Prescription Treatment Options for Mild to Severe Atopic Dermatitis

Reviewed by: HU Medical Review Board | Last reviewed: April 2024

Atopic dermatitis is also known as eczema. It is a common skin condition that causes red, itchy, and inflamed skin. Non-prescription treatments and at-home remedies can provide relief for some people with eczema. But others may need prescription medicines to manage their symptoms.1

What are the treatments for mild to moderate eczema?

For people with mild to moderate eczema, topical treatments are typically the first line of defense. These medicinal creams are applied directly to the skin. They can help reduce:1,2

  • Inflammation
  • Itching
  • Dryness

Here are some commonly prescribed medicines for mild to moderate eczema:

Topical steroids

Topical steroids are available in varying strengths. They work by reducing inflammation and itching. They are typically used for short periods to help manage acute eczema symptoms.1

Using topical steroids can cause side effects. These include thinning of the skin at stronger concentrations and acne. Your doctor may recommend you avoid applying stronger topical steroids where the skin is thinner and more delicate. These areas include the:1,2

  • Face
  • Eyelids
  • Groin

Lower concentration or weaker topical steroids may be recommended by your doctor to be applied to the face and eyelids if you have eczema in those areas.

Topical calcineurin inhibitors

Topical calcineurin inhibitors do not contain steroids. So they are suitable for sensitive areas like the face and groin. These drugs help suppress the immune response that triggers eczema flare-ups.1

One example of this type of drug is Elidel® (pimecrolimus).1,2

Topical PDE4 inhibitors

PDE4 inhibitors are another type of topical medicine. They help reduce eczema-linked inflammation. PDE4 inhibitors can be an alternative for people who do not respond well to other treatments. Burning or stinging is a common side effect.1,3

One example of a PDE4 inhibitor is Eucrisa® (crisaborole).1

Topical JAK inhibitors

Topical janus kinase (JAK) inhibitors are a newer class of medicine. They target specific immune pathways involved in inflammation. JAK inhibitors help reduce itching and redness. JAK inhibitors can increase the risk of serious infection.1,4

One example of a JAK inhibitor is Opzelura™ (ruxolitinib).1

What are the treatments for moderate to severe eczema?

People with moderate to severe eczema often need stronger medicine to manage their symptoms. So a doctor may prescribe oral medicines to target inflammation from within the body. These are also called systemic drugs. That is because they affect the entire body rather than targeting 1 specific area.1

For more severe eczema that is not responsive to oral therapy, injected medications called biologics may be necessary.1

Here are some prescription options for moderate to severe eczema:

Topical medicines

Some of the topical drug types mentioned above have stronger versions for moderate to severe eczema. Examples include:1,2

  • Topical steroids
  • Topical calcineurin inhibitors such as Protopic® (tacrolimus)
  • Topical PDE4 inhibitors such as Eucrisa® (crisaborole)

Oral JAK inhibitors

Oral JAK inhibitors help regulate the overactive immune response. This response contributes to inflammation and skin irritation. The drugs do this by blocking certain pathways in the body that drive itch and inflammation. They are typically taken in pill form.1

Examples include:1

  • Rinvoq® (upadacitinib)
  • Cibinqo™ (abrocitinib)

Systemic immunomodulators

Systemic immunomodulators work by suppressing the immune system. This helps prevent inflammation. They may be prescribed for people with moderate eczema who do not respond well to other treatments.1,2

Examples include:1,2

  • Methotrexate
  • Cyclosporine
  • Azathioprine
  • Mycophenolate mofetil

Biologic therapies

Biologic therapy targets specific components of the immune system. Biologic drugs are given by an injection or infusion. They can provide long-term relief for people who have severe cases of eczema. Biologics are usually given when other treatment methods have not worked.1,2

Examples include:1,2

  • Dupixent® (dupilumab)
  • Adbry® (tralokinumab)

Which treatments are right for you?

If you have eczema, work closely with your doctor to determine the most suitable treatment plan. Prescription medicines can help manage symptoms. But they may also have side effects. Your doctor will likely want to monitor you to ensure a drug is safe and working.

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