Eczema is a condition in which patches of skin become inflamed, itchy, cracked, and rough. Some types can also cause blisters.
Different types and stages of eczema affect 31.6 million people in the United States, which equals more than 10% of the population.
Many people use the word eczema when referring to atopic dermatitis, which is the most common type. The term atopic refers to a collection of conditions that involve the immune system, including atopic dermatitis, asthma, and hay fever. The word dermatitis refers to inflammation of the skin.
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In June 2022, the FDA approved dupilumab (Dupixent) for children as young as 6 months. This biologic was first approved for ages 18 and up in 2017. Dupilumab is an interleukin inhibitor and blocks the effects of proteins called cytokines that increase inflammation, weaken the skin barrier, and cause severe itching.
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In the last year, the FDA has approved three new eczema treatments in a class of drugs called Janus kinase (JAK) inhibitors. A fourth drug is under review. These drugs block JAK enzymes, which play a part in driving the abnormal immune responses that lead to eczema symptoms.
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Ruxolitinib (Opzelura) is a medicated cream you spread on your skin. The FDA approved it in September 2021. This new option is a promising alternative if you need treatment other than a topical steroid, but your eczema isn’t bad enough for oral medication.
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Doctors can prescribe one of the two newly approved oral JAK medications, abrocitinib (Cibinqo) and upadacitinib (Rinvoq), if you have severe eczema on a large part of your body and you’ve already tried a systemic eczema medication like a biologic. You take them once a day.
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If you can’t use cyclosporine as a treatment, there may be an alternative coming through the pipeline. Baricitinib (Olumiant) is another pill version of a JAK inhibitor still awaiting FDA approval. Doctors hope it can treat very severe eczema cases.
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In December 2021, the FDA approved tralokinumab (Adbry) as a second biologic drug to treat moderate to severe eczema. Unlike dupilumab (Dupixent), which is for all ages, this new injectable drug is only for adults 18 and up. It works by blocking certain proteins responsible for the inflammatory response that causes eczema symptoms.
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Roflumilast is a medicated cream that is a PDE4 inhibitor like crisaborole (Eucrisa), but studies show it may be even more potent. It was recently approved for use in people with plaque psoriasis and is now in phase III trials as a possible option for treating atopic dermatitis.
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Tapinarof is the first in a new class of topical drugs called therapeutic aryl hydrocarbon receptor modulating agents (TAMA). These drugs inhibit two pro-inflammatory pathways that lead to itchy, inflamed skin. Tapinarof is approved for treating plaque psoriasis and is in phase III trials for atopic dermatitis.
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Researchers are looking into whether treating “bad” bacteria on the skin by using “good” bacteria will help prevent damage to the skin barrier. Some clinical trials show promise for bacteriotherapy creams or sprays that reduce symptoms with fewer side effects such as stinging.
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Light therapy, or phototherapy, uses a machine with UV rays to slow down the inflammatory response in skin. Treatment typically involves UVB light or a combination of UVB and UVA light. Researchers are doing clinical trials to better understand which UV light or lights will work best.
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