What Is Atopic Dermatitis? Symptoms, Causes, Diagnosis ... - Everyday Health

A dermatologist will prescribe medications for atopic dermatitis based upon the severity of disease.

"For mild atopic dermatitis, topical steroids and other topical, nonsteroidal, anti-inflammatory medications may be used," says McMichael. Over-the-counter oral antihistamines can help with itch.

Corticosteroids. Also known as topical steroids, corticosteroids can take the form of ointment, cream, lotion or spray, according to the National Eczema Association. These medications can reduce inflammation and allow the skin to heal.

"This is probably the most common topical treatment and can be used in adults and children," says Wan.

Topical steroids are classified by strength, ranging from "super potent" to "least potent."

Nonsteroid-Based Topical Treatments Dermatologists may prescribe nonsteroid-based topicals instead of corticosteroids for long-term use, or for cases involving sensitive areas like the face or genitals, says Wan. This group of medications includes:

• Topical PDE4 Inhibitors These medications block PDE-4, an enzyme that's involved in AD inflammation. Crisaborole (Eucrisa) ointment is approved to treat atopic dermatitis in children ages 3 months and older and adults.
• Topical Calcineurin Inhibitors (TCIs) TCIs reduce inflammation by preventing the immune system from activating certain cells. Medications include tacrolimus ointment (sold as a generic and under the brand name Protopic) and pimecrolimus cream (sold as a generic and under the brand name Elidel). Both can be used in people ages 2 and up.
• Topical JAK Inhibitor This type of medication works by blocking enzymes that contribute to inflammation in the skin and itch and affect skin barrier function. There's currently one medication in this class, ruxolitinib (Opzelura), approved for adults and children 12 and older whose disease is not adequately controlled with other topical prescription therapies or who shouldn't use those therapies. The U.S. Food and Drug Administration (FDA) requires that ruxolitinib carry a warning because of the small risk of potentially serious side effects.

Phototherapy Dermatologists often reserve medically regulated light therapy for more widespread or severe atopic dermatitis, says Wan. The most common type of phototherapy used to treat AD is narrowband ultraviolet B (NB-UVB) light, per the National Eczema Association, although your dermatologist may recommend other types.

Systemic Treatments These therapies are taken by mouth (oral) or as an injection that treat the inflammation of the atopic dermatitis systemically, from the inside out, says Wan. Physicians will usually reserve these treatments for people with more severe AD. This group includes:

• Biologics These injectable medications specifically target molecules in the body that are responsible for triggering inflammation. Dupilumab (Dupixent) is approved for atopic dermatitis in people ages 6 and older, and tralokinumab-Irdm (Adbry) is approved for adults ages 18 and older. Doctors can prescribe other biologics off-label (meaning they may work to control the inflammation, but they aren't specifically approved for AD).
• Oral Immunosuppressants These medications can help suppress the immune system to reduce inflammation and lessen AD symptoms. Abrocitinib (Cibinqo) and Upadacitinib (Rinvoq) are oral JAK1 inhibitors for people who aren't getting adequate symptom relief from biologics: Cibinqo is approved for adults, Rinvoq for people ages 12 and older. Both of these medications carry an FDA warning because of the small risk of potentially serious side effects.

Other immunosuppressive drugs are sometimes used to treat atopic dermatitis, per the National Eczema Association, but are not specifically approved for AD:

Home Therapies for Atopic Dermatitis

Bleach Baths A diluted bleach bath can help with AD flares, especially when the skin is infected, says Wan.

Wet Wrap Therapy This therapy involves applying moisturizer and medication to a flare-up, then wrapping the affected area with warm, damp fabric or gauze and then a second layer of dry cloth. Wet wrap therapy helps topic treatments work a bit more effectively, says Wan. The therapy can help rehydrate and calm the skin, too, according to the National Eczema Association.