Medications For Eczema

The medications used for treating eczema can be categorized into several groups:

Topical Corticosteroids

These are anti-inflammatory medications applied directly to the skin to relieve itching, redness, and swelling. They vary in strength and are often used until symptoms improve. These reduce inflammation by suppressing the activity of certain cells and chemicals in the immune system. They decrease DNA synthesis and mitosis in dermal epithelial cells and fibroblasts, leading to reduced skin inflammation.

- Hydrocortisone (over-the-counter, low potency): Common brands include Cortizone-10 and Locoid.
- Desoximetasone (prescription, higher potency): Known under the brand name Topicort.
- Triamcinolone: Available as Kenalog in topical form.
- Halobetasol: Branded as Ultravate and Halonate.

Common Side Effects:
Potential side effects include thinning of the skin, stretch marks, lightening of the skin, and acne. They may also affect the eyes with prolonged use. 

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Biologics

These target specific parts of the immune system. For example, Dupixent (dupilumab) blocks proteins known as interleukins (IL-4 and IL-13) that contribute to the inflammation seen in atopic dermatitis. Lebrikizumab targets IL-13 alone, while Nemolizumab targets the IL-31 receptor, which plays a role in the itching associated with eczema.

- Dupixent (dupilumab): The first approved biologic for atopic dermatitis.
- Lebrikizumab: In clinical trials, targets IL-13.
- Nemolizumab: Also in trials, targets IL-31 receptor.

Common Side Effects:
- Dupixent: Injection site reactions, eye redness or itching, puffy eyelids, stomach pain, nausea, vomiting, sore throat, tooth pain, sleep problems, cold symptoms, joint or muscle pain.
- Lebrikizumab: Injection site reactions, herpes virus infections, eye infections.
- Nemolizumab: Upper respiratory tract infection, nasal inflammations.

These biologics represent a targeted approach to treating atopic dermatitis, focusing on specific immune pathways. Each has its unique profile of efficacy and side effects. For more detailed information, it's advisable to consult healthcare professionals.

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Topical Calcineurin Inhibitors

These are used when corticosteroids are ineffective or inappropriate, such as in sensitive skin areas. They work by blocking an overactive immune response and are applied directly to the affected skin areas. They inhibit the enzyme calcineurin. This inhibition prevents T-lymphocytes from producing cytokines, which are involved in the inflammation process, thereby reducing immune system activity in the skin.

- Pimecrolimus: Marketed as Elidel, a common non-steroidal cream.
- Tacrolimus: Available under the brand name Protopic.

These may cause burning or itching at the application site. Other side effects can include flu-like symptoms, headache, cough, and rarely, skin infection.

*Warning, people have shown withdrawal symptoms from this

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Systemic Medications

These include a variety of drugs such as methotrexate and dexamethasone, which work on the whole body rather than a specific area. They are usually considered for more severe cases of eczema. These medications impact the immune system throughout the body. For example, methotrexate inhibits an enzyme involved in the rapid growth of cells, which is a key factor in the inflammatory process of eczema.

- Methotrexate: A systemic medication used off-label for eczema. 
Potential side effects include nausea, fatigue, and liver problems. It may also impact blood cell counts and increase the risk of infections.
- Dexamethasone: Available under various brand names like Dexamethasone Intensol and Dxevo. 
Common side effects include fluid retention, alteration in glucose tolerance, increased appetite, and mood changes.

 Jak Inhibitors 

Function: Interfere with signals causing inflammation, reducing immune response.
Brands:

- Rinvoq (upadacitinib): Used for moderate-to-severe eczema.
- Olumiant (baricitinib): Also used in eczema treatment.

Side Effects: Common cold, bronchitis, ear/urinary tract infections, headache, nausea.

Side effects include common cold, bronchitis, ear infections, urinary tract infections, headaches, and nausea. Serious side effects like pneumonia and tuberculosis have been reported in some cases.

Here's a concise summary for JAK inhibitors in the context of eczema treatment:

Oral Antihistamines

These may be recommended to help lessen itching and cause drowsiness, which can be particularly useful for nighttime itching and discomfort. These block histamine, a substance in the body that causes allergic symptoms. By blocking the action of histamine, they reduce the allergic response, which often manifests as itching and redness in eczema.

- Common over-the-counter options include cetirizine (brand name Zyrtec Allergy) and fexofenadine (Allegra Allergy).
- Diphenhydramine is also widely used and known as Benadryl.

 Side Effects: Drowsiness, dry mouth, headache.

*Warning: Causes withdrawal, can trigger the itch-scratch cycle

Each medication has its specific uses, dosage, side effects, and interactions. It's important for individuals with eczema to consult with healthcare professionals to determine the best treatment plan for their condition

[oai_citation:1,List of 139 Eczema Medications Compared - Drugs.com]( https://www.drugs.com/condition/eczema.html )

[oai_citation:2,Atopic dermatitis (eczema) - Diagnosis and treatment - Mayo Clinic]( https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/diagnosis-treatment/drc-20353279 )

[oai_citation:3,Medication for Eczema & Dermatitis | NYU Langone Health]( https://nyulangone.org/conditions/eczema-dermatitis/treatments/medication-for-eczema-dermatitis ).