TREATMENT OPTIONS
Treatment for atopic dermatitis, a chronic form of eczema, is an important part of managing this disease. See below for a wide array of available options.
Discover the different treatment options available to you
There are a range of treatment options available for atopic dermatitis, be it oral treatments, creams and injections for the more moderate-to-severe cases. Likewise, some of the treatments can be found on the shelf at your local pharmacy, while others require a prescription from your healthcare professional.
Remember everybody responds to treatments differently – work with your doctor to find the right treatment, or combination of treatments, for your specific needs.
Select an option from the treatment list below to learn more.
- Upper respiratory tract infection
- Skin reaction
- Flu-like symptoms
- Urinary tract infection
- Headache
What are they?
Biological therapy, or biotherapy, or immunotherapy, is commonly used to treat different kinds of immunological diseases, and other conditions. More specifically, biological therapy treatment is designed to stimulate, or restore the body’s immune system’s ability (its natural internal defence) to fight off infections and disease in the body1.
How do they work?
Certain types of proteins in your immune system, called “IL-4” and “IL-13”, play a major role in the symptoms of atopic dermatitis. Biologic therapies for atopic dermatitis block the action of those proteins, which helps reduce itch and improve the condition of your skin1.
How often do you take them?
Frequency of biologics administration by a patient varies. In general, administrations are required every two to four weeks. A patient’s age and or weight should also be taken into consideration for the frequency of administration.1
Patients wishing to undergo biologics treatment are recommended to seek a doctor or a professional healthcare expert’s advice on this matter, especially when it comes to the frequency and dosage required.
How are they administered?
Most biologics are liquid medicines administered to a patient by injection under the skin. This can be done either by the patient or by the treating physician.2
What are the possible side effects?
Biologics may cause side effects3, and each biologic treatment has its own possible side effects. It is important to discuss possible risks and side effects with you doctor or professional health expert before starting any new medication.
The possible side effects are:
How does biologics treatment affect atopic dermatitis
The human body contains a type of protein called the interleukin (IL), which helps our immune system fight off harmful viruses and bacteria. But for people with atopic dermatitis, the immune systems overreact and trigger certain ILs to respond by producing inflammation. This leads to itchy red patches on the skin and other symptoms common to eczema4.
Biologics block ILs from binding to their cell receptors, which stops the immune system from overreacting4. With a calmer immune system, comes lower or severe inflammation; meaning fewer symptoms of atopic dermatitis.
How do they work?
Suppress enzymes contributing to inflammation, they reduce symptoms such as itching and skin lesions, leading to reduction of AD signs and symptoms.5-10
How often do you use them?
Based on doctors advise5-7
How are they administered?
Orally5-7
What are the possible side effects?
Upper respiratory infections, nasopharyngitis, nausea, headache, and acne.7 Monitoring is recommended for potential risks during treatment, particularly the elderly, current or past smokers, or patients with other cardiovascular, thromboembolic or malignancy risk factors.7,10,11 Patients should seek emergency medical attention if they experience signs and symptoms of heart attack, stroke, or blood clot.12
What are they?
Topical corticosteroids (TCS) represent a broad range of medicines that help relieve the swelling, itching and redness of atopic dermatitis. Some variations of TCS can be used in both children and adults, while others are specifically for adult use only.
The need for a prescription depends on the type of TCS – some are available over-the-counter (OTC), while others require a prescription from your healthcare professional.
How do they work?
Corticosteroids typically work by reducing inflammation of the skin (redness and swelling) and itching.
How often do you use them?
TCS are usually applied one to four times per day. The duration of treatment can vary anywhere from 5 days to up to 3 weeks, depending on the type of TCS and area of skin being treated.
How are they administered?
TCS are available in a number of different formulations, including foam, cream, ointment, lotion and gel. In all cases, they should be applied directly to the affected area(s) of your skin.
What are the possible side effects?
TCS may cause side effects such as reactions at the application site, skin thinning or softening, burning, tingling, stinging, itching, irritation, dryness, cracked skin, pain, itchy rash (urticaria), inflammation of hair follicles (folliculitis), unwanted hair (hypertrichosis), acne-like reactions, skin colour changes (hypopigmentation) and allergic contact dermatitis.
These are not all the possible side effects you may feel. Read your Product Insert for a complete list.
What are they?
Topical calcineurin inhibitors (TCI) are used to treat atopic dermatitis in both children (2 years and older) and adults after other therapies have been shown to be ineffective or unsuitable.
TCI require a prescription from your healthcare professional.
How do they work?
The exact mechanism of TCI is unknown, but they have been shown to help control inflammation, itch or redness associated with atopic dermatitis.
How often do you use them?
TCI are generally applied twice daily, for example, once in the morning and again in the evening.
They are used for short or intermittent long periods of treatment. Once your signs and symptoms resolve, you should stop taking TCI treatment and be instructed by your doctor about what to do if symptoms recur.
How are they administered?
TCI are available in both cream and ointment formats. As such, they should be applied directly to the affected area(s) of your skin.
What are the possible side effects?
TCI may cause side effects such as stinging, a burning feeling, a sensation of warmth at the application site or itching of the skin that is being treated.
These are not all the possible side effects you may feel. Read your Product Insert for a complete list.
What are they?
Oral corticosteroids are used to treat numerous conditions, including atopic dermatitis, in children over 6 years of age and adults.
Oral steroids require a prescription from your healthcare professional.
How do they work?
Corticosteroids decrease your body’s reaction to some diseases and reduces symptoms of inflammation (e.g., redness and swelling).
How often do you take them?
Your healthcare professional will determine the appropriate dose and dosing frequency based on your condition. When your atopic dermatitis has improved, your doctor will gradually reduce your dose. Be sure to follow your healthcare professional’s guidance when tapering to reduce the risk of side effects.
How are they administered?
Oral steroids are tablets that should be taken orally (by mouth).
What are the possible side effects?
Oral steroids may cause side effects such as increased appetite, weight gain, bloating, change in taste, abnormal fat deposits, nausea, vomiting, diarrhea, abdominal pain, indigestion, hiccups, thinning hair, unusual hair growth, feeling of general discomfort or uneasiness, dizziness, forgetfulness, confusion, tired, irritated, euphoria (intense feelings of well-being, elation, happiness, excitement and joy), change in strength and reflexes, rounder face, increased sweating, headache, increased or decreased motility and number of sperm, and skin problems. These medicines may also hide symptoms of infections, may cause latent infections to become active, and may induce infections by normally inoffensive organisms due to lowered body resistance.
These are not all the possible side effects you may feel. Read your Product Insert for a complete list.
What are they?
Topical PDE4 inhibitor are non-steroid medicines that are applied to the skin to treat mild to moderate atopic dermatitis.
This type of treatment requires a prescription from your healthcare professional.
How do they work?
The exact way these products work is unknown, but it is thought that PDE4s work by reducing the amount of substances in your body that trigger the rash and itchiness caused by eczema.
How often do you use them?
Topical PDE4 inhibitors are usually applied to the affected areas twice daily, however your healthcare professional will determine what is appropriate based on your medical condition and response to the drug. Never use any more or less of the drug than what your healthcare professional says.
How are they administered?
This type of medicine is typically available as an ointment and should be applied directly on the affected area(s) of your skin.
What are the possible side effects?
Topical PDE4 inhibitors may cause side effects such as pain on the area where you applied the medicine, such as burning or stinging.
These are not all the possible side effects you may feel. Read your Product Insert for a complete list.
What are they?
Topical combination products are creams used to treat atopic dermatitis, in which skin is red, swollen, itchy and infected by germs (bacteria). They can be used in both children (over 2 years) and adults.
This type of therapy usually requires a prescription from your healthcare professional.
How do they work?
Topical combination products combine two types of medicines: a corticosteroid with either an antibiotic or an antibacterial/antifungal ingredient. These medicines work together in different ways to both kill the bacteria and reduce the swelling, redness, pain and itchiness in the skin.
It’s important to remember that these therapies only work on bacterial or fungal infections. They do not treat viral infections.
How often do you use them?
Topical combination products are generally applied up to three times daily for approximately one to two weeks, depending on the treatment prescribed.
How are they administered?
This type of medicine is typically available as a cream and should be applied directly on the affected area(s) of your skin.
What are the possible side effects?
Topical combination products may cause side effects such as redness, itching, burning or irritation in the area where the medication is used, various types of skin rashes (dermatitis) in the area where the medication is used, thinning skin, stretch marks or surface veins, skin redness, lightening of your skin colour, changes in the growth of your body hair, excessive sweating or other signs not present before using these medications.
These are not all the possible side effects you may feel. Read your Product Insert for a complete list.
There are also non-drug products that may be used to help prevent dryness. Look for these products on the shelf at your local pharmacy.
Non-drug products
What are they?
Hydrating creams are products that contain moisturizing ingredients, such as ceramides or colloidal oatmeal, to help improve the skin’s moisture barrier and increase skin hydration.
Hydrating creams are cosmetics that are available over-the-counter.
How do they work?
Depending on the ingredients that they contain, hydrating creams work in a variety of ways to relieve dryness. Some creams work by improving the skin’s moisture barrier and increasing skin hydration.
How often do you use them?
Hydrating creams should be used after every bath or shower to help seal the moisture in your skin. They can also be applied several times throughout the day.
How are they administered?
Hydrating creams should be applied directly to the affected area(s) while your skin is still damp. This will trap moisture in the skin.
Are you experiencing any of the symptoms above? Make An Appointment With A Dermatologist Now!
Find the treatment that suits your needs with our list of consultation experts here.
Understand how Atopic Dermatitis impacts your life with our simple
10 seconds skin assessment.
Use the self-assessments to help you and your doctor identify specific concerns about your atopic dermatitis treatment and management.
REFERENCES:
- Schneider S, et al. The New Era of Biologics in Atopic Dermatitis: A Review. Dermatol Pract Concept. 2021 Oct; 11(4): e2021144.
- Biologics and Biosimilars. Health Hub. https://www.healthhub.sg/a-z/medications/625/Biologics-and-Biosimilars. Accessed on September 2023.
- https://www.aad.org/diseases/psoriasis/psoriasis-biologics (Accessed on 20/3/2020)
- https://nationaleczema.org/eczema/treatment/ (Accessed on 20/3/2020)
- Baricitinib Summary of Product Characteristics. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/olumiant. Accessed September 2021.
- Upadacitinib Summary of Product Characteristics. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/rinvoq. Accessed February 2022.
- Upadacitinib Prescribing Information. January 2022. Available from: https://www.rxabbvie.com/pdf/rinvoq_pi.pdf. Accessed February 2022.
- Samuel, C, et al. (2023). A Review on the Safety of Using JAK Inhibitors in Dermatology: Clinical and Laboratory Monitoring. 13(3): 729–749. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930707/pdf/13555_2023_Article_892.pdf
- European Medicines Agency. (2020). “New oral treatment for moderate to severe atopic dermatitis”, https://www.ema.europa.eu/en/news/new-oral-treatment-moderate-severe-atopic-dermatitis (Accessed July 29, 2022)
- Schwartz DM, et al. JAK inhibition as a therapeutic strategy for immune and inflammatory diseases. Nat Rev Drug Discov. 2017;16(12):843-862.
- Janus Kinase (JAK) inhibitors and risk of major adverse cardiovascular events, malignancy, thrombosis and death. Health Sciences Authority. https://www.hsa.gov.sg/announcements/safety-alert/janus-kinase-(jak)-inhibitors-and-risk-of-major-adverse-cardiovascular-events-malignancy-thrombosis-and-death. Accessed September 2023.
- FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions. U.S. Food & Drug Administration. Accessed September 2023.
Health information contained herein is provided for general educational purposes only. Your healthcare professional is the single best source of information regarding your health. Please consult your healthcare professional if you have any questions about your health or treatment.
MAT-SG-2300274-1.0-09/2024