Living With Eczema
Studies have found that patients who have eczema—also called atopic dermatitis, or AD—often report a decreased overall sense of well-being, known as quality of life, which is experienced to an even greater degree with moderate to severe disease.1,2 Besides appropriate treatment, an understanding about the ways to improve daily living with eczema is essential to a comprehensive management approach.
Certain allergens found in the environment, such as dust and mold, can increase the risk of developing eczema. In the urban environment, additional allergens including pollution, household pests (for example, cockroaches and dust mites), tobacco smoke, and excessive heat may also trigger eczema.3 Maintaining skin moisture through proper skin care, such as applying unscented creams or lotions immediately after bathing, is important in helping prevent irritants and allergens from entering the skin.1,3 Simply improving skin hydration may help reduce the need for and use of topical corticosteroids to control eczema symptoms.1
Available treatments for eczema
Approaches to optimal management include additional personalized treatment options based on eczema severity. However, a mainstay of treatment for anyone affected by eczema includes gentle skin care, such as bathing or showering in warm (not hot) water, limiting bathing time to less than 10 minutes, and frequent use of moisturizers.3
If prescription intervention for mild to moderate flares is needed, topical corticosteroids (TCS) are typically used first at the affected area for a short duration.1,3 Additional nonsteroidal options can include topical calcineurin inhibitors (TCIs) and phosphodiesterase-4 (PDE4) inhibitors.1
Moderate to severe eczema may require treatments with phototherapy (light-based treatments) or possibly medications that affect the whole body, which are taken in pill or injectable form.1,3 These types of medications target different areas of the body’s immune system to help treat AD more aggressively.1,3 specifically target a protein chemical messenger called an interleukin (IL). Biologics stop IL from binding to its receptors and blocks specific inflammatory proteins that play a role in eczema symptoms.4 Several biologics are approved to treat poorly controlled moderate to severe eczema: dupilumab, targets IL4 and IL13, lebrikizumab and tralokinumab, both target IL13, and nemolizumab, targets iIL31.5-8
Dupilumab is approved for the treatment of moderate to severe AD not controlled by prescription topical therapies or when such therapies cannot be used in patients 6 months and older.5 Studies of AD with moderate to severe hand involvement have also demonstrated improvements in cleared skin and reductions in itch.5,9 Additionally, dupilumab can be used with or without TCS.5 Lebrikizumab and tralokinumab are also approved or the treatment of moderate to severe AD not controlled by prescription topical therapies or when such therapies cannot be used in patients 12 years and older, and can also be used with or without TCS.6,7 Nemolizumab, the most recently approved biologic, is approved for use in people aged 12 or older with moderate to severe AD in combination with TCS and/or TCI when disease is not adequately controlled with topical prescription medications.8
In addition to biologics, other classes of medications are also used to treat AD. JAK inhibitors work by blocking certain signaling pathways inside the cell related to immune response.10 JAK inhibitors have unclear associations with increased risk for cancer, cardiovascular events and blood clots; due to safety concerns, this medication class is not considered first line therapy, but is approved for use in moderate to severe AD that has failed treatment with other immunosuppresants or injectable biologics, or when those other treatments are not advised.10,11 Furthermore, oral JAK inhibitors should not be taken during pregnancy or while breast feeding.10,11 Upadacitinib and abrocitinib are FDA-approved oral JAK inhibitors for the treatment of moderate to severe AD.11 Immunosuppressants such as oral corticosteroids and other off-label therapies including methotrexate, azathioprine, cyclosporine and mycophenolate mofetil can have side effects that require laboratory monitoring and limit how long they can be used.11
Lifestyle approaches to managing eczema
With new ways of identifying eczema and evolving medications to treat it, patients now have additional methods to help manage their eczema. However, eczema also affects a patient’s lifestyle since it is such a visible problem that may affect the arms, neck, legs, head, and other areas of the body. There is a strong social element to having eczema and getting it under control.
One of the biggest challenges with eczema is managing your day-to-day life outside of the doctor’s office. How can patients learn to help themselves lead their most fulfilling life with the lowest disease burden?
Options for facing your eczema symptoms include:12,13
Knowing your triggers so you can be better prepared to defuse them
Getting regular exercise
Trying new things, such as yoga, meditation, or jogging
Finding time for yourself every day
Trying oils, such as coconut oil or sunflower oil
Putting a regular skin-care routine in place—finding what works for you
Downloading apps for meditation, relaxation, and eczema tracking and insights
Doing something creative—such as drawing, coloring, and reading—to take your mind off your eczema
Open communication is also very important. Ask your clinician as many questions as you can. Bring a family member or friend to doctor visits so that your support person can also be informed. Request as much follow-up as you need to get your questions answered. Remember, your caregivers are there because they want to help you. Working together with them is one of the most important aspects of your care!
References
- Sangha AM. Dermatological conditions in skin of color: Managing atopic dermatitis. J Clin Aesthet Dermatol. 2021;14(3 suppl 1):S20-S22. www.ncbi.nlm.nih.gov/pmc/articles/PMC8211323/pdf/jcad_14_3_s1_s20.pdf
- Free dictionary by Farlex. Quality of life. 2012. https://medical-dictionary.thefreedictionary.com/quality+of+life
- Kaufman B, Alexis A. Eczema in skin of color: What you need to know. https://nationaleczema.org/eczema-in-skin-of-color/
- American College of Allergy, Asthma & Immunology (ACAAI) and the Asthma & Allergy Network (AAN). Eczema in skin of color: Social and economic factors. https://eczemainskinofcolor.org/social-and-economic-factors/
- Dupilumab (Dupixent®). Prescribing Information. Regeneron Pharmaceuticals, Inc; 2024. https://www.regeneron.com/downloads/dupixent_fpi.pdf
- Tralokinumab (Adbry®). Prescribing Information. Leo Pharma A/S; 2023. https://www.leo-pharma.us/AdbryPI
- Lebrikizumab-lbkz (EbgylssTM). Prescribing Information. Lilly USA; 2024. https://pi.lilly.com/us/ebglyss-uspi.pdf
- Simpson, EL. et al. Dupilumab treatment improves signs, symptoms, quality of life, and work productivity in patients with atopic hand and foot dermatitis: Results from a phase 3, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2024:90:1190-1199.
- Chu DK, et al. Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE– and Institute of Medicine–based recommendations. Ann Allergy Asthma Immunol. 2024;132:274-312.
- Davis, DMR, et al. Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies. J Am Acad Dermatol. 2024;90:e43-e56.
- Healthline. Targeted Treatments for Eczema: Everything You Need to Know. 4/13/22. https://www.healthline.com/health/eczema/biologics-for-eczema
- What is Eczema. National Eczema Association. Medically reviewed January 27, 2025. Accessed June 23, 2025. https://nationaleczema.org/eczema/
- Managing Stress From Eczema. National Eczema Association. Medically reviewed May 05, 2025. Accessed June 23, 2025. https://nationaleczema.org/eczema-management/stress/
- Crane MW. Living well with eczema (and all the ways to do it). Available at: https://nationaleczema.org/how-to-live-well-eczema/
- National Eczema Society. Living with eczema. 2023. https://eczema.org/information-and-advice/living-with-eczema/
All URLs accessed September 23, 2024.