What Medications Are Used to Treat Atopic Dermatitis?
Atopic dermatitis is the most common type of eczema. Eczema is a common chronic skin condition that causes dry, itchy rashes that come and go. The rash may be red in people with lighter skin and purple-brown in darker skin. It affects all ages. One in 10 people in the United States has eczema.1
Eczema symptoms tend to come and go. Flares may be triggered by dry skin, weather, or stress. Skincare routines can help relieve the itch, which improves daily comfort and sleep. Avoiding triggers also helps.1
Types of atopic dermatitis medications
However, many people also need prescription and over-the-counter (OTC) medicines to control their eczema. The medicines used to treat atopic dermatitis include:1,2
- Skin creams, gels, and ointments
- JAK inhibitors
Some of these medicines may only be prescribed if someone’s symptoms are moderate to severe. Not all of these drugs can be used in children. Side effects vary widely depending on the specific medicine you are using.
Skin creams, gels, and ointments
Topical treatments are medicines smoothed or sprayed onto the skin. There are 3 main types of topical treatments:2,3
- Calcineurin inhibitors
- Phosphodiesterase-4 inhibitors (PDE4)
Steroids, which is short for corticosteroids, are usually the first treatment your doctor will try. Steroids come in OTC and prescription skin creams, ointments, gels, and sprays. Weaker, OTC steroid creams may control symptoms well for people with mild to moderate eczema. Stronger prescription steroids may be needed for those with moderate to severe symptoms.2
Topical calcineurin inhibitors
Topical calcineurin inhibitors (TCIs) block chemical messengers (cytokines) that trigger rashes, itching, and inflammation. These drugs are not steroids. Unlike steroids, TCIs can be used on delicate or thinner skin, such as the face, eyelids, and genitals.3
Topical PDE4 inhibitors
Topical phosphodiesterase-4 inhibitors (PDE4) also reduce levels of cytokines involved in causing atopic dermatitis symptoms.3
As the name suggests, immunosuppressants are a group of drugs that suppress the immune system. Steroids are one type of immunosuppressant. There are many others used to treat moderate to severe eczema, including:2
- Mycophenolate mofetil
These drugs reduce the immune system’s response that causes the symptoms of atopic dermatitis. These treatments are systemic, which means they treat the whole body, not just a certain area the way topical treatments do.
Biologics are precision drugs made from living cells. These cells may come from parts of the blood, proteins, viruses, or tissue. Biologics for eczema work by blocking or “turning down” the immune system’s overreaction. This overreaction is what causes the redness, itching, and inflammation of atopic dermatitis.4
Janus kinase (JAK) inhibitors are a newer group of drugs used to treat eczema. Cytokines are created by the immune system. When cytokine levels are too high, it can cause symptoms like redness, itching, and inflammation. JAK inhibitors lower cytokine levels and reduce symptoms. Depending on the brand, these drugs may be used topically (rubbed onto the skin) or taken by mouth (pills).1
Antihistamines block the release of histamines, a chemical your immune system sends out during an allergic reaction. Histamine increases blood flow and nerve activity. Studies show that antihistamines have little effect in treating itching. However, the types of antihistamines that cause drowsiness may help a person sleep better when symptoms flare.2
People with eczema are at a higher risk of infections because scratching sometimes breaks the skin. Any break in the skin barrier means germs can get into the body. Antibiotics in skin cream or pill form may be prescribed to treat bacterial infections.1
Before beginning any treatment for eczema, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.