How Atopic Dermatitis Is Treated

Atopic dermatitis is the most common form of eczema, a chronic skin condition that causes dry, inflamed, itchy skin. It’s estimated that atopic dermatitis affects up to 30% of people in the United States.

While there is no cure for atopic dermatitis, several treatment options may ease the symptoms of the condition, from home remedies to procedures performed by a dermatologist. Moisturizing your skin regularly and avoiding scratching areas affected by atopic dermatitis are important parts of any treatment plan.

Treatment for Atopic Dermatitis

Verywell / Joules Garcia

Home Remedies and Lifestyle

Because there is no cure for atopic dermatitis, treatments are usually focused on relieving the symptoms. Home remedies can help relieve the intense itching that often accompanies the dry rash caused by the condition.

Research has shown that regular use of a moisturizer reduces the itching and rash associated with atopic dermatitis. Using a moisturizer every day may even decrease the need for prescription topical medication. It’s best to moisturize your skin two to three times daily. 

Look for a high-quality moisturizer that is free of artificial dyes and fragrances. The cream or petroleum-based moisturizer should be thick, with little water content. Lotions can be drying and are usually avoided in the care of atopic dermatitis.

Look for moisturizers with humectants, such as glycerin and urea. They attract water from the environment and the skin’s surface into deeper layers of skin. They also help the skin shed dead skin cells and appear healthier.

Other home remedies that may relieve atopic dermatitis include:

  • Using a humidifier
  • Avoiding irritants like dyes, scents, and chemicals in skin products
  • Testing any new skin products on a small patch of skin first
  • Taking short, lukewarm showers and baths, because bathing may help remove dead skin cells, irritants, and allergens from the skin, and because moisturizing within three minutes of patting your skin dry with a towel can help lock in moisture absorbed in the skin during bathing
  • Wearing loose-fitting, cotton clothing
  • Avoiding very cold or very hot weather

Over-the-Counter (OTC) Therapies

When a moisturizer alone is not effective at relieving your dry, itchy skin, an over-the-counter (OTC) topical medication is usually the next step.

Topical corticosteroids are considered first-line treatment when moisturizing is not helpful. Topical corticosteroids are usually applied twice daily. If your atopic dermatitis is currently well controlled, your dermatologist may recommend using topical corticosteroids once to twice weekly to prevent flares. 

Hydrocortisone (Cortisone 10 and Cortaid) creams and ointments are common OTC topicals used to treat atopic dermatitis. 

Topical antihistamines have been used for itching in the past, but they have not proven effective and are not recommended in most cases of atopic dermatitis. In rare cases, patients with atopic dermatitis who have severe itching that prevents sleep may benefit from short-term use of a sedating antihistamine to help them sleep through these symptoms.

Prescriptions

When moisturizers and OTC corticosteroids are not effective, it’s time to see your dermatologist or allergist-immunologist for prescription treatment. 

JAK Inhibitors

In September 2021, the FDA approved OPZELURA (ruxolitinib) for the treatment of mild to moderate atopic dermatitis. It is recommended for those whose symptoms do not properly respond to topical prescription therapies. OPZELURA is the first and only Jak inhibitor approved for atopic dermatitis treatment in the United States, making it the first treatment of its kind. The drug works by selectively blocking pathways that cause many of the symptoms of atopic dermatitis, including inflammation and itching.

Topical Steroids 

Prescription topical steroids have a higher potency than OTC medications. A possible side effect of some prescription topicals is skin thinning over time. Talk with your dermatologist about the risks and the best prescription medication for you. 

Topical Calcineurin Inhibitors

Common prescription topicals include pimecrolimus and tacrolimus. These medications are classified as topical calcineurin inhibitors, which help block the inflammatory response in the skin. They can be used in addition to prescription topical steroids.

This class of medication may be better for sensitive areas of the body like the eyes because they do not risk thinning the skin or causing cataracts with prolonged use. 

Biologic Agents

In recent years, at least one biologic agent has been approved for the treatment of atopic dermatitis, and others have been explored.

Biologic agents are substances made from a living organism and used for treatment. Examples include vaccines, antibodies, and interleukins. In atopic dermatitis, they can help block the inflammation that leads to itching. 

Dupilumab is an antibody treatment that has been found to be effective at treating moderate to severe atopic dermatitis in adults and children who are at least 6 years old. It is given as an injection every two weeks. 

Phosphodiesterase Inhibitors

Another class of drugs now used to treat atopic dermatitis is phosphodiesterase inhibitors. These medications work by blocking substances in the body that lead to inflammation.

The medication crisaborole (Eucrisa) is a common phosphodiesterase inhibitor used in treating skin conditions. Crisaborole has been proven to help prevent the redness, swelling, and itching that often accompany atopic dermatitis. This is a topical medication that is usually applied directly to the skin twice daily. 

Antistaphylococcal Antibiotics

Because atopic dermatitis can cause intense itching, it’s natural to scratch your skin. However, this breakdown can lead to infection of the skin. Antibiotics may be needed to treat a bacterial skin infection

Can I Use Wet Wrap Therapy for Atopic Dermatitis?

For more severe cases of atopic dermatitis, your dermatologist may recommend wet wrap therapy. It involves applying topical corticosteroids, followed by wet bandages and then dry bandages. This is often performed in the hospital or dermatologist’s office because it can be labor-intensive. Wet wrap therapy is believed to help your skin absorb the corticosteroids, decrease water loss, and provide a physical barrier against scratching. If you are interested in trying wet wrap therapy at home, ask your physician whether it is safe to use corticosteroids and if so, which type. Because wet wraps improve the absorption of corticosteroids, care should be used to prevent overexposure.

Summary

Atopic dermatitis symptoms can be treated with over-the-counter topical steroids. Prescription-strength corticosteroids may be used if the OTC treatments are not enough. Your dermatologist may also recommend light therapy and wet wrap therapy for more severe and persistent cases. Moisturizing your skin regularly can relieve the itching and rash caused by the condition.

A Word From Verywell

Atopic dermatitis is a chronic skin condition that causes redness, itching, and rash. This common condition can be very frustrating, especially when moisturizing your skin alone does not help.

Fortunately, for many people, atopic dermatitis resolves on its own over time. This is especially true for children.

If you have been experiencing dry, itchy, red skin, talk with your dermatologist to make a plan. 

Frequently Asked Questions

What is the best treatment for atopic dermatitis?

The best treatment for atopic dermatitis is moisturizing your skin regularly. It’s recommended that people with atopic dermatitis use a quality moisturizer two to three times per day. Other treatment options include OTC corticosteroid creams and ointments, prescription topicals, wet wrap therapy, and light therapy.

How do you cure atopic dermatitis?

There is no cure for atopic dermatitis, but it is possible to control the symptoms and reduce the number of flare-ups.

What does atopic dermatitis look like?

Atopic dermatitis appears as a red rash with dry, itchy, inflamed skin. The skin may bleed if it’s scratched often.

How long does atopic dermatitis last?

Each case of atopic dermatitis is unique, so it is not possible to provide an exact timeline. If you have been trying home remedies and OTC medications for over two weeks without relief, see your dermatologist or allergist-immunologist.

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11 Sources
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