How to Treat Severe Eczema

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Severe eczema is typically treated with topical steroids or other oral options of varying intensities. Find out which medications are recommended to treat severe eczema with help from a dermatologist in this free video on skin care and eczema.

Part of the Video Series: Dermatology Treatments
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Video Transcript

Hi I'm Dr. Raphael Darvish with "Skinpeccable Dermatology and Cosmetic Laser Center" here in Los Angeles, California and I'm here today to discuss with you how to treat severe eczema. Eczema is an inflammatory condition on the upper layers of the skin. Sometimes it's triggered by different things such as stress and sometimes it's just there regardless of any particular trigger. There are a number of good treatments for eczema. The first most commonly prescribed treatment is a topical steroid. The most potent of the topical steroids are the Class 1 Steroids such as Clobetasol and they work very well. Class 2 and Class 3 Steroids are less potent and are prescribed generally after a short course of a Class 1 Steroid. So the doctor will prescribe a Class 1 Steroid maybe for like a week, ten days and transition the patient to a Class 2 or Class 3 Steroid because intense or potent steroid creams can cause thinning of the skin or telangiectasias which are broken capillaries in the area treated by a steroid cream for a prolonged period of time. In the case where you are responding to the steroids but you can't be on them long term because of the thinning of the skin and the telangiectasias and such, your doctor may opt to put you on a topical calcineurin inhibitor such as Tacrolimus. It works very well, not as well as the steroids in general but you don't have the side effects. Anti itching cream is also helpful if you have a lot of symptoms of itching. In the case where the steroids and the topical calcineurin inhibitors don't work, you have other options. Oral options include oral Prednisone. They help to really calm down the situation. This is something that you would take for a short course or even for longer than that but generally as a short course and it just helps to calm the situation down. Secondly there are UVA and Psoralen UVA or Puva treatments that are available and helpful. And lastly, the most intense treatments are some oral medicines such as Methotrexate and Cyclosporin that are very intense, very rarely used but reserved for the most intense of patients with eczema. So you can talk to your dermatologist and see if that's something that's right for you. I'm Dr. Raphael Darvish and that's a brief overview on how to treat severe eczema. Thank you.

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