In cases of severe eczema, treatment can stop working. This may happen because an individual is not following the treatment correctly or has an adverse reaction.

Changing treatment options and talking with experts may lead to more positive responses to treatment.

This article discusses why eczema treatments fail. It also provides some advice on what to do when eczema treatments stop working.

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According to a 2019 review of the scientific literature, most people can manage their eczema with relatively simple measures.

These measures include avoiding eczema triggers, adequate skin care, and using topical pharmaceuticals such as creams and ointments.

However, some individuals require more involved eczema treatments. These treatments include phototherapy and injections of the antibody dupilumab.

However, not everyone with severe eczema will benefit from these treatments.

There are many reasons why treatments for severe eczema can stop working. These include:

  • inadequate or incorrect use of medication
  • lack of access to medication
  • adverse reactions to topical medications
  • complications, such as skin infections
  • exposure to eczema triggers

Some people may find that eczema treatments stop working even if none of the above applies to them. Scientists do not understand why some cases of eczema are so resistant to current treatments.

If an individual’s eczema is not improving with treatment despite correctly using their medication and complying with a treatment plan, they may wish to consult a dermatologist about trying different therapies.

A dermatologist can work with a person to find the most effective treatment for their eczema. It may take a lot of trial and error before they discover the most appropriate therapy.

The sections below detail other therapy options and the next steps if eczema medications are ineffective.

There are many different medications for eczema, and switching to alternatives may be beneficial.

For instance, even if someone’s skin has an ineffective reaction to a particular topical product, they may better tolerate other topical treatments.

According to a 2022 paper, the following medications may help with treatment-resistant eczema:

Learn more about JAK inhibitors for atopic dermatitis.

According to a 2019 paper, phototherapy can treat eczema when other treatments have been ineffective.

Phototherapy, or light therapy, uses UV light beams to treat eczema. This technique has this effect because UV light can reduce skin inflammation and promote skin cell division.

Phototherapy takes place over 2 to 6 sessions per week across at least 1 month. These sessions may only last for less than a minute initially.

However, sessions may last several minutes once the skin has adapted to the UV light.

Eczema specialists have extensive knowledge of the best possible treatments and how to use those treatments properly.

Speaking with an eczema specialist may help individuals find a treatment plan that works for them.

According to the National Institutes of Health (NIH), several lifestyle changes can benefit individuals with eczema. These include the following skin care options:

  • taking a lukewarm bath once per day
  • using mild and unscented bar soap or nonsoap cleansers
  • patting the skin dry after bathing rather than rubbing it dry
  • regularly moisturizing clean and dry skin
  • protecting the skin from irritants and rougher clothing

Other useful tips include:

  • discussing potential food allergies with a doctor
  • managing stress
  • getting enough restorative sleep
  • keeping a mild and regular home temperature and humidity
  • avoiding smallpox
  • avoiding eczema triggers

There is anecdotal evidence that complementary therapies can help with eczema. However, robust evidence for such claims is lacking.

A 2018 review and meta-analysis examined randomized control trials of complimentary eczema therapies for children under 14 years. The authors found limited evidence for the efficacy of the following strategies:

  • using probiotics
  • swimming
  • using biofilms, which are biological substances that may protect the skin
  • dietary changes

The review authors noted common research issues with studies on such topics and high risk of bias. They conclude their review by calling for better research on this topic.

There are some reasons why eczema treatments stop working. These range from patients not adhering to the treatment to lack of access to medications.

Topical treatments can also cause adverse reactions, and exposure to eczema triggers may make treatments less effective.

If a person’s eczema treatment has stopped working, they should discuss this with a doctor. Switching medications, phototherapy, and lifestyle changes may help improve their condition.