Types of Medication for Eczema

Eczema is an inflammatory skin condition that causes your skin to become dry, itchy, and bumpy. Several different types of eczema exist, which include:

• Atopic dermatitis
• Contact dermatitis
• Dyshidrotic eczema
• Nummular eczema
• Seborrheic dermatitis
• Stasis dermatitis

Eczema may range from mild to severe and can begin during childhood, adolescence, or adulthood. It can weaken the skin’s barrier function, which is responsible for retaining skin moisture and protecting your skin from external elements.

Eczema can be treated with topical and oral medications. Topical medications are directly applied to the skin to relieve itching, redness, and swelling. Topical medications may include the following:

1. Topical corticosteroids: They are anti-inflammatory medicines that are effective in treating symptoms of eczema and dermatitis. Hydrocortisone is commonly used for treating mild eczema.
2. Topical phosphodiesterase-4 (PDE4) inhibitors: It eases inflammation and helps skin look more normal. Crisaborole is the commonly used topical PDE4 inhibitor that can treat mild to moderate forms of eczema.
3. Topical barrier repair moisturizers help retain water in the skin, repair damage and ease dryness, redness, and itching.
4. Topical calcineurin inhibitors: These drugs ease inflammation. Pimecrolimus and tacrolimus are indicated for moderate to severe eczema.

Oral medications for eczema include:

• Systemic immunomodulators: These drugs weaken your immune system to prevent your body from overreacting. Some examples include:
  • Cyclosporine
  • Azathioprine
• Antibiotics: They prevent any skin infection caused due to broken skin. It prevents infection from spreading. Some examples include:
  • Cefadroxil
  • Dicloxacillin
• Antihistamines: These drugs help relieve itching and improve your sleep. Some examples include:
  • Hydroxyzine
  • Levocetirizine
  • Loratadine
  • Cetirizine
• Biologics: These are artificial medicines with proteins from living tissues or cells. They calm your immune system and ease inflammation and eczema symptoms. Dupilumab and tralokinumab-ldrm are the FDA-approved biologics used for the treatment of moderate to severe eczema for those aged 6 years and older.

For mild eczema, topical hydrocortisone is the first choice of drug. The best medication for an individual may vary depending on:

• Age
• Medical history
• Severity of symptoms

The doctor may work out with you to try a few options to see what works best for you.

Common side effects of topical steroids include:

• Thinning of the skin (atrophy)
• Stretch marks (striae)
• Spider veins (telangiectasia)
• Perioral dermatitis (around the mouth)
• Acne or rosacea-like rashes

Common side effects of topical PDE4 inhibitors include:

• Burning, stinging, swelling, or irritation of the skin
• Hives or welts, itching or skin rash
• Redness of the skin

Common side effects of topical calcineurin inhibitors include:

• Mild burning
• Stinging sensation

Common side effects of systemic immunomodulators include:

• High blood pressure
• Kidney problems

Common side effects of antibiotics include:

• Rash
• Diarrhea
• Nausea and vomiting
• Headache
• Tendon or nerve damage

Common side effects of antihistamines include:

• Nausea and vomiting
• Restlessness or moodiness (in some children)
• Dry mouth
• Drowsiness
• Dizziness
• Trouble peeing or not being able to pee
• Blurred vision
• Confusion

Common side effects of biologics include:

• Conjunctivitis (pink eye) 
• Injection site infections 
• Cold sores on the lips and in the mouth

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Some of the safest eczema medications during pregnancy include:

• Mild to moderate topical steroids
• Oral histamines like loratadine and cetirizine

If the above drugs do not work, the physicians may prescribe other drugs like:

• Stronger topical steroids
• Oral steroids
• Cyclosporine and other medications that suppress the immune system

Some women may experience flare-ups during pregnancy and for some, the symptoms may completely disappear. Hence, it is important to consult your physician before taking any eczema medicines.

Although there is no evidence that alcohol would worsen eczema and cause flare-ups, many people reported having an exacerbation of symptoms after taking alcohol. Eczema medications may interact with alcohol and cause adverse reactions. It is better to avoid alcohol when you have eczema. Ask your doctor if you can combine your medications and alcohol.