How to treat my eczema along with autoimmune syndrome?

Question

Hi doctor,

I have been struggling with atopic dermatitis since childhood, and over the past few months, the flare-ups have become more frequent and intense. My skin feels constantly dry, itchy, and inflamed, especially around my neck, arms, and face. In addition, I was recently diagnosed with Polyglandular Autoimmune Syndrome Type 2, which includes Addison’s disease and Hashimoto’s thyroiditis. I am on daily corticosteroids and thyroid hormone replacement, but I am concerned that these medications, or the underlying hormone imbalances, might be contributing to my worsening skin condition.

Could my autoimmune status be making my skin more reactive or harder to treat? I am also worried about using topical steroids or immunosuppressive creams, given my adrenal issues. Are there safe treatments for my eczema that will not interfere with my endocrine therapy? Should I be cautious with certain skincare products or ingredients?

I feel like my skin and hormones are both out of balance, and I am wondering if I need a coordinated care plan between my dermatologist and endocrinologist to manage everything more effectively.

Please advise.

Answer 1

Hi,

Welcome to icliniq.com

Given your history of atopic dermatitis and Polyglandular autoimmune syndrome type 2, which includes Addison’s disease and Hashimoto’s thyroiditis, your skin may be more reactive and harder to treat.

Here is how we can address your condition:

Autoimmune activity and fluctuations in hormones can weaken the skin barrier, increase inflammation, and reduce healing capacity, leading to more frequent or severe flare-ups.
Long-term corticosteroid therapy for Addison’s disease can thin the skin, while thyroid imbalances may cause dryness and sensitivity.
Apply bland, fragrance-free emollients multiple times a day. Avoid products that contain alcohol or fragrances.
Use mild to moderate topical corticosteroids in short courses under supervision. Consider using topical calcineurin inhibitors (such as Tacrolimus or Pimecrolimus) to minimize steroid exposure.
Narrowband ultraviolet B (UVB) phototherapy is effective for eczema and is safe for your endocrine condition.
Treat any bacterial or viral infections early to prevent exacerbating your eczema.
Wear soft, cotton fabrics, avoid extreme temperatures, and manage stress to help minimize flare-ups.
Regular communication between your dermatologist and endocrinologist is essential to ensure that skin treatment and hormonal stability are well-balanced.

This combined approach aims to manage your eczema effectively while ensuring it does not interfere with your endocrine therapy.

I hope this answers your query.

Thank you.