8 Medications for Atopic Dermatitis

Different drugs may be useful for different stages of eczema

pills and cream
bluehill75/iStockphoto

Since atopic dermatitis—dry, scaly, itchy patches of skin also known as eczema—is a rash that can come and go, different medications are often prescribed for various stages of the condition. Since the skin affected by the disease is considered to be "leaky," the goal of treatment is to make that skin become a better barrier. Let's take a look at the following medications that may be prescribed to help manage the condition.

Topical Steroids

Topical steroids are steroids that you rub onto the skin, such as creams, as opposed to those that you take in pill form by mouth. They are still the first-line treatment for atopic dermatitis flare-ups because they are effective at reducing the inflammation of the skin. Topical steroids come in seven different strengths and it is important to use the correct strength for the affected part of the body.

High-strength topical steroids are typically reserved for use on the arms and legs. Eczema that is on the face and skin folds, like armpits or groin, on the other hand, can usually be treated with a low-strength steroids. Sometimes, a doctor might recommend taking a potent steroid for a limited time for faster relief and then moving to a milder steroid.  

Calcineurin Inhibitors

The calcineurin inhibitors are Protopic (tacrolimus) and Elidel (pimecrolimus). They are known as immunomodulators because they change the parts of the immune system that cause atopic dermatitis without suppressing the whole immune system.

They should be used only during flare-ups.

Antihistamines

Oral antihistamines, such as Benadryl (diphenhydramine) or Atarax (hydroxyzine), can be used to treat the itch that's associated with eczema. It's important to note, however, that they can cause sleepiness and may not help in all cases of atopic dermatitis.

Antihistamine creams should not be used on eczema rashes because they contain chemicals that can actually worsen the rash.

Oral Antibiotics

Atopic dermatitis reduces the skin's natural defenses, making it easier for the skin to become infected. If a person's atopic dermatitis is not improving as expected, it may be because the skin has become infected. In this case, oral antibiotics—such as Duricef (cefadroxil) or Keflex (cephalexin)—are often prescribed at the first sign of infection.

Oral Steroids

Oral corticosteroids, such as prednisone, prednisolone, and medrol, may be used for more severe flare-ups of eczema. They are used if the rash covers a large part of the body and face.

Though they are effective, oral steroids that are used for a long time have numerous side effects, including weight gain, thinning of the bones, and suppression of the immune system.They are considered more of a last resort than a first-line defense. 

To reduce the risk of side effects, a doctor may prescribe a short course (five days) of an oral steroid to calm the rash. Topical steroids can then be used on the remaining rash.

Coal Tar

Coal tar, which is actually made by melting coal, has long been a treatment for a variety of skin conditions.

Shampoos and soaps containing coal tar can help with mild cases of atopic dermatitis.

Coal tar tends to work better on thickened skin that is not scaly. Sometimes it is used to ease very early symptoms of itching. However, coal tar can be very irritating to skin that's already inflamed. It is OK to try coal tar for mild cases of eczema, but you should stop immediately if you experience any increase in itching or redness of the rash.

Leukotriene Inhibitors

Leukotriene inhibitors, such as Singulair (montelukast) or Accolate (zafirlukast), are medications that may help reduce skin inflammation. These medications are often used to treat other allergy-related diseases, such as asthma and allergic rhinitis (seasonal allergies).

Though they may be recommended by some, there is currently no good data that shows that leukotriene inhibitors improve atopic dermatitis.

Other Immune-Suppressing Medications

Many medications are being investigated to see whether they can be used to treat eczema. Most of them are used to treat other related diseases, such as psoriasis or allergic rhinitis (seasonal allergies). These medications include:

  • Cyclosporine
  • Interferon
  • Methotrexate
  • Azothiaprine

Sources:

"Elidel Information." FDA.gov. 22 Sep 2007 

"Protopic Information." FDA.gov. 22 Sep 2007 

Continue Reading