Atopic dermatitis can be persistent. You may need to try various treatments over months or years to control it. And even if you respond to treatment, your signs and symptoms may return (flare).
It's important to recognize the condition early so you can start treatment. If regular moisturizing and other self-care steps don't help, your doctor may suggest the following treatments and drugs:
- Creams that control itching and inflammation. Your doctor may prescribe a corticosteroid cream or ointment. Talk with your doctor before using any topical corticosteroid. Overuse of this drug may cause skin irritation or discoloration, thinning of the skin, infections, and stretch marks.
- Creams that help repair the skin. Drugs called calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) — affect your immune system. Applied to the skin, they help maintain normal skin, control itching and reduce flares of atopic dermatitis. Due to possible side effects, these prescription-only drugs are used only when other treatments have failed or if someone can't tolerate other treatments. They are approved for children older than 2 and for adults.
- Drugs to fight infection. You may need antibiotics if you have a bacterial skin infection or an open sore or cracked skin caused by scratching. Your doctor may recommend taking oral antibiotics for a short time to treat an infection. Or he or she may suggest you take it for a longer time to reduce bacteria on your skin and to prevent another infection.
- Oral anti-itch drugs. If itching is severe, oral antihistamines may help. Diphenhydramine (Benadryl, others) can make you sleepy and may be especially helpful at bedtime.
- Oral or injected drugs that control inflammation. For more-severe cases, your doctor may prescribe oral corticosteroids — such as prednisone — or an injected corticosteroid. These drugs are effective but can't be used long term because of potential serious side effects. Continue moisturizing and using other self-care remedies to prevent a flare-up after you stop taking the corticosteroids.
- Wet dressings. An effective, intensive treatment for severe atopic dermatitis involves wrapping the affected area with topical corticosteroids and wet bandages. It has proven to control signs and symptoms within hours to days. Sometimes it is done in a hospital because it's labor intensive and requires nursing expertise. Or, ask your doctor about learning how to do this technique at home.
Light therapy. The simplest form of light therapy (phototherapy) involves exposing your skin to controlled amounts of natural sunlight. Other forms use artificial ultraviolet A (UVA) and narrow band UVB either alone or with medications.
Though effective, long-term light therapy has harmful effects, including premature skin aging and an increased risk of skin cancer. For these reasons, phototherapy is not used for infants and young children. Talk with your doctor about the pros and cons of light therapy in your situation.
- Treatment for stress. Counseling may help children and young adults who are extremely embarrassed or frustrated by their skin condition.
- Relaxation, behavior modification or biofeedback. These approaches may help you with habitual scratching.
Treatment for infantile eczema includes:
- Identifying and avoiding skin irritations
- Avoiding extreme temperatures
- Lubricating your baby's skin with bath oils, lotions, creams or ointments
See your baby's doctor if these measures don't improve the rash or if the rash looks infected. Your baby may need a prescription medication to control the rash or to treat an infection. Your doctor may recommend an oral antihistamine to help lessen the itch and to cause drowsiness, which may be helpful for nighttime itching and discomfort.
July 26, 2014
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