Neurodermatitis: Which treatments work best?

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There are many remedies available to treat atopic dermatitis (AD), both over the counter and prescription. You can try ointments and creams, or your doctor may suggest light therapy or medications that you take by mouth or get an injection.

“There are always new treatments for atopic dermatitis that help ease the burden and make treatment more effective,” said Geeta Patel, DO, founder of River Oaks Dermatology in Houston.

“Topical steroids are the mainstay of treatment right now, but they’re not always the most effective,” she says. What works well for one person doesn’t always work well for another. Finding the right treatment can take time.

Your doctor will make recommendations based on how severe your AD is and what areas of your body it affects.

Best Treatments for Mild AD

“Mild atopic dermatitis usually involves topical therapy,” says Patel. If you have mild AD, your doctor may recommend one of these topical treatments:

Topical steroids. These creams or ointments relieve itching and reduce inflammation. They put them on red or inflamed skin.

Topical steroids come in a variety of strengths. Prescription steroids tend to be more effective than over-the-counter products. The stronger it is, the more effective it can be in controlling inflamed skin. But it may have more side effects, such as B. Thinning skin. Never use high potency steroids on the face, armpits, or groin area. For long-term use, get the lowest strength you can.

Topical calcineurin inhibitors. These creams and ointments contain drugs that target your immune system to suppress inflammation and relieve itching symptoms in mild to moderate AD. They can be used safely in the long term. You apply them after moisturizing your skin, but some have rules about how soon you can use them afterwards, so check the prescribing information. Examples are pimecrolimus (Elidel) and tacrolimus (Protopic).

Topical PDE4 inhibitors. These topical medications curb inflammation by blocking PDE4, an enzyme that triggers it. They reduce itching, redness, thickened skin and oozing in mild to moderate AD. There is currently only one FDA-approved PDE4 inhibitor. It’s called crisaborole (Eucrisa). It is approved for people from 3 months of age and can be used long-term on all parts of the body.

If you have mild AD, your doctor may also tell you:

  • Avoid triggers
  • Moisturize after bathing
  • eat well
  • manage stress
  • To sleep well

Best Treatments for Moderate to Severe AD

If you have moderate or severe AD, your doctor may recommend the following:

wet wrap therapy. With this treatment, you wrap the affected skin with wet bandages after applying moisturizers or topical corticosteroids. “Moist bandages help relieve itching, heal your skin, and make your creams or ointments more effective,” says Patel.

Your doctor will tell you how to do it and how often.

Oral medication. If creams don’t work, your doctor may recommend oral medications. “These work by slowing down your immune system’s response, which can help reduce the severity of symptoms,” says Patel.

UV light or phototherapy. “Light therapy is often used to treat severe eczema that doesn’t respond to creams,” says Patel. The treatment exposes your skin to a controlled amount of natural sunlight, UVA, or UVB light to relieve symptoms.

It usually involves going to your dermatologist 2-3 times a week. Try to be patient. “It can sometimes take 1-2 months for the effects to kick in,” says Patel.

Dupilumab (Dupixent). This new laboratory-made drug can reduce inflammation, itching, the severity of the disease and its spread. You get it as a shot. Your doctor may recommend it when other treatments aren’t working or when you can’t use products you put on your skin.

“Studies have shown that after about 16 weeks, most people had clearer skin and less itching,” says Patel.

Complementary Treatments for AD

These treatments may help relieve your symptoms:

mind-body practices. “Stress can make atopic dermatitis worse,” says Patel. Management can help reduce flares. Try mindfulness meditation, yoga, tai chi, acupressure, hypnosis, or biofeedback, all of which teach you how to control things in your body, such as: B. Your heart rate to help you relax. These practices can also help if you scratch a lot.

message therapy. Massage is known to reduce stress, so it can reduce flare-ups. Choose a therapist who is accredited and has experience working with people with similar skin conditions. Make sure they don’t use any oils or lotions that could trigger or worsen your AD.

coconut oil. Studies suggest that applying coconut oil to your skin can reduce staph and prevent infection. “Apply to damp skin once or twice a day,” says Patel. Choose virgin or cold-pressed oil that contains no chemicals.

sunflower oil. “Sunflower oil strengthens the skin’s barrier function and helps it retain moisture. It also has anti-inflammatory properties,” says Patel. Apply twice a day, once after bathing to keep your skin moist.

You may have heard that vitamins, supplements, and probiotics help with AD. But there isn’t enough research to support their use, and they can be harmful if you’re taking certain medications.

Lifestyle tips for AD

Take these steps to make your treatments work better and relieve symptoms:

Take a lukewarm bath. Keep it at 10-15 minutes. Then pat your skin dry and apply a moisturizer while it’s still wet.

Moisten twice a day. Apply a moisturizer at least twice a day to strengthen your skin’s barrier.

Prevent scratches. If your skin is itchy, try squeezing it instead of scratching it. “Covering the itchy area also helps keep you from scratching it,” says Patel.

Use a humidifier. “Hot, dry indoor air can dry out sensitive skin and make itching and flaking worse. A portable home humidifier, or one attached to your furnace, adds moisture to the air in your home,” says Patel.

Avoid irritants. Choose mild soaps and detergents without dyes or fragrances. Avoid fragrances and cosmetics with chemicals, woolen and synthetic clothing, and smoking. Keep your home dust mite free. Avoid foods that could trigger a flare-up.

taking allergy medication. Over-the-counter antihistamines, such as cetirizine (Zyrtec) and fexofenadine (Allegra), can help with itching. If your itching is severe, you can try diphenhydramine (Benadryl). It can make you drowsy, so take it before bed.


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Neurodermatitis: Which treatments work best?
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