Help with the Springtime Eczema Flares

While many are suffering from hayfever during the Spring season, a number of people are also suffering from skin itchiness and rashes. In the U.S., approximately 31.6 million people (10.1%) have some form of eczema. Eczema is an itchy, red, inflamed skin rash that tends to occur on the inner part of the elbows, behind the knees, back of the hands, eyelids, and face, but can be present on other body areas. Eczema is more common in children, but can persist into adulthood, and for some, it may even start as an adult.

Treatment for eczema includes moisturizers, emollients, topical corticosteroid creams, topical calcineurin inhibitors (such as Elidel or Protopic), topical PDE4 inhibitor (Eucrisa), and oral antihistamines (to help block the itch sensation). Avoidance of allergic triggers, such as pollen, dust mites, animal dander, and avoiding irritating skin products with harsh chemicals, dyes, or fragrances can also help minimize skin flare ups. When skin symptoms appear to be infected, treatment with oral antibiotics is sometimes necessary to help clear the secondary skin infection. In more severe cases, patients may be instructed to take diluted bleach baths to help treat bacteria on the skin that may be exacerbating their condition. Unfortunately, eczema is a chronic skin condition, meaning that it tends to persist for years (with flare ups and remissions). Until recently, this has been the cycle that so many children and adults have grown accustomed to.

In March 2017, the FDA approved a biologic therapy, Dupixent, for the treatment of moderate to severe atopic dermatitis (eczema). Biologic therapies are designed to target specific parts of the immune system that contribute to inflammatory diseases, such as atopic dermatitis. Dupixent (dupilumab) works by blocking a type of protein called an interleukin, or IL, from binding to the cell receptors. Dupixent specifically targets two interleukins thought to contribute to allergic diseases: IL-4 and IL-13. By blocking IL-4 and IL-13 from binding to the receptors, Dupixent helps to curb the immune system’s “over-reaction” that results in eczema. When the immune system is less reactive, the eczema rashes and skin itchiness tend to improve significantly. In clinical trials, more than half of patients using Dupixent for 16 weeks reported their AD symptoms were reduced by 75%.

Dupixent is currently approved for adults 18 and older, but is being studied in children and adolescents, as this population is significantly affected by eczema. Dupixent is given as an initial dose of 2 injections in the office, and then is taken as one injection every other week at home. It comes as a pre-filled syringe to help make it easier for patients to self-administer.

If you have eczema, particularly eczema that has been difficult to control or has not responded well to topical steroid creams, schedule a visit with one of our healthcare providers. We can discuss the treatment options that work best for you, beginning with allergy testing for environmental and food allergies, to help avoid allergic causes. We will also discuss whether you are a candidate for Patch Testing, which helps to identify causes of Allergic Contact Dermatitis (such as Nickel, Fragrance, Formaldehyde, Parabens, etc). Together, we can determine a treatment plan that is right for you!

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