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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

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.

Calcineurin inhibitors

Other topical medications used to treat AD are topical calcineurin 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.

PDE4 inbibitors

Topical phosphodiesterase-4 (PDE4) inhibitors are also used to treat AD. PDE4 inhibitors increase the levels of a chemical messenger called cyclic adenosine monophosphate (cAMP). This chemical suppresses the immune response.2-4

Immunosuppressants

In people with atopic dermatitis (AD), there is a dysfunction in the immune system, which results in an overactive, inflammatory state. Because of this dysfunction in the immune system, treatment with immunosuppressants may be appropriate for individuals with severe AD. Immunosuppressants suppress or interfere with the immune system response and may indirectly improve the function of the skin barrier.

Biologics

Biologic medications are medications that are targeted to treat diseases at the immune level. For atopic dermatitis, biologic agents target the cells in your body that cause inflammatory reactions by blocking specific proteins in your system called cytokines. The specific cytokines targeted are called known as Interleukin-4 (IL-4) and Interleukin-13 (IL-13).

Cytokine therapies

Cytokines are signaling molecules that assist in cell to cell communication in the body’s immune response Cytokine therapies 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

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

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

Systemic medications

Systemic medications are used to treat severe AD or those with severe flares of AD that has not responded to topical medication. Systemic medications are treatments that affect the whole body and are generally administered orally or via injection.

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 | May 2019
  1. Tollefson MM, Bruckner AL. Atopic dermatitis: skin-directed management. Am Acad Pediatrics. 2014 Dec;134(6):e1735-1744. doi: 10.1542/peds.2014-2812.
  2. Eichenfield LF, Tom WL, Chamilin SL, et al. Guidelines of care for the management of atopic dermatitis. Journal of the American Academy of Dermatology. 2014;71:116-32.
  3. Eucrisa prescribing information. Accessed online on 6/5/17 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/207695s000lbl.pdf.
  4. Medscape. Accessed online on 6/5/17 at .http://www.medscape.com/viewarticle/815272_4.
  5. Simon D, Bieber T. Systemic therapy for atopic dermatitis. Allergy. 2014;69:46-55.
  6. Sidbury R, et al. Guidelines of care for the management of atopic dermatitis. J Am Acad Dermatol. 2014;71:327-49.