Is It Time to Change Your Severe Atopic Dermatitis Treatment?

That’s why it’s important to reach out to your doctor if you aren’t satisfied with how well your medication regimen is managing your eczema symptoms, says Melissa Piliang, MD, a dermatologist at Cleveland Clinic in Ohio.

“Because our bodies are unique, we all respond to different medications in different ways. On top of that, we have different personal preferences,” Dr. Piliang says. It may take some trial and error, but there are several options for managing atopic dermatitis, she says.

Signs It’s Time to Check on Your Atopic Dermatitis Treatment

Not sure if your current regimen is working as well as it should? Here are some of the most common signs that it’s time for a check-in with your doctor.

1. You’re Experiencing New or Worsening Symptoms

“If your eczema is under control — for example, your regular regimen of moisturizing your skin and using topical medications is working — you probably don’t need to check in with your dermatologist,” says Piliang. “But if you suddenly develop areas where your medicines aren’t working, you develop itching, or things get a lot worse overall, you should call your doctor.”

Even if your atopic dermatitis is largely under control, it’s possible that it changes over time. Sometimes people come into contact with a new irritant or develop a new allergy that causes the condition to flare and affects how well the medication works, according to Piliang.

Outside stressors can also affect your condition and bring on flares, she says. “Maybe you’re doing fine on your regimen and then something happens — an example would be the COVID-19 pandemic — and your stress levels go through the roof. When that happens, your treatments may not work like they did before,” she says.

2. You’re Tired of Keeping Up With Your Skin-Care Routine

It can take a lot of effort to keep your atopic dermatitis symptoms at bay, so it’s not surprising that you may be tempted to give up your skin-care regimen altogether at times. “Sometimes people just get fed up with it,” Piliang says.

The problem is that when people stop sticking to their routine, they tend to experience a flare, she says. If you’re getting tired of your skin-care treatment — for example, it’s too time-consuming — talk to your doctor before you stop it. “We can help,” she says.

3. You Started a New Treatment but Can’t Cope With Worsening Symptoms

Sometimes a drug can take a few months to start working. In the meantime, it might be hard to deal with any worsening symptoms, Piliang says. It’s always a good idea to ask your doctor how long it takes for a new medication to kick in, she says. This way, you can cope with your symptoms as well as possible until then.

If you’re absolutely miserable and you have to wait longer than you’d hoped — maybe two to three months before starting to feel better — your doctor may be able to prescribe an additional medication that will help ease your symptoms until the first one kicks in, Piliang says. “Sometimes we’ll do a round of systemic steroids in the beginning to tamp down the inflammation and give the [new] medication time to work,” she says.

4. Your Symptoms Are Interfering With Your Day-to-Day Plans

Atopic dermatitis can really affect your quality of life. “Especially if you have moderate to severe eczema, it can impact school performance, work performance, and relationships with family and friends,” says Piliang.

If you find yourself missing out on activities because of your atopic dermatitis symptoms, in either your work or personal life, you should talk to your doctor about changing up your treatment.

5. Your Health Insurance Changes

It happens all too often: You and your doctor have tried different medications and found the ones that work for you, but then your prescription drug coverage changes. When that happens, you may not know whether your insurance will continue covering your current medications. “It can be really discouraging and frustrating,” Piliang says.

But if you talk to your doctor, they can send a letter to your insurance company explaining that you’re being treated successfully with a certain medication, and hopefully, the coverage can continue, she says. “It takes a lot of work on your doctor’s part and on your part to get that to happen, but that’s something you can work on with your dermatologist,” she says.

6. The Side Effects of Your Medication Are Bothering You

The side effects of atopic dermatitis medications, including itching, stinging, and burning, can be very bothersome, says Piliang. Plus, if you’re using a topical medicine, you may not like how it feels on your skin.

“Some of the ointments we use for eczema can be greasy. When you put it on, it gets all over your clothes and leaves stains, so you don’t want to use it,” she says. If you don’t want to use the medication because of the side effects or how it is applied, that’s a sign that you may want to try a different treatment.

7. Your Previously Well-Managed Symptoms Are Coming Back, Despite Following Your Treatment as Directed

“If your treatment stops working as well as it once did, that’s a time to come in,” Piliang says. People sometimes feel bad when they have a flare, and that may keep them away from checking in with their provider, she says.

What Are My Options When It Comes to Changing My Atopic Dermatitis Treatment?

Once you’ve talked to your doctor about your concerns about your atopic dermatitis treatment, there are a few options you can explore together. Your doctor may suggest these changes:

• Switch you to a new treatment. There are times when it’s appropriate to switch treatments, according to Piliang. This can include if your symptoms aren’t well controlled or you’re experiencing unpleasant side effects from your current regimen.
• Do some trial and error to find the right treatment or combination of treatments. It can take some time to find the right eczema treatment, so you shouldn’t feel bad about telling your doctor if a medication isn’t working, says Piliang.

“If there were one perfect treatment that worked for everybody in the same way, we wouldn’t need all the different options that are available,” she says. “There’s no reason for you to suffer because your treatment isn’t the right one for you.”