Eczema (dermatitis) is a term used to describe a group of skin disorders that is characterized by irritation and inflammation. Irritations on the skin lead to a number of persistent, bothersome symptoms such as swelling, redness, itchiness, dryness and sometimes blister formation and ulceration. There are a number of over-the-counter and prescription medications available to help treat the underlying cause and symptoms of eczema.
Antipruritics
Antipruritics are medications that help to reduce symptoms of itchiness. Antihistamines may be effective in relieving itch for some people. Older antihistamines that have a sedative effect (cause drowsiness) may be taken at bedtime to provide effective relief of itching. Newer non-sedative antihistamines might not be as effective at treating itching related to common types of eczema such as atopic dermatitis, but may relieve itching related to hives.
The American Osteopathic College of Dermatology advises individuals not to apply topical creams containing antihistamines such as diphenhydramine directly to the skin because it is not likely to be effective and may cause an allergic reaction. Instead, lotions containing menthol or pramoxine (a topical anesthetic) may provide effective anti-itch relief.
Antibiotics
Antibiotics may be prescribed when your eczema is showing symptoms of oozing or weeping as these may be signs of infection. In such cases, oral antibiotics like cephalexin or dicloxacillin might be administered.
Topical Corticosteroids
Topical corticosteroids are available as creams or ointments. While creams are generally white in color and not very greasy when applied, ointments tend to feel greasy and may be useful for thick, dry skin that has been resistant to other treatment formulas. One of the most common corticosteroid medications used to treat eczema is 1 percent hydrocortisone cream. In more serious cases, a medium potency steroid called triamcinolone may be prescribed. Chronic corticosteroid use can cause thinning and discoloration of the skin, so these medications should not be used for more than 2 weeks at a time.
Topical Immunomodulators
Topical Immunomodulators (also known as topical calcineurin inhibitors, or TCIs) are a newer class of drugs similar to topical corticosteroids in that they also act to calm the immune system and improve symptoms. Unlike other corticosteroids, however, these drugs do not cause skin thinning with long-term use. The two topical immunomodulators currently available for adults and children ages 2 and older are tacrolimus ointment and pimecrolimus cream.
Other Medications
Some medications primarily intended for individuals with other medical conditions have also shown promise in helping relieve the symptoms of eczema. Asthma medications such as montelukast and zafirlukast, and cyclosporine (a drug that suppresses the immune system) have all been effective in treating eczema skin conditions. Because cyclosporine can cause kidney damage with long-term use, it is generally prescribed for only brief periods. Roughly one-third of patients with severe eczema treated with hydroxychloroquine (an anti-malarial drug) will improve.
Coal tar is sometimes used in 1 to 5 percent liquor carbonis detergens (LCD) creams or in other gel formulations. Because these contain alcohol, they have the potential to cause burning and irritation.
Steroid-free barrier repair moisturizers containing ceramide are also available over-the-counter and by prescription. Some patients report relief from eczema symptoms when using these moisturizers.
