Medications
Medications for
atopic dermatitis include the following.
- Topical corticosteroids (such as
hydrocortisone, betamethasone, and fluticasone propionate) are the most common
and effective treatment for atopic dermatitis.5 They
are used until the rash clears and may be used to prevent atopic dermatitis
flares. Topical medications, such as creams or ointments, are applied directly
to the skin. Only low-strength topical corticosteroids should be used on your
face.
- Calcineurin inhibitors (pimecrolimus and tacrolimus)
are topical immunosuppressants—medicines that weaken your body's
immune system. However, Health Canada and the U.S.
Food and Drug Administration (FDA) recommend caution when prescribing or using
Elidel (pimecrolimus) cream and Protopic (tacrolimus) ointment because of a
potential cancer risk.6, 7
Health Canada and the FDA also stress that these medicines only be used as
directed and only after trying other treatment options. Calcineurin inhibitors
are expensive and are not usually covered under provincial drug plans. They are
not approved for children younger than 2 years of age.
- Antihistamines (such
as diphenhydramine and hydroxyzine) are often used to treat atopic dermatitis
itch and to help you sleep when severe night itching is a problem. However,
histamines are not always involved in atopic dermatitis itch and may not help
all people with the condition.2
- Oral
corticosteroids (such as prednisone and prednisolone) are used in severe
cases when the rash covers large areas of the body or when complications occur.
- Cyclosporine or
interferon is sometimes used in adults if other
treatment is not successful.
If the rash becomes infected,
antibiotic, antiviral, or antifungal medications are
used. Skin that has been broken down by scratching and inflammation can become
infected.
Coal tar preparations applied to the skin may help
reduce itching. They are sometimes used to control the condition after a
stronger medication has successfully improved atopic dermatitis.
Mild- to moderate-strength corticosteroids that are applied to the
skin, together with heavy moisturizing, are effective in reducing atopic
dermatitis rash in most cases. Specific treatment depends on the
type of rash you have.
If you or your child has a very mild itch and rash, you may be able
to control it without medication by using home treatment and preventive
measures. However, if symptoms are getting worse despite home treatment, it is
essential that you use medical treatment to prevent the itch-scratch-rash cycle
from getting out of control.
Leukotriene inhibitors, such as zafirlukast (Accolate) and
montelukast (Singulair), may have a role in the treatment of atopic dermatitis.
They are taken by mouth (orally) and reduce inflammation that may lead to the
rash. Azathioprine has been used in severe atopic dermatitis. It suppresses the
response of the immune system to reduce symptoms.