Know Your Options: Choices for Managing Atopic Dermatitis Symptoms

March 1, 2023

Woman scratching eczema on arm

Know Your Options: Choices for Managing Symptoms

Relief from your atopic dermatitis (AD) itch is a team effort. At home, you can practice good self-care habits such as regular moisturizing and avoiding triggers. With your doctor, you can find a medical treatment to help keep the itch from returning.

Breaking the Itch-Scratch Cycle

The itch-scratch cycle is a phenomenon that starts when you feel an itch sensation and you scratch it out of instinct. “When a person scratches the skin, they injure the skin cells, which in turn releases various chemicals that themselves cause itch,” says
Jorge Aldo Hinojosa, MD, a dermatologist at U.S. Dermatology Partners in Plano, TX. “In turn, the person will scratch even more and repeat the vicious cycle or worsen the itch.”

The solution? Stop scratching. But that’s easier said than done.

Hinojosa says using ice or over-the-counter anti-itch creams with a topical anesthetic or menthol can help in the moment, or antihistamines.

Prescription Relief

When home remedies or over-the-counter options don’t work well enough for your itch management, your doctor can help you choose one of the growing number of prescription treatments, which Hinojosa says are effective for most people. “Overall, eczema is treatable,” he says.

Topical creams. Most people can control their AD with a medicated ointment, gel, or lotion that goes on the skin. These treatments help boost your skin barrier to keep out germs or other irritants as well as keep more moisture in so you have fewer cracks and fissures.

Oral steroids. These are medications you take by mouth that go through your bloodstream to control inflammation. You take oral steroids only on a short-term basis as a way to treat severe flares. Using them for a long time can cause serious side effects. Steroids are also available as over-the-coun-ter topical creams. You can use these for less severe flares, but consult your doctor so that you don’t overuse them or apply them to areas you shouldn’t.

JAK inhibitors. Some of the newest options for AD treatment include Janus kinase (JAK) inhibitors. These prescription topical medications you spread on your skin help block chemical messengers in your blood and skin called cytokines. Cytokines increase itch and inflammation, so when JAK inhibitors keep them from delivering their message, your symptoms tone down.

Biologics. These targeted therapies use proteins from living tissues or cells and work by muting the body’s immune system. You get them as an injection into the skin. A calmer immune system means lower or less severe inflammation and fewer symptoms.

Light therapy. Also called phototherapy, doctors usually reserve this treatment until topical treat-ments haven’t worked. Your doctor may have you try sunlight on the parts of your skin with a rash, or you may need a form of ultraviolet light in a clinic along with medication that enhances its effects.

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