated skin.
     • Pat skin dry gently with a towel and immediately apply moisturizer to lock in moisture.
   • Manage Stress: Stress can trigger or worsen eczema, so stress management techniques such as meditation, yoga, and deep breathing exercises can be helpful.
   • Avoid Scratching: While itching is a key symptom of eczema, scratching can further damage the skin and cause infection. Consider wearing cotton gloves at night or using cold compresses to reduce itching.

9. Infection Prevention

   • Bacterial or fungal infections are common in eczema-prone skin due to the breakdown of the skin barrier.
   • Treatment: If signs of infection (e.g., pus, increased redness) are present, a doctor may prescribe topical or oral antibiotics or antifungal medications.

Preventing Eczema Flare-Ups:

1. Hydration: Keep your skin moisturized daily to prevent dryness and irritation, which are common eczema triggers.
2. Sunscreen: Some eczema treatments (like steroids) can make the skin more sensitive to the sun. Use a broad-spectrum sunscreen with SPF 30 or higher to protect the skin.
3. Manage Triggers: Maintain an awareness of personal triggers (such as certain fabrics, foods, or environmental factors) and try to avoid them when possible.

   When to See a Doctor:

   • Severe flare-ups that don’t respond to over-the-counter treatments.
   • Signs of infection (increased redness, pus, pain, etc.).
   • Changes in symptoms or if eczema is significantly affecting daily life.
   • Need for stronger medications (e.g., oral steroids, biologics).