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Should You Try a Biologic for Eczema?

By

Erin Azuse

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This content is created or selected by the Healthgrades editorial team and is funded by an advertising sponsor. The content is subject to the Healthgrades medical review process for accuracy, balance and objectivity. The content is not edited or otherwise influenced by the advertisers appearing on this page except with the possible suggestion of the broad topic area. For more information, read the HealthGrades advertising policy.

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PHYSICIAN CONTRIBUTOR

Treating Moderate to Severe Eczema

Because eczema can vary greatly in severity, a thorough understanding of treatment options is important.
female-nurse-holding-syringe

Eczema is a chronic skin condition characterized by patches of red, itchy skin. Standard treatments, including moisturizers and topical steroid creams, are helpful for many patients, but if your eczema symptoms aren’t improving as much as you would like, ask yourself the following questions: Is the itchiness caused by your eczema unrelenting? Have you developed skin infections because of your constant scratching? Is a large portion of your body affected? If you answered “yes,” a new line of treatment known as biologic therapy, also called biologics, may be right for you.    

Biologics target the root of inflammation.

The medical community has been touting the benefits of biologics for some time. Biologics are being used to treat a variety of medical conditions, including asthma, cancer, arthritis, and inflammatory bowel disease; more recently, eczema has joined the list.

Caring for sensitive skin and eczema can be challenging, but with the right tips and tricks, you can give your skin the love it needs.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Apr 28, 2017

2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

Biologics are different than the kinds of drugs we are most familiar with, like ibuprofen or antibiotics. Traditional drugs are made from chemicals. Biologics, on the other hand, are made from living cells, often human or animal proteins. They are difficult to create and are very sensitive to changes, such as temperature or the way they are handled.

Biologics are considered targeted therapies because they can act on very specific points in your body’s immune response. Your immune system helps protect your body from harmful things like bacteria and viruses through the process of inflammation. There are special proteins in your body that trigger and coordinate this immune response. Sometimes, though, your immune system mistakenly attacks its own tissues, causing chronic inflammation. This is where biologics can help—they can find and block those special proteins that trigger the overactive inflammatory response, so inflammation decreases or doesn’t occur at all.

The first biologic was recently approved to treat atopic dermatitis.

The term “eczema” is actually an umbrella term encompassing several different types of inflammatory skin conditions. Of these, atopic dermatitis is the most common form. It often starts in childhood, but can occur at any age. People with atopic dermatitis tend to have a genetic predisposition to develop allergic diseases, including asthma and hay fever. The U.S. Food and Drug Administration (FDA) approved dupilumab (Dupixent), a biologic, to be used for adults with moderate to severe cases of atopic dermatitis after clinical trials showed promising results.

Researchers have discovered some of the specific immune proteins involved in the inflammation that occurs with atopic dermatitis: interleukin-4 (IL-4) and interleukin-13 (IL-13). Dupilumab blocks these proteins, slowing down the immune response and inflammation, therefore decreasing atopic dermatitis symptoms.

As with any treatment, there is a risk of having a serious allergic reaction to dupilumab. Other possible side effects include:

  • Redness, pain, or swelling at the injection site

  • Cold sores in the mouth or on the lips

  • Pink eye

  • Inflammation of the cornea

You should always be followed closely by a doctor anytime you start a new treatment.

New eczema treatments are expected in the future.

In the past, patients who had eczema that didn’t respond to topical treatments were sometimes given strong medications that suppressed the entire immune system. While these medications may have worked to treat eczema, they also carried the risk of severe side effects, including damage to the liver and kidneys. This is why the success of dupilumab is so exciting; it offers symptom relief without impacting the whole immune system or causing dangerous side effects.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 28, 2017

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Atopic Dermatitis. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/eczema/basics/definition/con-20032073
  2. Biologic Therapy. National Eczema Association. https://nationaleczema.org/eczema/treatment/dupixent/
  3. Dupilumab, a Monoclonal Antibody for Atopic Dermatitis: A Review of Current Literature. Medscape. http://www.medscape.com/viewarticle/861428_3
  4. FDA Approves New Eczema Drug Dupixent. US. Food and Drug Administration. https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm549078.htm
  5. Management of Difficult-to-Treat Atopic Dermatitis. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/Managemen...
  6. New Biologic is ‘Potential Blockbuster’ for Eczema Treatment. Medscape. http://www.medscape.com/viewarticle/876704
  7. New Era of Biological Therapeutics in Atopic Dermatitis. Expert Opinion on Biological Therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819721/
  8. Understanding Biologic Drugs. National Eczema Association. https://nationaleczema.org/understanding-biologic-drugs-2017/

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