Eczema is a deeply misunderstood condition. As a result, the often-prescribed medicine for eczema won't solve the underlying problems that keep triggering a flare. Instead, these eczema medications are often more of a band-aid that keeps you frustratingly stuck in a never-ending cycle of managing your skin.
We spend so much time trying to treat eczema from an “outside in” approach without much success (at least until the next flare) that you end up suffering needlessly. The reality is that eczema is difficult to treat because the conventional model hasn't truly kept up with other options that do offer relief.
So on and on you go searching for answers with yet another medication…
Yet another bottled product you bought online or at the drugstore…
Hoping that just maybe it will work.
Until it doesn't.
And you can add it to your growing pile of products and medicine for eczema that's failed to address what's really triggering your eczema.
Let's be honest for a moment… I think you deserve that.
Eczema is complicated to treat because often the solution for each person is different.
And while you’d think eczema medications and treatments should work best if they are applied to the skin, that notion is outdated.
We now know that eczema absolutely has an autoimmune component to it, there is a microbiome that also exists on the skin, your hormone balance and stress levels play an important role, AND it is irrevocably linked to what's going on with your gut.
If you’ve ever struggled with a rash that won’t go away, I feel your pain and frustration. I’ve personally experienced how a gut health overhaul drastically improved my skin (among other things) that had been ravaged by dyshidrotic eczema.
After 3 years of failed eczema treatments suggested by my dermatologist, I decided to take a different approach… And I'm glad I did.
One of the many reasons why you suffer is because today's conventional approach uses different medicine for eczema to pick away at your symptoms.
As a result, the underlying causes of eczema are totally ignored. Ultimately this results in you feeling increasingly hopeless as your options appear to become limited.
Hidden Pitfalls of Common Medicine For Eczema
Most conventional dermatologists approach an eczema situation from the standpoint that there’s something inherently wrong with your skin. They also fail to recognize the incredible complexity of your body by ignoring the many other important facets that directly impact your skin health which I've outlined here.
Therefore they often make topical recommendations – or worse, they recommend powerful drugs that have a widespread, and non-discriminatory effects.
Often these drugs and additional elements added to the skin are used without fully knowing exactly WHAT is wrong. Essentially, it's like the doctor is throwing spaghetti at the wall hoping something will stick.
[HERE'S MY LIST OF TESTS THAT CAN HELP YOU FIGURE OUT WHAT'S CAUSING YOUR FLARES]
Here are some of the most common and least effective medication for eczema treatments:
Antibiotics for Eczema Treatment
When you have eczema, oral antibiotics are often prescribed, but you should consider long and hard whether this is the right course for you. Antibiotics wreck your gut microbiome for up to two years after just a seven-day course.
They are indiscriminate killers of both the good and bad bacteria.
The void that’s left is often filled with not-so-pleasant gut residents such as yeast (candida) and unfriendly bacteria responsible for gut infections. This is precisely what you don’t want when you’re struggling with eczema because the gut microbiome is tied directly to the health of your skin.
In fact, studies have found that infants who are exposed to antibiotics are much more likely to develop eczema.
Topical antibiotics can sometimes be prescribed if your doctor suspects that you have an infection. If there is a true infection, that’s one thing. However, using topical antibiotics unnecessarily will negatively alter your skin’s natural microbiome.
We are learning more and more about the microbiome of the skin as new research is done. But what we do know is that alterations in the skin microbiome play a role in development and triggering of eczema.
Steroids For Eczema Treatment
Some conventional doctors still prescribe oral steroid medicine for eczema though they are no longer recommended.
Meanwhile, corticosteroids are typically used typically via creams, ointments, lotions, and sprays.
Steroids are only a temporary solution.
One of the reasons why is that they can cause a rebound effect – which is when the eczema skin rash becomes worse than before. Red Skin Syndrome (RSS) is one of several names by which this effect is called along with “Topical Steroid Addiction (TSA) or Topical Steroid Withdrawal (TSW)”.
It can be caused by both over-the-counter and prescriptive eczema medication treatments.
Rebounding can occur when either reducing the medication or stopping it which then triggers redness (even where the steroid hasn't been applied), itchiness, stinging, and even burning sensation on the skin. A study from 2003 noted that about 19% of adolescent and adult eczema sufferers end up with Red Skin Syndrome.
Another consideration here is that steroids suppress your immune system. This ultimately means that they are halting a process in your body rather than identifying and addressing WHY this is happening to your body.
Other side effects include elevations in blood pressure, glaucoma, cataract formation, swollen ankles and feet, mood issues, weight gain, blood sugar imbalances, osteoporosis, and decreased wound healing. This last point is important if your eczema has developed wounds that you're having trouble healing.
Though steroid creams can be helpful for reducing symptoms as you work on a root cause solution, they are ultimately not going to solve the underlying problem.
Biologic Medicine for Eczema
Biologic medicine for eczema treatment is admittedly pretty innovative. And they have helped to confirm that eczema is an autoimmune disease.
Differing from the more well-known immunosuppressant drugs on the market, biologics are essentially based on a single cloned cell (thus they are termed “monoclonal antibodies” and their drug names end in “mab”). Their job is to bind to cytokines (inflammatory proteins) and prevent them from causing skin inflammation.
Duplixent (dupilumab) is the first-ever biologic drug that's specific to the treatment of eczema. Another biologic is currently in the pipeline as of February 2018 called nemolizumab which is still in clinical trials and requires assessment for efficacy and safety on a larger scale.
Other biologics exist, but using them to treat eczema would be considered off-label. Those include Humira and Embrel, both of which are tumor necrosis factor blockers (which differs from the actions of the newer biologics).
According to Dr. Stephanie Davis, going this route means that you're basically committing to taking the drug for life. You can't just stop it once you eventually get relief as the symptoms will return.
These drugs can have pretty serious consequences. Side effects of biologics include allergic hypersensitivity (including anaphylaxis), increased risk of infection, injection-site infection risk/reaction, cancer, autoimmune thyroiditis and hypothyroidism, GI symptoms and serious GI concerns, and many more. The list is pretty long and should be seriously reviewed before you start this sort of treatment.
If you're prepared to go this route, know that these drugs come with a hefty price tag. Duplixent runs $37,000 per year while Humira and Embrel clock in at about $50,000 per year each. With increasing insurance deductibles and out-of-pocket maximums, you may be footing a pretty hefty portion of this bill especially if this is a long-term commitment.
And one last point… this type of medicine for eczema blocks your body's chemical drivers causing inflammation. So why not figure out what's driving the inflammation in the first place (ahem… the root cause approach) rather than suppress it and hope it doesn't rear its ugly head at some later date?
Immunosuppressive drugs
When topical creams don’t work, doctors will go so far as to prescribe immunosuppressant drugs that were originally designed for preventing transplant rejection. This type of medicine for eczema is often considered to be a “last resort” because the other conventional treatment options have been exhausted.
This class of eczema medication drugs includes azathioprine, methotrexate, mycophenolate mofetil, and cyclosporine.
These lower your body’s immune system response, which can temporarily make symptoms better. However, you can’t go through life with a permanently weak immune system, so you cannot rely on these.
Please don't be fooled… these drugs have adverse side effects that include:
- high blood pressure
- photosensitivity
- increased risk of infection (to things like shingles, chicken pox, colds, flu, other infections)
- gum swelling
- nausea
- diarrhea
- tremors
- liver inflammation
- severe anemia
- cancer (Yes, CANCER.)
- increased hair growth
- increased hair loss (depends on which drug you're prescribed)
Steroids are included in the immunosuppressive category along with mTOR inhibitors, Calcineurin inhibitors, and IMDH inhibitors.
Common Moisturizers
Though I don't consider moisturizers to be part of medicine for eczema treatment, they certainly are often recommended by dermatologists.
And it's not uncommon to try many different moisturizers on your journey!
I bet you have a big box full of products that either didn't really work or increased burning, dryness, itchiness, and/or redness.
It's all so very frustrating especially when the products are labeled as being good for eczema or extreme dryness.
But the reason that these products often don't work (or make things worse) is due to WHAT the companies formulate them with.
It's not uncommon to find that these readily available over-the-counter products contain triggering chemicals, fragrances, petrochemicals, and more. I did a fantastic interview on what toxic ingredients are in a lot of the commonly available lotions, moisturizers, and creams HERE.
Even when you find a cream that doesn’t irritate your skin, they often only give you relief for a short time. One of the reasons why is that these companies intentionally formulate the products to dry out your skin so that you continue to use the product. For someone like you and I who struggles with eczema (that includes dryness), this is not what you want a moisturizer to do.
Trying to add moisture from the outside in often doesn't work that well anyway. Though there are some better suited natural oils that may work for you, ultimately the loss of your natural moisture barrier must be addressed along with ensuring that you actually drink enough water throughout the day.
Skin Humectants For Eczema Relief
Humectants are common ingredients in many skincare products that attract moisture to wherever it is applied. Humectants are typically a part of the toolbox of medicine for eczema because of the common symptom of intense dryness of the skin (more officially known as xerosis).
If a humectant isn't balanced with an occlusive (more on that in a moment), it can actually dry your skin out further.
Instead of drawing moisture from the air, it would pull moisture from the deeper layers of skin. So you really would do yourself a disservice by drying out those deeper layers in an attempt to hydrate the more superficials ones.
Some humectants include hyaluronic acid, glycerin, and even honey! Glycerol is considered to be the most effective of them all.
That said, many used in drugstore eczema creams and lotions use harsh synthetic chemicals such as urea, silicone, propylene glycol, and polyethylene glycols (PEG) as humectants. The last two are actually petroleum derivatives!
Occlusives (Vaseline and Crisco) For Treating Eczema
As I just mentioned, you have to put something on top of the humectant in order to maintain moisture since one of the hallmarks of eczema is the loss of your skin's moisture barrier.
That “thing” would be called an occlusive.
It's not uncommon to get the recommendations from dermatologists to put Vaseline (and even sometimes they'll recommend Crisco) on your skin. I kid you not… the National Eczema Association apparently gave the thumbs up on this.
You know… to smother your irritated, red skin with a petroleum-based product.
It's also pretty common for people to then wrap the area in plastic wrap in order to truly seal in the moisture in.
Sure… Vaseline creates a waterproof barrier on the skin which sounds great if you've got very dry skin.
The problem is that it also traps bacteria, sweat, and waste products from both your cells along with that from the skin microbiome. This can cause more irritation and dysbiosis within the vast bacterial communities living all over your skin.
And don't forget, Vaseline contains harmful hydrocarbons since it is made from petroleum.
Crisco is less commonly suggested, but some people swear it helps them. That said, if it's notoriously terrible for your health, why would you apply on your skin which is the largest organ of the body?
In case you didn't know, it contains TBHQ which (to be fair) is also added to some commercial skin products.
But in digging a bit deeper, TBHQ isn't entirely innocent. Some research has found interesting side effects after being ingested “…liver enlargement, neurotoxic effects, convulsions, and paralysis in laboratory animals.”
Sure… you're not eating the Crisco, but you are slathering it all over a struggling organ that has the capacity to absorb chemicals. So keep that in mind.
Again, none of these treatments are long-term solutions. They aren’t even great temporary solutions because many of them mess with your immune system – which needs balance, not further dysregulation. Ultimately, if you want long-term relief from your eczema symptoms, you need to identify your root cause eczema triggers and heal your gut.
Heal Your Gut to Heal Your Skin in 3 Steps
The answers you’re looking for are not likely hidden in medicine for eczema. Instead, you must begin with your gut. Your journey for clear, beautiful skin can start in three steps:
1. Eliminate triggers and damaging foods –
Finding and eliminating your eczema triggers should be priority number one. Start an elimination diet and introduce lifestyle changes to work your way through these common triggers.
- Gluten is a huge one for many skin conditions. In fact, I often refer to the effects collectively as gluten skin.
- Eggs (Though there is no clinical data that explains the reason why, often eggs are a problem.)
- Sugar
- Stress
- Hormone changes
- High histamine foods
- Gut infections
- Leaky gut syndrome
Getting tested for common root causes of eczema can tell you a lot about what changes you need to make – you can download my list of Root Cause Skin Tests that I use.
2. Eat gut nourishing foods –
This means eating lots of nutrient-dense whole foods. Include lots of veggies, fruits, healthy fats, and higher amounts of healthy, clean protein. Research has found that nutrient-dense diets were capable of reducing the risk of eczema in children.
I’ve also developed 7 smoothies for those with eczema. You can start your day with these soothing, healing recipes.
3. Reinoculate your gut –
Increase prebiotic and probiotic foods to help establish diversity and heal your gut microbiome. These include:
- Sauerkraut
- Kimchi
- Jerusalem artichoke
- Onion
- Garlic
- Leek
- Asparagus
(Please note that these are all high FODMAP foods that can be problematic if you've got SIBO or a GI infection.)
If you need a comprehensive overview of eczema – check out Your Definitive Guide to Eczema Treatment + 7 Remedies That Actually Work.
Also, I seriously recommend these healing and delicious smoothies for those with eczema – these are a great place to get started if you’re interested in healing your eczema by focusing on gut health.
Part of why this chronic skin condition is so misunderstood is doctors are still treating it with medicine for eczema that only addresses part of the problem.
It’s up to us to get the word out! Share this article far and wide so that you can share the solution that someone has been desperately looking for.
Resources:
https://www.ncbi.nlm.nih.gov/pubmed/25482871
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831151/
https://www.ncbi.nlm.nih.gov/pubmed/19725897
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336433/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516989/
Jennifer Fugo, MS, CNS
Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.
An excellent article.
As an eczema sufferer for 53 years and constantly researching the topic, I never knew hyaluronic pills moisture from deeper levels!
Will you be covering the issue of Topical Steroid Withdrawal in this series? I have been suffering for 2.5 years and for me there is no end in sight. With 2 young children to look after, no support network and limited finances my life is hell.
Unfortunately I’m not directly addressing it though we do have a patient story that highlights the issue. This series is looking at root causes, but I will dive deeper into TSW in 2020 on the Healthy Skin Show.
I agree…. I’m also shocked that some humectant moisturizers are meant to ultimately dry out your skin. Which one do you recommend then? Thank you so much!
Hi Mary, I tend to recommend more single oil options like avocado oil or jojoba oil. Everyone is different so you can test things out for yourself, but I do not recommend coconut oil for eczema skin.
My friend’s husband has eczema…ithy. He is getting light treatments for months. Infrared perhaps? What do you think?