Key takeaways
- Home remedies for severe eczema include using emollient moisturizers regularly and avoiding irritants and itching.
- A doctor may recommend wet wraps and phototherapy to reduce inflammation in people with severe eczema.
- If conservative treatments do not work, doctors may prescribe immunosuppressant drugs like JAK inhibitors or biologics such as dupilumab. These suppress the immune response and alleviate symptoms.
Eczema is a common group of skin conditions that result in inflamed, itchy patches on the skin. In severe instances, these patches may cause constant discomfort and open weeping sores. The most common form of the condition is atopic dermatitis.
Doctors cannot cure eczema, but treatments
This article discusses the treatment options for severe eczema in adults and children.
Individuals with eczema may experience mild symptoms. However, the condition can be chronic and cause frequent symptoms, such as painful, cracking, or oozing skin. When these symptoms appear often, a doctor may consider a person’s eczema to be moderate or severe.
The Allergy and Asthma Network notes that, currently, there is no specific test to measure the severity of a person’s eczema. Instead, a doctor will determine if a person has severe eczema depending on the severity and extent of symptoms.
Severe eczema can
- do not respond to standard treatments
- covers a large area of their body
- flare up for extended periods
- cause unbearable itching or pain
Eczema appears pink or red on those with light or fair skin tones, with silvery-white scales. On medium skin tones, it can appear salmon-colored with silvery-white scales. On darker skin tones, eczema could look violet with gray scaling. It can also appear dark brown and difficult to see.
A person with severe eczema can speak with their doctor to develop a personalized treatment plan. This may include some or all of the following.
The United Kingdom’s National Health Service (NHS) notes that treatment commonly involves using over-the-counter creams or emollients on the affected areas. Doctors may also recommend trying coping strategies, such as avoiding:
- itching
- regular contact with water
- cosmetic products containing irritants
People with severe eczema may find that their condition does not respond to initial treatments. In these instances, talking with a doctor is essential. Without proper treatment, the condition can cause the skin to crack, increasing the risk of infection.
A doctor might prescribe further treatment if a person’s eczema does not respond to initial treatments.
Wet wraps
Wet wrap therapy involves applying damp strips of fabric onto the skin where eczema is flaring up. This aims to increase the skin’s moisture content and prevent the skin from becoming dry and cracked.
To use this therapy, a person applies medication or moisturizers to the skin and then wraps clean, water-soaked gauze or fabric around the area. This helps maximize the time the lotions stay in contact with the skin.
It can help to apply a dry layer on top of this treatment to stop the wraps from drying out.
The National Eczema Association notes that the best time to use wet wraps is just after bathing and moisturizing. People can leave the wraps on for a few hours or overnight.
Phototherapy
Phototherapy can help reduce the body’s inflammation response and ease the symptoms of eczema and other similar skin conditions. This treatment involves exposing the skin to UV light in a controlled environment.
The National Eczema Association notes that during phototherapy, a person enters a machine that emits UVB light for a few seconds or minutes. Healthcare professionals can target phototherapy to specific areas.
People usually need to continue phototherapy treatments for several months. They can reduce the frequency of their treatments once their symptoms start to improve.
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Phototherapy can help:
- relieve itchiness
- reduce inflammation
- increase vitamin D in the skin
Immunosuppressing drugs
The body’s immune response plays
The National Eczema Association lists that immunosuppressive drugs for eczema include:
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Similarly, a 2024 guide notes that these medications are effective for treating atopic dermatitis in short- and intermediate-length studies. However, more research into long-term use is still necessary.
Other medications
Eczema is a common condition among children and babies.
A challenge for parents and caregivers is that infants are unable to manage the urge to scratch their eczema. Scratching is one of the main factors that worsen eczema and can lead to infections.
Wet wraps may be particularly helpful for children and babies, as they can prevent the individual from scratching the affected areas.
The treatments for infants are similar to adults and focus on moisturizers and anti-inflammatories. The National Eczema Association also recommends avoiding key triggers, such as:
- not addressing dry skin
- irritants
- heat and sweating
- allergens
The exact cause of eczema is unclear, but
Additionally, those with an overactive immune system may experience more severe inflammatory responses to irritants.
Furthermore, the Allergy and Asthma Network notes that severe eczema may result from an even more severe inflammatory response called type 2 inflammation. This type of inflammation is caused by proteins that lead to high amounts of histamine and immune cells called eosinophils in the body.
Risk factors
While the exact causes of eczema are unclear, certain risk factors may make people more likely to develop the condition.
A family history of atopic dermatitis is one of the strongest risk factors for the condition.
The National Eczema Association notes that other risk factors include:
- having overly dry skin
- having an overactive immune system
- living in areas of extreme humidity or cold
Environmental irritants
- allergens such as pollen and dust
- irritants such as harsh soaps and perfumes
- hormonal changes
- tight clothing
The National Eczema Association notes that anxiety and stress can also be triggers of eczema. This means a “vicious cycle” can develop, with eczema making a person’s anxiety and stress worse and anxiety and stress affecting eczema.
Evidence also exists that links eczema to other mental health issues.
Although there is no cure for the condition, people can manage its physical and mental health effects, and many different treatments are available.
Eczema is a chronic condition, and there is no cure currently. It is more common in children, and symptoms often lessen in adulthood.
However, adults can also develop eczema, which is often more severe than childhood forms of the condition. Adult eczema typically involves periods of flare-ups when it is worse and periods of remission when it improves.
While doctors cannot cure the condition, treatments focus on a person managing symptoms to reduce the severity of flares. Doctors can also recommend that someone with eczema make changes to their everyday life to help avoid key triggers.
Doctors may classify eczema as severe when it covers a large area of a person’s body, is resistant to treatment, or when flares last a long time.
People with severe eczema can try intensive treatment methods, including wet wraps, phototherapy, and therapies that reduce immune system function. They can also take steps to look after their mental health.
Eczema is more common in children and tends to improve as a person ages. There is no cure for the condition, but people can manage their symptoms and treat or prevent flare-ups from affecting their quality of life.
