Immunosuppressants for Eczema

When our eczema brings us to our wit's end, we begin to explore more powerful solutions. We don't have many in our community, but one has been immunosuppressants.

Disclaimer: Though immunosuppressants are drugs available to eczema sufferers, they should not be taken lightly. Suppressing our immune system can bring up other serious issues. These drugs are also not indicated for use in eczema relief by the FDA. It is important to work with a healthcare provider to weigh the pros and cons of taking an immunosuppressant.

What are immunosuppressants?

Immunosuppressants are used to suppress the immune system. Pretty simple. It's a massive blanket, no target intended. These drugs are mostly used for transplant patients, which allows the foreign organ to settle into its new environment without being attacked or rejected. Rheumatoid arthritis patients, as well, can use these in their treatment.

Why do we use them for eczema?

Because they help suppress our immune system, it relieves some of the more severe eczema symptoms. The dryness and redness, especially the oozing caused in topical steroid withdrawal (TSW), lessens. It is a way to feel a bit of normalcy in the face of constant suffering.

As we know, eczema is more than just skin - it is a mental battle. Moreover, if you're a parent suffering with TSW or severe eczema, it feels impossible to stay afloat. Trying to take care of yourself, as well as little children or a partner, can leave anyone in a desperate or helpless state.

What are the most common ones?

The top four immunosuppressants used on eczema patients include cyclosporine, methotrexate, azathioprine, and CellCept. However, cyclosporine (Cyclo) and methotrexate (MTX) are the most frequently prescribed.

Again, these are not indicated for use in eczema treatment and can come with serious side effects.

What are the side effects?

With Cyclo, its biggest concern is the kidney. Most people on this drug need regular blood checks to see how the kidney handles the drug. Whether it is short-term use or long-term use, surveillance is crucial. It can even up the risk factor for cancers to brew since your immune system is no longer working at full capacity.

With MTX, the liver is the big hitter. Drinking alcohol on this drug, especially in higher doses, is not recommended. The liver is one of our main detox centers. We wouldn't want to damage that.

With all of these most frequently prescribed immunosuppressants, infections are also increased. Again, your immune system is being quieted, meaning it won't be able to fight off certain bacteria or viruses effectively.

It is a deep concern, too, when it comes to COVID-19. Those who are immunocompromised must be extra cautious at this time.

Kelly's experience

A friend of mine, who is part of my documentary on TSW, was kind enough to share her experience with cyclosporine.

Kelly, 42, lives across the pond in Kent, England. She was hit, monstrously, with TSW and needed respite.

Why did she start using Cyclo?

"Dr. Marvin Rapaport uses Cyclo, so I felt confident using it. I had young kids, and I was hoping the Cyclo would provide relief so I could continue to be a functional Mum," she explained.

Did she find relief?

After getting her prescription, she experienced a bit of that relief. Nonetheless, it wasn't the complete answer.

"It really only took the edge off. I was still very TSW symptomatic on cyclosporine; mentally, I felt both positive that it was stopping the ferociousness of the symptoms, but at the same time, disappointed it didn't calm it more."

Why did she keep using it?

She persisted with the drug despite its lack of a full aid effect. In her eyes, some relief was better than none. The mental toll needed all the help it could get. It is echoed by so many others who are on this drug, just trying to stay afloat.

Why did she stop using it?

Furthermore, Kelly stayed on this drug for about six years, even with the risk factors mentioned above. The main reason she came off was due to other health concerns.

"I was showing pre-menopause symptoms, so I wanted to be drug-free for that. My body from the breasts down was healed, too," she revealed. However, this was not the only truth unveiled.

Would she use it again?

"I wouldn't go back on it," she stated. "I was ok while on them with no side effects, but it didn't clear me as I wished it could have. If I could've not gone on it, I wouldn't have. I was so desperate at the time, though."

The choice

That desperation is real. Many just need a break, a reason to keep going. It is never an easy choice to start such a serious drug. Immunosuppressives will always be taken very seriously.

Whether you're a parent striving to take care of loved ones, a student studying in college, or someone who is struggling financially, there is no judgment in asking for help. Everyone has a different journey, with some more demanding than others. Do what is best for you. Do what you need to survive, physically and mentally.