I am 35 with eczema flare-ups. What treatments are safe?

Question

Hello doctor,

I am a 35-year-old woman who has been struggling with itchy, dry, and red skin patches on my arms and legs since childhood. Lately, my eczema has flared up more often, especially around my period or when I am stressed.

I also have sensitive skin that reacts badly to perfumes and detergents. Can you give your suggestions on:

Are there long-term treatments that can control eczema without causing thinning of the skin?
Can hormonal changes or diet make eczema worse in women?
I am worried about using steroid creams for too long. Are there safer options to keep my skin calm and moisturized daily?

Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your description, such as chronic itching, dry, red patches, sensitivity to perfumes or detergents, and flares associated with stress or menstrual cycles, your condition is most consistent with atopic dermatitis (eczema).

I am going to give you a few long-term non-steroid options, which include both lifestyle modifications and medications that you can consider.

For topical medications, you can use topical calcineurin inhibitors (TCIs) such as Tacrolimus ointment 0.1 percent for the body and 0.03 percent for the genital or facial areas.

These help reduce inflammation without causing skin thinning. Another option is Crisaborole ointment, which is also steroid-free and suitable for long-term maintenance.

You may use mild to moderate steroid creams or ointments, such as Clobetasol or Betamethasone, for 15 days, followed by switching to steroid-free options for another 15 days to help avoid skin damage. You can also consider biologic therapy like Dupilumab for long-term disease remission.

Regarding your query, hormonal changes can make eczema worse. Periods (due to a drop in estrogen), stress, and pregnancy can worsen atopic dermatitis.

A few lifestyle modifications that can help you are:

Avoid perfumes, colored soaps, nickel jewelry, carpets, and pets.
Wear 100 percent cotton clothing.
Use a generous amount of emollients.
Apply ceramide-based moisturizers and petroleum-based moisturizers frequently to keep the skin barrier strong.

I hope this helps you.

Thank you.