Table of ContentsView AllTable of ContentsHome RemediesOTC TherapiesPrescriptionsProceduresFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Home Remedies
OTC Therapies
Prescriptions
Procedures
Frequently Asked Questions
Finding the right treatment for the relief of symptoms and the prevention of flare-ups when you have severeeczemais crucial. The skin can become red and swollen, and the itch can be extreme and disruptive. In some cases,eczemacan affect over 40% of the body’s surface area.
This article will discuss how you can managesevere eczemawith home remedies, over-the-counter (OTC) treatments, prescription medication, and phototherapy.
Olga Ostapenko / Getty Images
Home Remedies and Lifestyle
Eczema treatmentfor any severity starts with trigger management and a good skin care routine.
Identifying and Avoiding Triggers
Eczema often hastriggers, which are anything that irritates the skin and causes aneczema flare-up(periods when the eczema is worse). Anything can be a trigger, but common ones for eczema include:
If you can identify what triggers your eczema, avoiding or minimizing your exposure to it can help reduce the severity of your symptoms.
Sometimes exposure can’t be avoided. In these cases, take measures to protect your skin, such as using a humidifier for dry air or wearing cotton gloves under waterproof gloves during activities for which your hands are in water.
Skin Care
Start with bathing or showering using warm, not hot, water. This helps hydrate skin and remove crusts, scales, and irritants.
After bathing, pat dry with a soft towel. Apply a good moisturizer within three minutes of getting out of the water. This helps your skin retain the hydration from bathing.
Apply moisturizer frequently throughout the day.
Your healthcare provider may suggest trying somehome treatmentsto soothe symptoms such as itching, or to prevent infections. You should try these treatments under the guidance of your healthcare provider. Don’t try them without consulting with them first.
Wet Wrap Treatment
Wet wrap treatment involves wrapping the affected skin in layers of wet and dry dressings.
To make wet wrap treatments:
Diluted Bleach Baths
If your healthcare provider recommends it,diluted bleach bathstwo to three times per week can help prevent infections, to which eczema-affected skin is prone. At this level of dilution, it is similar to swimming in a chlorinated pool.
ImportantIt is important to use the right amount of bleach to ensure safety and effectiveness. Use a measuring cup or measuring spoons, don’t estimate. Never apply bleach directly to the skin.
Important
It is important to use the right amount of bleach to ensure safety and effectiveness. Use a measuring cup or measuring spoons, don’t estimate. Never apply bleach directly to the skin.
To prepare a bleach bath:
Over-the-Counter (OTC) Therapies
OTC options are a good place to start. Severe eczema may require additional treatment, but OTC products provide a treatment base.
Topical
Topical eczema treatments mean they are applied to the skin.
Using the right moisturizing product is key to eczema treatment. Look for thicker ointments or creams. These have a higher oil content than lotions, which contain too much water. Use products that containminimal ingredientsand are fragrance-free and dye-free.
Some options to try include:
Tips for applying moisturizer:
Mild anti-itch lotions, such asCaladrylorCalamine, may also help soothe dry, scaly patches.
Systemic
Oralantihistaminesare sometimes suggested for itchy eczema. They tend not to relieve the itch itself, but they are sedatives and can help make for more restful sleep when taken at bedtime.
When to Get Medical Help
Severe eczema may require medical intervention. Call 911 if you think it is a life-threatening emergency.
Seek immediate medical attention if:
Contact a healthcare provider within 24 hours if:
Check in with your healthcare provider during office hours if:
It is common for people withsevere eczemato need prescription treatments.
Some prescription eczema treatments are applied to the skin.
Steroids
Topical steroidsmay be prescribed for short-term use to help clear affected areas and manage itching and inflammation.
CalcineurinInhibitors
Protopic(tacrolimus) ointment and Elidel (pimecrolimus) cream are topical non-steroidimmunosuppressantsthat help reduce inflammation. Unlike steroids, they do not cause skin thinning. Anyoneover 2 years of agecan safely take them.
Common side effects include mild stinging or burning when first applied to the skin.
JAK Inhibitors
The enzymes JAK1 and JAK2 are involved with processes that contribute to skin inflammation, itch, and skin barrier function.
JAK inhibitors are for short-term and non-continuous treatment, and people who have a weakened immune system or are under 12 years of age should not use them.
Phosphodiesterase 4 (PDE4) Inhibitors
Steroids and Immunosuppressants
Systemiccorticosteroidsandimmunosuppressantssuch ascyclosporine, Imuran (azathioprine), and CellCept (mycophenolate mofetil) may be prescribed if topical treatment is ineffective.
Because of side effects and the potential for rebound flares that can arise after you stop taking your medication, these are typically avoided as much as possible and are only used for short-term treatment of acute, severe flares.
People using these medications need monitoring from their healthcare provider.
JAK inhibitors
Cibinqo(abrocitinib) andRinvoq(upadacitinib) are oral JAK1 inhibitors for moderate to severe eczema that other treatments (including other systemic treatments) cannot adequately control.
Dupixent
Dupixent(dupilumab) is an injectable medication that inhibits the inflammatory response. It can treat adults with moderate to severe eczema that topical therapies cannot control. Side effects may include a reaction at the injection site, cold sores in the mouth or on the lips, and inflammation of the eye or eyelid.
Specialist-Driven Procedures
Phototherapycan treat moderate to severe eczema. This type of light therapy uses certain wavelengths of ultraviolet light to inhibit the inflammatory response in the skin. People sometimes use it witha medication calledpsoralen, which sensitizes the skin to ultraviolet light. This combination therapy is called psoralen plus ultraviolet A (PUVA).
During a treatment session, you will:
Treatments are usually two to three times a week for a duration of several weeks. Your healthcare provider may later advise more treatments.
Phototherapy may cause side effects such as skin sensitivity and may increase the risk of skin cancer. Talk to your healthcare provider about thebenefits and risks of this treatment.
Skip the Tanning Bed and SunbathingTanning bedsand sun exposure should never serve as phototherapy. Effective phototherapy requires specific wavelengths that the sun and tanning beds cannot supply. Exposure to radiation from tanning beds or the sun also increases your risk of skin cancer.
Skip the Tanning Bed and Sunbathing
Tanning bedsand sun exposure should never serve as phototherapy. Effective phototherapy requires specific wavelengths that the sun and tanning beds cannot supply. Exposure to radiation from tanning beds or the sun also increases your risk of skin cancer.
Summary
Moisturizers and topical medications can also treat eczema. Severe eczema may require more intensive treatments such as systemic immunosuppressants orphototherapy.
If you are experiencing severe or frequent eczema symptoms that are not improving with skin care and moisturizing alone, talk to your healthcare provider about other treatment options. You can also ask for a referral to a board-certified dermatologist who can help you make a plan thatoffers you relief.
Frequently Asked QuestionsSevere eczema can be extremely itchy. It can also cause dry, sensitive, inflamed, rough, and/or scaly skin patches, which may crust or ooze.Learn MoreSymptoms of Eczema (Atopic Dermatitis)Ointments are the best moisturizers for eczema because they have the highest oil content. “Greasy” moisturizers are the most effective for eczema. Creams are the next best choice. Lotions contain a lot of water and tend to be less effective.Learn MoreThe 8 Best Lotions for Eczema of 2022
Severe eczema can be extremely itchy. It can also cause dry, sensitive, inflamed, rough, and/or scaly skin patches, which may crust or ooze.Learn MoreSymptoms of Eczema (Atopic Dermatitis)
Severe eczema can be extremely itchy. It can also cause dry, sensitive, inflamed, rough, and/or scaly skin patches, which may crust or ooze.
Learn MoreSymptoms of Eczema (Atopic Dermatitis)
Ointments are the best moisturizers for eczema because they have the highest oil content. “Greasy” moisturizers are the most effective for eczema. Creams are the next best choice. Lotions contain a lot of water and tend to be less effective.Learn MoreThe 8 Best Lotions for Eczema of 2022
Ointments are the best moisturizers for eczema because they have the highest oil content. “Greasy” moisturizers are the most effective for eczema. Creams are the next best choice. Lotions contain a lot of water and tend to be less effective.
Learn MoreThe 8 Best Lotions for Eczema of 2022
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Taylor K, Swan DJ, Affleck A, et al.Treatment of moderate-to-severe atopic eczema in adults within the U.K.: results of a national survey of dermatologists.Br J Dermatol. 2017;176(6):1617-1623. doi:10.1111/bjd.15235American Academy of Dermatology Association.Can anything relieve severe atopic dermatitis?Seattle Children’s Hospital.Eczema.American Academy of Family Physicians.Eczema and atopic dermatitis.National Eczema Association.Available eczema treatments.Cancer Therapy Advisor.Severe eczema.Andersen RM, Thyssen JP, Maibach HI.The role of wet wrap therapy in skin disorders – a literature review.Acta Derm Venerol. 2015;95(8):933-939. doi:10.2340/00015555-2134American Academy of Pediatrics.How to treat & control eczema rashes in children.American Academy of Allergy, Asthma & Immunology.Eczema (atopic dermatitis) overview.American Academy of Dermatology Association.Atopic dermatitis: bleach bath therapy.American Osteopathic College of Dermatology.Eczema.Mount Sinai.Eczema.Food and Drug Administration.Zoryve label.Food and Drug Administration.FDA approves new eczema drug Dupixent.Institute for Quality and Efficiency in Health Care (IQWiG).Eczema: light therapy and oral medications.American Academy of Dermatology Association.Eczema treatment: phototherapy.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Taylor K, Swan DJ, Affleck A, et al.Treatment of moderate-to-severe atopic eczema in adults within the U.K.: results of a national survey of dermatologists.Br J Dermatol. 2017;176(6):1617-1623. doi:10.1111/bjd.15235American Academy of Dermatology Association.Can anything relieve severe atopic dermatitis?Seattle Children’s Hospital.Eczema.American Academy of Family Physicians.Eczema and atopic dermatitis.National Eczema Association.Available eczema treatments.Cancer Therapy Advisor.Severe eczema.Andersen RM, Thyssen JP, Maibach HI.The role of wet wrap therapy in skin disorders – a literature review.Acta Derm Venerol. 2015;95(8):933-939. doi:10.2340/00015555-2134American Academy of Pediatrics.How to treat & control eczema rashes in children.American Academy of Allergy, Asthma & Immunology.Eczema (atopic dermatitis) overview.American Academy of Dermatology Association.Atopic dermatitis: bleach bath therapy.American Osteopathic College of Dermatology.Eczema.Mount Sinai.Eczema.Food and Drug Administration.Zoryve label.Food and Drug Administration.FDA approves new eczema drug Dupixent.Institute for Quality and Efficiency in Health Care (IQWiG).Eczema: light therapy and oral medications.American Academy of Dermatology Association.Eczema treatment: phototherapy.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Taylor K, Swan DJ, Affleck A, et al.Treatment of moderate-to-severe atopic eczema in adults within the U.K.: results of a national survey of dermatologists.Br J Dermatol. 2017;176(6):1617-1623. doi:10.1111/bjd.15235American Academy of Dermatology Association.Can anything relieve severe atopic dermatitis?Seattle Children’s Hospital.Eczema.American Academy of Family Physicians.Eczema and atopic dermatitis.National Eczema Association.Available eczema treatments.Cancer Therapy Advisor.Severe eczema.Andersen RM, Thyssen JP, Maibach HI.The role of wet wrap therapy in skin disorders – a literature review.Acta Derm Venerol. 2015;95(8):933-939. doi:10.2340/00015555-2134American Academy of Pediatrics.How to treat & control eczema rashes in children.American Academy of Allergy, Asthma & Immunology.Eczema (atopic dermatitis) overview.American Academy of Dermatology Association.Atopic dermatitis: bleach bath therapy.American Osteopathic College of Dermatology.Eczema.Mount Sinai.Eczema.Food and Drug Administration.Zoryve label.Food and Drug Administration.FDA approves new eczema drug Dupixent.Institute for Quality and Efficiency in Health Care (IQWiG).Eczema: light therapy and oral medications.American Academy of Dermatology Association.Eczema treatment: phototherapy.
Taylor K, Swan DJ, Affleck A, et al.Treatment of moderate-to-severe atopic eczema in adults within the U.K.: results of a national survey of dermatologists.Br J Dermatol. 2017;176(6):1617-1623. doi:10.1111/bjd.15235
American Academy of Dermatology Association.Can anything relieve severe atopic dermatitis?
Seattle Children’s Hospital.Eczema.
American Academy of Family Physicians.Eczema and atopic dermatitis.
National Eczema Association.Available eczema treatments.
Cancer Therapy Advisor.Severe eczema.
Andersen RM, Thyssen JP, Maibach HI.The role of wet wrap therapy in skin disorders – a literature review.Acta Derm Venerol. 2015;95(8):933-939. doi:10.2340/00015555-2134
American Academy of Pediatrics.How to treat & control eczema rashes in children.
American Academy of Allergy, Asthma & Immunology.Eczema (atopic dermatitis) overview.
American Academy of Dermatology Association.Atopic dermatitis: bleach bath therapy.
American Osteopathic College of Dermatology.Eczema.
Mount Sinai.Eczema.
Food and Drug Administration.Zoryve label.
Food and Drug Administration.FDA approves new eczema drug Dupixent.
Institute for Quality and Efficiency in Health Care (IQWiG).Eczema: light therapy and oral medications.
American Academy of Dermatology Association.Eczema treatment: phototherapy.
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