Leading Edge Treatment Options for Eczema

April 07, 2021

eczema treatment

by Dr. Stacy Matthews Branch

Eczema is a form of atopic dermatitis and is a chronic skin condition that affects over 20 million children and adults in the United States. Eczema stems from an overactive immune system that causes inflammation and resultant skin damage. The skin is typically dry, scaly, extremely itchy, and develops rashes of varying appearance and coloration. The traditional mainstay of treatment involves environmental and lifestyle changes such as stress management, recognizing and avoiding triggers, use of skin moisturizes, and other self-care measures.

Pharmacologic intervention with topical corticosteroids or immunosuppressant ointments such as Elidel is an often needed approach to eczema. The latest eczema-specific drug approved by the FDA is Eucrisa (crisaborole). Eucrisa 2% ointment is a non-steroidal topical prescription medication labeled for use to treat mild to moderate atopic dermatitis in children and adults. It works by inhibiting an enzyme, phosphodiesterase-4, involved in immune-mediated inflammation via the release of cytokines (1). Various cytokines are found to be present at high levels in people with eczema (2). Clinical trials with Eucrisa suggest that it is safe and efficacious, but there are potential side effects such as stinging or burning at the site of application and allergic reaction.

Eucrisa can be applied to skin on any part of the body including the face, but is not to be applied to mucous membranes such as the mouth and vagina. In the case of lip eczema, it may be difficult to use Eucrisa because some of the medication could get into the mouth. The potential benefits of Eucrisa comes with an impressive price tag of over $600 for a 60 g tube, which can be prohibitive for those who are under- or uninsured, and prior authorization and failure with standard treatments may be needed for those with health coverage (3).

Seaside Medical’s Post-Traumatic Response Gel with MatrX B is a non-prescription product with natural substances beneficial for inflammatory conditions such as eczema. Unlike the case for Eucrisa, The Response Gel can be used on the lips because a small amount getting into the mouth is not associated with safety concerns. It has been reported as effective in relieving lip eczema without adverse effects and with long-term results. The Response Gel is a viable option for people with eczema who prefer a cost-effective, non-prescription, and natural option even for those with lip eczema.

 

References

  1. Woo TE, Kuzel P. Crisaborole 2% Ointment (Eucrisa) for Atopic Dermatitis. Skin Therapy Lett. 2019 Mar;24(2):4-6.
  2. Klonowska J, Gleń J, Nowicki RJ, Trzeciak M. New Cytokines in the Pathogenesis of Atopic Dermatitis-New Therapeutic Targets. Int J Mol Sci. 2018;19(10):3086. Published 2018 Oct 9. doi:10.3390/ijms19103086
  3. Castelli G, Schaffer M. Crisaborole (Eucrisa) for Mild to Moderate Atopic Dermatitis. Am Fam Physician. 2018 Sep 15;98(6):379-380.

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