How To Treat Eczema (Dermatologist Explains)
Summary
TLDRIn this informative video, Dr. Osama Hamdy, a dermatologist known as the 'Real Skin Doctor,' discusses various treatment options for eczema, a common skin condition affecting millions worldwide. He outlines lifestyle interventions like moisturizers, humidifiers, and bleach baths to manage symptoms. Prescription treatments include topical steroid creams and non-steroidal options like tacrolimus and Eucrisa. For severe cases, phototherapy and new biologic medications like Dupilumab are explored. The video also mentions experimental JAK inhibitors for resistant cases, emphasizing the ongoing need for treatment due to eczema's chronic nature.
Takeaways
- π Eczema is a widespread skin condition affecting millions, causing itchiness, discomfort, and impacting sleep and quality of life.
- π¨ββοΈ Dr. Osama, a dermatologist, offers evidence-based advice on eczema treatment options, including new life-changing methods.
- 𧴠Lifestyle interventions include using moisturizers like CeraVe or La Roche-Posay to reinforce the skin's barrier function.
- π§ Humidifiers are recommended to reduce water loss from the skin, especially during winter months.
- πΏ Reducing shower frequency and temperature can help retain skin moisture and reduce dryness.
- π Bleach baths can help control bacterial overgrowth on the skin, which contributes to eczema inflammation.
- π Prescription treatments include topical steroid creams that are anti-inflammatory and can be used safely for up to two weeks.
- πΏ Non-steroid creams like tacrolimus ointment and Eucrisa are safe for prolonged use and can be applied to sensitive areas.
- π Phototherapy involves exposure to specific light that reduces immune cells causing itchiness, and is covered by most insurances.
- π Dupilumab is a biologic injection targeting a key immune driver of eczema, providing significant relief with regular use.
- π JAK inhibitors are oral medications for resistant cases, offering potential but with more immune system impact.
Q & A
What is eczema?
-Eczema is a common skin condition where the skin's barrier function is compromised, leading to dryness, itchiness, and irritation.
How does moisturizing help with eczema?
-Moisturizing reinforces the skin barrier, reducing water loss and providing relief from dryness and itchiness associated with eczema.
Why is using a humidifier recommended for eczema patients?
-A humidifier increases the water concentration in the air, reducing the gradient for water loss from the skin, which is beneficial for eczema-prone skin.
What is the significance of taking less frequent and less hot showers for eczema sufferers?
-Less frequent and cooler showers help to minimize skin dehydration that can occur after showering, which can exacerbate eczema symptoms.
Can you explain the concept of bleach baths for eczema treatment?
-Bleach baths involve using a small amount of bleach in a full bath to reduce bacterial overgrowth on the skin, which can contribute to inflammation in eczema.
What role do topical steroid creams play in eczema treatment?
-Topical steroid creams are anti-inflammatory and are used to manage severe eczema symptoms. They are effective but should be used under medical supervision and with caution.
Why is it important to take breaks from using topical steroids?
-Taking breaks from topical steroids is important to prevent potential side effects on the skin and to allow the skin to recover.
What are some non-steroid topical cream options for eczema?
-Non-steroid topical creams such as tacrolimus ointment and Eucrisa ointment are safe for prolonged use and can be used on sensitive areas like the face.
How does phototherapy work for eczema treatment?
-Phototherapy uses a specific type of light, most commonly narrow band UVB, to reduce the number of immune cells causing itchiness in eczema, leading to remission.
What is Dupilumab and how does it treat eczema?
-Dupilumab is a biologic medication that targets a specific part of the immune system involved in eczema, reducing inflammation. It is administered through self-injections every two weeks.
What are JAK inhibitors and how do they relate to eczema treatment?
-JAK inhibitors are a class of oral medications being experimented with for eczema treatment. They have a more significant effect on the immune system than Dupilumab but are considered less safe.
Outlines
𧴠Eczema Treatment: Lifestyle Interventions and Topical Therapies
The first paragraph introduces eczema as a common skin condition affecting millions, causing itchiness and discomfort. It emphasizes the importance of treatment options, including lifestyle interventions. The speaker, a dermatologist, discusses the use of moisturizers like CeraVe and La Roche-Posay to reinforce the skin barrier, the benefits of humidifiers, the recommendation to take less frequent and less hot showers to retain skin moisture, and the unusual but effective practice of bleach baths to reduce bacterial overgrowth. The paragraph also covers prescription treatments, highlighting topical steroid creams as the primary treatment for eczema, with a discussion on their varying strengths and the importance of using them safely and effectively. It concludes with a mention of non-steroid topical creams like tacrolimus ointment and Eucrisa ointment as alternatives for long-term use.
π Advanced Eczema Treatments: Phototherapy and Biologics
The second paragraph delves into more advanced treatments for eczema that may be necessary when lifestyle changes and topical creams are not sufficient. Phototherapy is introduced as a treatment involving exposure to specific light, which reduces itchiness by targeting immune cells in the skin. Although effective, it requires regular visits to a dermatology office, which can be inconvenient. The paragraph also introduces newer treatments like Dupixent (dupilumab), a biologic medication administered through injections that targets a specific immune system component involved in eczema, leading to significant improvements. The speaker notes that while Dupixent is considered safe, it requires ongoing treatment as the body metabolizes the medication. Finally, the paragraph mentions experimental treatments like JAK inhibitors, which are oral medications used for severe cases of eczema that do not respond to other treatments, although they may have more side effects.
Mindmap
Keywords
π‘Eczema
π‘Skin Barrier Function
π‘Moisturizers
π‘Humidifier
π‘Bleach Baths
π‘Topical Steroid Creams
π‘Non-Steroid Topical Creams
π‘Phototherapy
π‘Biologics
π‘JAK Inhibitors
Highlights
Eczema affects millions of people worldwide causing itchiness, discomfort, and loss of sleep.
Treatment options for eczema can be life-changing.
Eczema occurs when the skin's barrier function is compromised.
Lifestyle interventions are the first line of treatment for eczema.
Moisturizers help reinforce the skin barrier in eczema.
Humidifiers can be beneficial for eczema-prone patients.
Taking less frequent and less hot showers can help manage eczema.
Bleach baths can reduce bacterial overgrowth on the skin.
Topical steroid creams are a main treatment for eczema.
Steroids are anti-inflammatory and can be used safely for short periods.
Non-steroid topical creams like tacrolimus and pimecrolimus are alternatives to steroids.
Phototherapy can be an effective treatment for severe eczema.
Dupilumab is a new biologic treatment for eczema that targets a specific immune system component.
Dupilumab requires long-term use for sustained eczema control.
JAK inhibitors are a newer class of medications being tested for eczema.
Eczema has no one-time cure and requires ongoing management.
The video provides a comprehensive overview of eczema treatments.
Transcripts
eczema is an incredibly common skin
condition that affects millions of
people around the world it causes
itchiness discomfort loss of sleep and
it really affects the quality of lives
of so many people in a profound way most
extra sufferers just give up and decide
that they're going to have to deal with
it but in this video i'm going to tell
you about the treatment options
available for eczema including some
newer ones that i think are truly
life-changing my name is osama aka real
skin doctor and i am a dermatologist
living and working in new york on this
channel i give evidence-based skin care
advice as well as talking about some
common dermatology conditions like this
video here about eczema so if you're
interested in this content make sure to
hit that subscribe button so let's kick
things off with a really brief
explanation of what eczema is eczema is
basically when your skin's barrier
function is no longer working
effectively and so you lose too much
moisture and water and you get dry and
irritated skin left behind when it comes
to extra treatment options the first
category that i'm going to discuss are
known as lifestyle interventions the
first major lifestyle intervention are
things like moisturizers which i have a
few examples of here this is cerave
moisturizing lotion which i'm a big fan
of and this is a similar laroche per se
product which i also like these are not
paid features i just happen to have them
in my bathroom now a moisturizer as an
intervention makes sense when you think
about the introduction i gave where i
explained that in eczema your skin's
barrier function is not working like
it's supposed to what you're doing is
reinforcing that skin barrier using this
artificial external layer kind of like
cement filling in the gaps between
bricks in a building and therefore your
skin's barrier becomes more effective
you don't lose as much water and so you
no longer have as dry and itchy skin
another example of a lifestyle
intervention that i think is great is
actually having a humidifier and i
recommend it to all of my eczema prone
patients especially in the winter months
a humidifier as the name suggests
increases the water concentration in the
ambient air in your room and because of
that there is less of a gradient for you
to lose water from the surface of your
skin to the outside air another useful
intervention i think is to take less
frequent and less hot showers that might
sound counterintuitive because when we
take a shower we're actually putting
water onto our skin but when that
surface water dries off it actually
leaves our skin more dehydrated after a
shower than before now i'm not
suggesting you guys stop showering and i
take no responsibility for any weird
smells that begin to emerge as a result
of this video all i'm saying is trying
to minimize the length of those showers
and try not to shower more than once per
day the final lifestyle tip is going to
sound weird but bear with me you can
actually do something called bleach
baths which involves taking clorox like
actual bleach a small amount of it like
half of a cap and putting that into an
entire bath full of water you then soak
the entire body beneath the chin in that
bathtub for around five to ten minutes
and the reason why this is effective is
because eczema sufferers actually have
too much of a specific type of bacteria
known as staph aureus taking over their
entire skin it's normal for all of us to
have bacteria on our skin but usually we
have different combinations of bacteria
that help to keep each other in check in
eczema sufferers they tend to have what
we call a monoculture of staph aureus
and that staphorious overgrows takes
over every other type of bacteria and
this leads to more inflammation in the
skin with a bleach bath you basically
nuke the entire surface of the skin get
rid of all of the staph aureus and all
of the other type of bacteria and then
you hope that it regrows in more of a
balance now you shouldn't be doing
bleach baths too frequently and i would
say a maximum of once a week or once
every two weeks depending on how your
skin handles it so moving on to the next
level of eczema and that is prescription
treatments you could be doing everything
right when it comes to your lifestyle
moisturizing frequently having your
humidifier on 24 7 but maybe your eczema
is so severe that you are going to need
prescription strength treatments the
main weapon we have against eczema is
topical steroid creams and the reason
for that is that steroids are
anti-inflammatory within the family of
steroids you can have mild steroids like
hydrocortisone one percent which is
available over the counter and then 2.5
percent which is prescription and you
can work your way up to a medium
strength like triumph syndrome which i'm
holding right here and even all the way
up to something like clobatazol which is
a top strength topical steroid cream as
a reflex some people don't like the idea
of using topical steroids because they
associate it with having harms to the
inside of the body but the reality is
that if you use a topical steroid cream
twice a day for up to two weeks maximum
at any one point in time you can
actually do it safely and effectively
although as always this is not medical
advice and you should always speak to
your own dermatologist after that
usually two week limit of using a
topical steroid consecutively you would
then be advised to take a break to make
sure that there's no side effects on the
skin and at that point there are also
non-steroid topical cream options and
you would hope that after that
short-term steroid use your skin is
calmed down enough that you can just
switch over to using the moisturizers
and it will stay under control for a
period of time because eczema is a
chronic condition you might have to
cycle between these periods of using
steroids and then taking a break and
using it and taking a break and it can
be really frustrating there are also
other types of creams which are
non-steroid anti-inflammatory options
and the most popular of these are
tachronymous ointment and eucrisa
ointment both of these are seen as safe
to use for prolonged periods of time
beyond two weeks consecutively and they
can also be used on places like the face
where we're otherwise a bit more scared
to use a topical steroid so what happens
if these topical creams fail or maybe
there's too much of the body involved
for the creams to be able to keep it
under control one great treatment option
is known as phototherapy this involves
going to usually a dermatology office
and standing in something called a light
booth the light booth emits this really
specific type of light most commonly
narrow band uvb and over time this light
therapy reduces the amount of a specific
type of immune cell in the skin which is
actually the first domino in the cascade
that causes itchiness in eczema it's a
great treatment super safe and covered
by most insurances but the main downside
is that you have to go in two to three
times a week usually for around eight to
ten weeks in a row that is a huge hassle
to anyone's schedule but if you're able
to complete that treatment usually
you'll go into a state of remission for
your eczema for around three to four
months at least now let's talk about
some newer treatments for eczema once
again i'm going to caveat that this is
not specific medical advice and you're
going to need to speak about this with
your own dermatologist but there is a
new type of treatment out for eczema
known as a dupilu map japinimab is a
type of medication known as a biologic
what that means is that it targets a
really specific part of your immune
system that is found to be a key driver
in eczema and it helps to turn the
volume down on that it's an injection
medication that people give themselves
at home every two weeks and it can lead
to absolutely life-changing results it's
actually considered to be a really safe
treatment as well and most providers
won't even require you to do blood work
at the beginning or during your
treatment with dupiluma but keep in mind
that it's a treatment you would have to
keep up for the long term there is no
one and done cure when it comes to
eczema your body breaks down dupilumab
and if you stop injecting yourself with
it every two weeks you'll find that in
around four to six weeks most of it
would have been broken down by your body
and your skin will go back to being
however it would have been without any
intervention and finally for those few
really resistant cases that don't
respond to even dupilumab there are even
newer medications that are being
experimented with right now especially a
class that are known as the jack
inhibitors the jack inhibitors are
actually tablet medications although
they do have slightly more of an effect
on your immune system and so they're not
considered to be as safe as dupilumab
however in some really resistant cases
they can still be absolutely
life-changing and a great medication for
those people so that is the a to z on
all of the eczema treatments that are
out there right now if you enjoyed this
video please consider dropping a like or
a comment down below and make sure you
check out the rest of the channel
because there might be some other videos
you find interesting too thank you so
much for watching and i'll see you in
the next one
Browse More Related Video
12 Life Changing Tips For Eczema: From a Derm with Eczema
Eczema (Atopic Dermatitis) | Atopic Triad, Triggers, Who gets it, Why does it happen, & Treatment
How to Treat ECZEMA | Black Brown skin | Dry Skincare Routine| The #1 Best Remedy for Eczema
Shrink Enlarged Pores Like a Dermatologist | Dr. Jenny Liu
Dermatologist eczema and dry skincare tips for winter | Dr. Jenny Liu
Get Rid of Back Pain Once and For All Diabetics!
5.0 / 5 (0 votes)