Eczema Treatment Options

Eczema occurs when the skin’s protective barrier becomes compromised, allowing irritants, allergens, and bacteria to cause inflammation. While eczema is often linked to a genetic predisposition, it can be triggered or worsened by external factors such as harsh weather, stress, environmental allergens, fragrances, or certain fabrics. The condition is characterized by red, dry, itchy patches that may crack, ooze, or become infected.

Managing eczema requires a comprehensive and individualized approach. There is no one-size-fits-all treatment, and what works for one person may not work for another. Dr. Al-Dujaili begins with a careful evaluation of each patient’s symptoms, history, and lifestyle to determine the most effective treatment strategy.

Topical treatments are often the first line of defense in managing eczema. These medications are applied directly to the skin and are used to reduce inflammation, relieve itching, and restore the skin barrier.

• Topical corticosteroids are anti-inflammatory medications that help reduce redness and swelling. They are typically used during flare-ups and come in various strengths, depending on the location and severity of the eczema.
• Calcineurin inhibitors, such as tacrolimus or pimecrolimus, offer a steroid-free alternative that can be safely used on sensitive areas like the face and eyelids for longer periods.
• Topical PDE4 inhibitors, such as crisaborole, are a newer class of medication that help control mild-to-moderate eczema without the potential side effects of steroids.
• Barrier repair creams and emollients are essential in daily skincare. These products help restore the skin’s natural protective barrier, retain moisture, and reduce sensitivity to irritants. Regular use of thick, fragrance-free moisturizers is one of the most important steps in managing eczema.
• JAK Inhibitors are newer topical treatments including Opzelura and Rinvoque may be prescribed for moderate-to-severe eczema to reduce inflammation and treat an overactive immune system.

For patients with moderate-to-severe eczema that does not respond to topical treatments, systemic therapy may be appropriate. These treatments target inflammation throughout the body and are carefully monitored to ensure safety and effectiveness.

• Oral antihistamines may help reduce nighttime itching and improve sleep, although they are generally less effective at reducing skin inflammation directly.
• Systemic immunosuppressants, such as cyclosporine or methotrexate, may be used in severe cases to calm the immune response. These medications require close supervision and are typically used for limited periods.
• Biologic therapies, such as dupilumab (Dupixent), are revolutionizing the treatment of eczema. This injectable medication targets specific pathways in the immune system that cause inflammation. Dupilumab is approved for use in both adults and children and has been shown to significantly reduce itch, skin redness, and flare frequency with continued use. Ebglyss is a recently approved biologic therapy for moderate‑to‑severe eczema, offers a promising new option alongside existing treatments such as Dupixent and Adbry.

For some patients, narrowband UVB phototherapy can be an effective option. This treatment involves exposing the skin to controlled doses of ultraviolet light, which can reduce inflammation and relieve itching. Phototherapy is typically administered in-office several times a week and may be recommended for patients who do not respond well to topical or systemic treatments.

At New Orleans Aesthetics, treatment for eczema also includes guidance on avoiding triggers and supporting the skin with gentle daily care. Dr. Al-Dujaili helps patients identify and eliminate potential irritants in their environment, such as:

• Harsh soaps and detergents
• Fragranced skincare products
• Wool or synthetic fabrics
• Food allergens or sensitivities
• Emotional stress, which can worsen flares

Lifestyle counseling may include stress management techniques, dietary recommendations, and instructions for using humidifiers during dry weather. These supportive strategies are essential for long-term control of eczema and reducing the frequency and severity of flare-ups.

Eczema commonly affects infants and children, often starting within the first six months of life. Treating pediatric eczema requires special consideration, as children’s skin is more delicate and sensitive. Dr. Al-Dujaili has extensive experience treating young patients and works closely with families to ensure a safe and effective plan of care that encourages healthy skin development and reduces discomfort.