Eczema Treatment

What Is Eczema?

Eczema is a group of conditions that cause inflamed, irritated, and intensely itchy skin. The most common form — atopic dermatitis — results from a combination of immune system dysfunction and a compromised skin barrier that allows moisture to escape and allergens and irritants to enter.

According to the American Academy of Dermatology, eczema affects approximately 25% of children and 10% of adults in the United States. About 60% of those with eczema develop it within their first year of life. While there is no cure, the condition is highly manageable with the right treatment plan.

Eczema is part of the "atopic triad" — a group of immune-related conditions that also includes asthma and allergic rhinitis. Many people with eczema have one or both of these conditions as well.

Types of Eczema

• Atopic dermatitis: The most common type. A chronic, relapsing condition linked to an overactive immune response. Most often begins in childhood.
• Contact dermatitis: Triggered by direct contact with an allergen or irritant — such as nickel, latex, fragrances, or certain cleaning products.
• Dyshidrotic eczema: Small, deep-set blisters on the palms, fingers, and soles. Often worsened by stress and seasonal allergies.
• Hand eczema: Affects the hands specifically; common in people who frequently wash their hands or work with chemicals.
• Neurodermatitis: Thick, scaly patches caused by a repeated itch-scratch cycle, often linked to stress or anxiety.
• Nummular eczema: Round, coin-shaped patches of irritated skin that may ooze or become crusty.
• Stasis dermatitis: Develops on the lower legs in people with poor circulation (venous insufficiency), causing swelling, discoloration, and skin breakdown.

Symptoms of Eczema

• Intense itching (pruritus) — often worse at night
• Dry, sensitive skin
• Red to brownish-gray patches
• Small, raised bumps that may weep fluid when scratched
• Thickened, cracked, or scaly skin
• Swollen, raw skin from repeated scratching
• In severe cases: skin infections from broken skin barrier

Eczema Treatment at Dermatology of Seattle

Because eczema varies widely in type, severity, and triggers, our dermatologists build individualized treatment plans for each patient. The goal is to restore the skin barrier, reduce inflammation, relieve itch, and identify triggers — minimizing flares long-term.

Skin Barrier Repair & Moisturization

The foundation of all eczema treatment. Regular, generous application of fragrance-free emollients immediately after bathing is essential to retain moisture and reduce flare frequency.

Topical Medications

• Topical corticosteroids — first-line anti-inflammatory treatment for flares
• Topical calcineurin inhibitors (tacrolimus/Protopic, pimecrolimus/Elidel) — steroid-free options for sensitive areas
• Topical PDE4 inhibitors (crisaborole/Eucrisa) — non-steroidal for mild to moderate eczema
• Topical JAK inhibitors (ruxolitinib/Opzelura) — fast-acting option for mild to moderate atopic dermatitis

Biologic Therapy

• Dupilumab (Dupixent) — FDA-approved injectable biologic targeting IL-4/IL-13; approved for patients 6 months and older with moderate-to-severe atopic dermatitis
• Tralokinumab (Adbry) — targets IL-13 specifically; approved for adults
• Lebrikizumab (Ebglyss) — another IL-13 inhibitor approved for adults

Oral Medications

• Oral JAK inhibitors (upadacitinib/Rinvoq, abrocitinib/Cibinqo) — for adults with moderate-to-severe atopic dermatitis
• Short-course oral corticosteroids — for acute, severe flares
• Oral antihistamines — to reduce nighttime itching and improve sleep
• Oral antibiotics — when bacterial skin infection (Staph aureus) is present

Phototherapy

Narrowband UVB phototherapy is an effective, steroid-free treatment option for widespread or difficult-to-control eczema. Available at our Burien and Bellevue locations.