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FROM PRO TO FAUX: ITCHING FOR ECZEMA RELIEF
If you are one the 30 million-plus people who live with eczema, you know the itch-scratch cycle all too well.
It starts with an itch that leads to a scratch. The scratch, in turn, makes the rash even worse, causing more inflammation and more scratching.
There is no cure for eczema – an itchy, red rash that can show up anywhere on the body — but treatments are available to soothe the itch, cool inflammation and prevent it from coming back. We swear!
If you are itching for eczema relief, here’s what you need to know about today’s treatments from the pro to the faux.
PRO
The Big Guns
Topical steroids are sometimes needed to calm the inflammation associated with eczema, says Diane S. Berson, MD, a New York City dermatologist. “These prescription creams work very well and very quickly to reduce inflammation, redness and itching, but we don’t want to use them for too long.†Risks of long-term steroid use may include thinning skin, she says. Some people may grow resistant to the effects, and will then require even higher doses to see relief. The higher the dose, the greater the chance of thinning skin, she says.
Another class of drugs used to treat eczema are calcineurin inhibitors including tacrolimus (Protopic) and pimecrolimus (Elidel). “These calm the immune system which is thought to be on high-alert when you have eczema,†she says. “I will put someone on steroids twice a day for a week to calm the inflammation and then switch to one of the calcineurin inhibitors at night for a week followed by calcineurin inhibitors twice a day until they are all clear,†she says. This class of drugs does have a black box warning from the US Food and Drug Administration citing a possible but extremely rare risk of certain cancers. That said, most dermatologists are comfortable and confident using these medications.
The good news is the eczema treatment pipeline is full. For years, there were few, if any, promising new treatments, but today there are several new drugs being studied for mild-to-moderate eczema and there’s even one for severe eczema. Stay tuned.
DIY
 Seal The Deal
“The main issue with eczema is that that the skin has a compromised barrier function,“ explains Dr. Berson “The first line of defense is a good emollient moisturizer to restore this barrier,†she says. “Moisturization helps to heal skin and prevent future flares.†When shopping for a moisturizer, look for any – but not necessarily– all of these words:
- Lipids
- Ceramides
- Glycerin
- Hyaluronic acid
- Niacinamide
These ingredients help restore moisture and lock it in. Besides daily moisturization, keeping skin cool and dry can also prevent a flare. “A cool mist humidifier can help keep your skin from becoming too dry,†she says.
For years, parents were told not to give children with eczema daily baths as it was believed to dry out skin and make eczema worse. Now new research debunks this and suggests that a good ‘soak and smear’ campaign can help keep eczema at bay. Daily bathing is fine for children with eczema as long as it’s followed by lots and lots of moisturizer, finds a study in the July 2016 issue of the Annals of Allergy, Asthma and Immunology. TIP: It can be hard for children to resist the urge to scratch the itch, which can result in an increased risk of infection, Dr. Berson says. A “bleach bath’ (add ½ a cup of bleach to the bath) can decrease this risk, she says. (Bleach is a disinfectant.)
FAUX
Steroid-free Solution
Steroids are the big guns for sure, but they come with their share of risks.
To the rescue: EpiCeram®, a new steroid-free prescription cream. It does more than add moisture back, EpiCeram repairs the skin’s natural barrier. It delivers a healthy dose of ceramides (which are some of the building blocks of the skin) as well as cholesterol and free fatty acids, which the skin also needs to help restore the all-important barrier function, It can be used alone among individuals with mild-to-moderate eczema or combined with steroids for more severe eczema. Kavita Mariwalla, MD, FAAD, Director, Mariwalla Dermatology in West Islip, New York is a big fan. “People really need to protect their skin to lower their risk of infections and improve healing. A product like EpiCeram® works to restore the skin’s natural barrier which is beneficial to the healing process,” she says.
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