How to treat atopic dermatitis
Atopic dermatitis is a skin condition that affects around 30 percent of people in the United States, most of whom are children and adolescents. A person with eczema will typically experience patches of dry, itchy skin that may crack, bleed, or become infected.
This article looks at treatments and home remedies for atopic dermatitis, as well as some tips for coping, possible treatments for babies, and when to see a doctor.
Treatments for atopic dermatitis
Moisturizers can help prevent and treat eczema flares.
There is currently no cure for eczema, but many people will find that it improves as they get older. Treatments aim to help a person manage the symptoms of their eczema.
According to a study paper published in the journal Trials, "The foundation of all treatment is the regular use of leave-on emollients to preserve and restore moisture to the skin."
Treatments for eczema typically fall into two categories:
- moisturizers to relieve dryness and itching
- anti-inflammatories to reduce swelling, itching, and redness
People usually apply moisturizers and anti-inflammatories directly to the skin as creams or ointments. It is possible to take some anti-inflammatories orally.
The following list describes some common treatments for atopic dermatitis:
A doctor may prescribe medicated creams or oral medication to hydrate the skin, reduce itching, and relieve inflammation. Medications include:
- corticosteroid creams to relieve itching and inflammation
- corticosteroid tablets, which are for short-term use only, to relieve itching and inflammation
- topical calcineurin inhibitors, which suppress inflammation to reduce symptoms
- antihistamines, which some scientists believe can reduce the severe itching that atopic dermatitis causes
People can buy milder steroids, such as hydrocortisone, over the counter at drug stores.
Research shows that wet-wrap therapy can help improve eczema symptoms by increasing the moisture of a person's skin.
After bathing and moisturizing, wrap wet strips of fabric or gauze around the eczema-affected areas. Doing this helps keep the skin hydrated and increases the action of medicated creams and moisturizers. Do not use wet wraps over prescribed corticosteroid creams unless a doctor has advised this.
Place a dry layer over the wet layer to prevent it from drying out. People can leave the wraps on for several hours or overnight.
People with severe eczema may benefit from ultraviolet (UV) light therapy. An estimated 70 percent of people with eczema see an improvement in their symptoms after undergoing phototherapy.
During phototherapy, a doctor or dermatologist will shine a UVB light on either the whole body or just the affected areas. This light helps reduce itchiness and inflammation, and it encourages the body to create vitamin D. It may also help the skin fight bacteria to prevent infection.
Home remedies for atopic dermatitis
Certain home remedies can help relieve the symptoms of atopic dermatitis, though people should talk to their doctor to find out the best course of treatment for their symptoms.
The following home remedies can help reduce the symptoms of atopic dermatitis:
Coconut oil is a popular home remedy for dry skin.
Some natural products can help lock in moisture and relieve itchiness. According to the National Eczema Association, common home remedies that evidence has shown to be effective in adults include:
- Coconut oil. Apply virgin or cold-pressed coconut oil directly to eczema to moisturize the area and reduce bacteria. Use it once or twice per day on damp skin.
- Sunflower oil. Sunflower oil may help improve the skin's protective barrier and reduce inflammation. Apply it twice a day.
- Cardiospermum. Cardiospermum is a plant extract that can reduce inflammation, itchiness, and bacteria on the skin.
Bathing every day is essential for eczema as it helps keep the skin hydrated and prevents infection. People can also try different kinds of bath for eczema, including:
- bath-oil baths
- oatmeal baths
- baking soda baths
- bleach baths
- vinegar baths
Always use moisturizer on affected areas of skin within 3 minutes of getting out of the bath to stop the skin from drying out.
Tips for coping
People can adopt various methods of skin care to help reduce the symptoms of their eczema. These might include:
- avoiding scratching the affected areas, which helps reduce inflammation
- taking antihistamines to reduce itchiness further
- avoiding wool, which can irritate the skin
- avoiding strong soaps and detergents and products that contain scents, dyes, or fragrances
- minimizing contact with water when washing objects, such as dishes, by hand
- avoiding scrubbing dry skin for too long
- washing with lukewarm water
Eczema can affect a person's mental health, which may lead to symptoms of depression, anxiety, and stress. Caregivers should be aware of these possible mental health issues, as well as any physical health issues, in relation to a child's eczema.
Likewise, an adult may find that speaking to medical professionals, friends, and family members helps them cope better with any mental health issues relating to their eczema.
Treatment for babies
Applying moisturizer regularly can help prevent a baby with eczema from scratching.
According to the National Institutes of Health (NIH), eczema usually develops when a baby is 3–6 months old.
There is little clear evidence about whether eczema in babies is preventable. Some research suggests that exclusive breastfeeding for 6 months may reduce eczema in infants who are at high risk, but the evidence is not conclusive.
Infants may make their eczema worse, as they can find it more difficult to avoid scratching.
Treatment for eczema in infants and babies is similar to that which adults use, with the focus being on the application of moisturizing creams or ointments and anti-inflammatories that reduce the urge to scratch.
Ensure that a baby's room is not too warm at night as sweat can make the symptoms of eczema worse.
Treating children with eczema can be difficult and time-consuming. According to a study published in the Journal of Advanced Nursing, speaking to children about the difficulties of treating eczema and developing strategies to make the process easier may help them ease into regular treatment routines.
Although there is no cure for eczema, most children who have this condition will outgrow it by adulthood. Eczema disappears within 10 years in 80 percent of children and within 20 years in 95 percent.
When to see a doctor
A person can often manage their eczema at home by using over-the-counter moisturizers and avoiding triggers. However, a person may need to see a doctor if complications occur.
Bacterial, viral, and fungal skin infections are common complications of eczema. This is because the skin of people with eczema lacks the proteins that fight infections.
Bacterial infections can make the symptoms of eczema worse.
People with eczema may be more prone to fungal infections, such as yeast infections. They are also more likely to get viral skin infections, such as eczema herpeticum, which can occur if they come into contact with the herpes simplex virus that causes cold sores.
People with eczema should look out for the following signs of skin infection:
- eczema suddenly becoming worse
- areas of the skin weeping
- a raised temperature
- flu-like symptoms
Once they have identified it, doctors can treat all forms of infection. They may prescribe antibacterial, antifungal, or antiviral medication. In rare instances of viral infection, a person may need to go to the hospital.
Most people will grow out of eczema, but it can return or develop in some adults. Those with eczema often find that it is an ongoing disease that gets better or worse over time.
Treatment options for atopic dermatitis include topical creams, oral medication, wet wraps, phototherapy, and special baths. These treatments can reduce itchiness and dry skin and lower the risk of skin infections.
There is no cure for atopic dermatitis, but treatments, home remedies, and coping tips can help relieve the symptoms. Some of these may even increase the amount of time that the disease stays in remission.