What Medications Are Used to Treat Atopic Dermatitis?

Atopic dermatitis (AD) is a common skin condition that is characterized by periods of worsening symptoms (“flares”) and periods of relief when symptoms are lessened or completely gone (remission). The chronic nature of AD can be frustrating, as it may return even with proper skin care. While incorporating a good skin care routine is critical for healing and preventing recurrences of AD, there are medications that are available for those whose AD isn’t managed with skin care alone.1

Topical and systemic medications

Topical medications are those that are applied directly to the affected areas of the skin, and topical treatment is an essential part of managing AD. Phototherapy is a type of ultraviolet light treatment applied to the skin. Systemic medications are treatments that affect the whole body and are generally administered orally or via injection. Systemic treatments are recommended for people with severe AD that has not responded to topical medications. However, even in cases of severe AD that require systemic treatment or phototherapy, topical medications are often used in combination with these other treatment approaches.2

Types of medication used to treat atopic dermatitis

Topical corticosteroids

There are several different medications used to treat AD. Topical corticosteroids are the foundation of anti-inflammatory therapy and are a primary treatment for AD that has not responded to proper bathing, regular use of moisturizer, and avoiding irritants. Topical corticosteroids are available in a range of potency, with milder formulations available for purchase over-the-counter and more potent medications being available only by prescription.

Other topicals

Other topical medications used to treat AD are topical calcineurin inhibitors and topical phosphodiesterase-4 inhibitors. Topical calcineurin inhibitors block cytokines (chemical messengers) that trigger the inflammatory response. Once absorbed into the skin, topical calcineurin inhibitors reduce symptoms of AD like redness and itchiness. Topical phosphodiesterase-4 inhibitors increase the levels of a chemical messenger called cyclic adenosine monophosphate (cAMP). This chemical suppresses the immune response.2-4

Systemic medications

Systemic medications used to treat severe AD or those with severe flares of AD include systemic corticosteroids, immunomodulators, or other cytokine therapies which suppress or interfere with the immune system response and may indirectly improve the function of the skin barrier and reduce the symptoms of AD, including itching, redness, and rash.5

Antibiotics

Antibiotics are another treatment that may be used in people with AD, as people with AD are at a higher risk of developing infections due to the damage in the skin barrier and the frequent scratching. Antibiotics may be topical or systemic, and are generally only used in those with signs of a bacterial infection.2,6

Antihistamines

Antihistamines are used to treat allergic reactions, such as hives, hay fever, and allergic skin reactions. They may be used in conjunction with the above treatments to treat the itch associated with AD, however, clinical studies have found that antihistamines have limited effectiveness in relieving symptoms of AD.2,6

Side effects

While each medication has its uses, each also has potential side effects, some of which resolve when the medication is discontinued. Some medications, like systemic corticosteroids, are best when used for short-term therapy to avoid the risk of long-term side effects. Each individual should discuss the risks and benefits of their medications with their doctor.

Emily Downward | June 2017
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