Los Angeles Allergist

Los Angeles Allergist

Alan Khadavi, MD, APC
  • Home
  • Meet Dr. Khadavi
  • Conditions We Treat
  • Your First Visit
  • Insurance Accepted
  • Allergy and Asthma Info
    • Asthma Info
    • Allergic Rhinitis
    • Allergic Triggers
  • Blog
  • Media
  • Contact Us

9001 Wilshire Blvd. Suite 204
Beverly Hills, CA 90211
Phone: 310-282-8822

16260 Ventura Blvd., Suite 140
Encino, CA 91436
Phone: 818-528-7776

January 20, 2015 by Alan Khadavi

Atopic Dermatitis (Eczema) Treatment

The mainstay of treatment for atopic dermatitis, also known as eczema has been topical steroids for years.  Atopic dermatitis has a prevalence in the United States between 9-18% of the population.  Approximately 50% of the patients develop the disease in the first year of life and 30% between 1-5 years of age.

For many years the only known treatment besides moisturizing was topical corticosteroids.  Over the last several years researchers have discovered different treatment options.

1. Bleach baths-The current recommendation is 0.005%.  To reach this concentration, 1/4 cup of bleach is added to a half-filled 40 gallon bath.  Twice weekly bathing showed that eczema severity significantly decreased.  Other studies have shown no significant difference.  Dry skin and burning are reported side effects.  This has been used as a maintenance therapy for Staphylococcus overgrowth.

2. Vitamin D-Studies have shown the beneficial effects of Vitamin D on the innate immune response in patients with atopic dermatitis.  Some studies have shown children with low Vitamin D have worse eczema.  Patients who took Vitamin D daily for 3 weeks showed improved innate antimicrobial protection.

3. Systemic Immunomodulatory Agents– In severe eczema, oral steroids are effective but they should not be used long term because of side effects.  Systemic immunomodulatory agents should be used instead.  Cyclosporine A is effective but it needs to be monitored closely.  Azathioprine has a slow onset of action and myleosuppression is a major potential adverse effect.  Other treatments are mycophenolate mofetil and methotrexate. Interfern gamma has also been used in severe patients.

4. Phototherapy– This is also another useful tool in severe eczema.  Narrow band UVB and broadband UVB are commonly used.  Skin malignancy and premature aging are potential long term risks.

5.  Allergy Specific Immunotherapy– Allergy shots can be effective for allergy induced eczema, they can be administered sublingually or subcutaneously.  They have been show to decrease topical steroid usage.  Studies have shown that patients with severe eczema showed significant improvements.  A study showed patients with atopic dermatitis allergic to dust mite given shots for 1 year could alleviate eczema.

6. Biologic Therapy– Omalizumab (Xolair), a monoclonal anti-IgE antibody has been used for severe eczema.  To date no studies show its efficacy for atopic dermatitis.  Other ones that have been used are Anti-TSLP, Rituximab and dupilumab, but all are not ready for clinical usage yet.

Dupixent (Dupilumab) for Atopic Dermatitis/Eczema

In conclusion, atopic dermatitis is an inflammatory skin condition that can have a chronic course.  Many patients are treated well with emollients or topical steroids.  However severe eczema may require advanced treatment options.

 

Filed Under: Blog, Pediatric

alan-khadavi
Dr. Alan Khadavi
Allergy & Asthma Specialist

Latest Posts

March 16, 2023

Does an Air Purifier help Asthma?

air purifier help asthma

March 13, 2023

Tezspire vs. Nucala vs. Fasenra vs. Dupixent for Eosinophilic Asthma, a comparison

Tezspire vs. Nucala vs. Fasenra vs. Dupixent

February 16, 2023

Cucumber Allergy can come in many flavors

cucumber allergy

February 10, 2023

Do Allergy Shots help Eczema?

Can allergy shots help eczema?

January 22, 2023

Is Benadryl Safe to use, or is it Time to Move on?

is benadryl safe

January 12, 2023

Airsupra for Asthma, a new rescue medication

airsupra

December 26, 2022

Cantaloupe Allergy comes in many flavors

cantaloupe allergy

December 23, 2022

Remibrutinib, a BTK inhibitor for Chronic Hives

remibrutininb

November 21, 2022

Eczema and Hard Water, is there a link?

eczema and hard water

November 19, 2022

Nucala, Fasenra or Dupixent for Severe Eosinophilic Asthma?

nucala fasenra dupixent

Read More Posts...

Follow Us…

© 2023 Allergy Los Angeles. All Rights Reserved · Log in · Return to top of page