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How To Talk to Your Doctor About Prescription Eczema Creams

Posted on August 18, 2022
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Joan Grossman

  • Researching prescription eczema creams can help you talk to your doctor about your treatment options.
  • Preparing for a doctor’s visit with notes and photographs is important for effective communication.
  • Open and honest communication with your doctor is essential.

To get the best results with prescription eczema creams, it’s important to talk to your doctor effectively. Clear communication with your doctor about your experiences, expectations, and needs can help you get better relief from eczema symptoms.

Eczema, also called atopic dermatitis, can cause skin to be itchy, dry, scaly, and red or discolored. It’s thought to be caused by a combination of genetic and environmental factors that affect the immune system and skin barrier. Eczema can occur at any age and commonly affects children. It’s a chronic condition for which there’s currently no cure, so treatment is focused on managing symptoms and controlling the disease.

Eczema symptoms, such as dry and itchy skin, can be managed with:

  • Topical treatments, including both over-the-counter (OTC) and prescription creams
  • Antihistamines
  • Light therapy (ultraviolet phototherapy)
  • Complementary and alternative treatments, including wet wraps, moisturizers, and gentle, nonirritating fragrances, lotions, soaps, and detergents

Doctors sometimes recommend prescription oral medications and injectable biologics when topical treatments are ineffective at controlling flare-ups.

It’s not uncommon for people with eczema to express frustration about talking to their doctors. “I’m trying to get to the bottom of this skin condition and it seems like I have to pull teeth with doctors to get any answers,” said one MyEczemaTeam member.

Another member wrote, “I feel I don’t get the full support of my dermatologist. Anyone else feel this way? I get the repeated questions … are you doing this and that?”

Although these sentiments may be familiar, there are steps you can take to help improve communication with your doctor and increase your satisfaction with prescription topicals and your quality of life.

Learn About Your Treatment Options

There are four types of prescription eczema creams approved by the Food and Drug Administration (FDA) for the treatment of eczema. Understanding eczema treatment options can give you more confidence in discussing prescription topicals that might be appropriate for you.

Be aware that each topical medication has a risk of side effects, which you should discuss in detail with your doctor. It is also essential to discuss proper treatment use and protocols. “Do research and ask a lot of questions,” one MyEczemaTeam member said. Another member agreed, “You have to work with your dermatologist and do some research as well.”

Types of prescription creams for eczema include the following:

Janus Kinase Inhibitors

Janus kinase (JAK) inhibitor creams are a newer form of topical treatment for eczema. They work by blocking certain inflammatory pathways in the immune system. Ruxolitinib (Opzelura) is currently the only JAK inhibitor currently available as a topical medicine for treating eczema. It’s approved for short-term use in people over 12 years old who are not immunocompromised and for whom other topical prescription therapies aren’t effective or advisable. JAK inhibitors all have black box warnings, assigned to medications with potential dangerous side effects.

Calcineurin Inhibitors

These drugs also target the immune system and block particular cells that cause eczema inflammation in the skin. Tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel) are topical calcineurin inhibitors that are available for both children and adults.

Phosphodiesterase 4 Inhibitors

Phosphodiesterase 4 (PDE4) inhibitors block an inflammatory enzyme in the immune system. Crisaborole ointment (Eucrisa) is the one topical PDE4 inhibitor available for the treatment of eczema.

Corticosteroids

Often called steroids, corticosteroids are hormones that help regulate a variety of functions, including immunity and inflammation. Topical steroids are derived from naturally occurring hormones. Steroid creams, gels, foams, solutions and ointments are available in different potencies and are usually used short-term to avoid serious side effects.

Ask About New Treatments and Clinical Trials

Scientists are continually working on developing and testing new treatments for conditions including eczema. Many of the newer treatments are injected or taken orally (by mouth) and are proving very effective at controlling atopic dermatitis. Ask your doctor about new treatment options that may become available in the near future. Clinical trials — research studies performed on people to evaluate treatments, procedures, and interventions — can give you access to new topical treatments that may provide benefits other medications haven’t. You may want to talk to your doctor about clinical trials to find out what may be involved and if you might be eligible for one.

Be Honest and Open With Your Doctor

It’s important to talk to your doctor about key aspects of your experience with eczema, such as:

  • How the condition affects your daily life
  • How satisfied you are with your prescription topical treatment plan
  • What treatment options you’re using and what side effects you may be experiencing

Communicate honestly and openly with your health care provider. If you are not using a prescription topical treatment as directed — perhaps because it is too complicated or messy — you need to tell your doctor. Using a topical treatment properly and maintaining skin care are crucial for best results with prescription creams.

Don’t ever change a prescription treatment plan without medical advice. There may be health risks associated with abruptly stopping a treatment. Your doctor may be able to provide advice on how to use a prescription topical treatment in a way that works better for you. Mixing certain prescription creams with moisturizers, for example, may reduce unwanted side effects. Otherwise, you can talk to them about switching treatments.

Make sure your doctor understands how eczema affects you on a day-to-day basis, and don’t minimize your experience. Explain your symptoms carefully, and tell your doctor if you are experiencing side effects. If you’re dissatisfied with your eczema prescription cream or have questions about other treatment plans, let your doctor know.

Prepare Carefully for Your Doctor Appointments

Seeing a doctor can be stressful, and stress can be distracting and may cause forgetfulness. Preparing for an appointment with your doctor ahead of time can help ensure that you cover all your questions and concerns in an organized and clear manner.

Here are some tips for preparing for a doctor’s visit:

  • Make a list of questions before your appointment and bring the list with you.
  • Bring a list of any other prescription medications or OTC topicals or lotions you are using.
  • In between appointments with your doctor, keep a journal of irritants and triggers, daily skin condition, and eczema flares.
  • Take pictures of your skin inflammation when it occurs. Concerning symptoms may not be apparent on the day you see your doctor.
  • Record your doctor’s visit or write down notes. You can also bring a friend or family member to take notes for you.

One MyEczemaTeam member described their concerns ahead of an upcoming doctor’s visit. “Two reasonably good days in a row after having a major flare last week. Wish I had a better sense of what triggers these flares. I can’t see my dermatologist until July so I will go in primed with a list of questions to ask,” they said.

You may want to ask your doctor for additional tests. “Since I had the allergy tests, I now know what to stay away from. These tests were the most brilliant idea because before this, I had been using the cream version of the prescription triamcinolone. I had to switch to the ointment version because it did not contain propylene glycol,” wrote a member.

Here are some conversation starters to help you express your concerns in a direct way with your doctor:

  • “I would like to discuss my concerns about my prescription topicals. I’ve brought some notes.”
  • “I have some symptoms that continue to be a problem for me. I brought some photographs I’d like to show you.”
  • “I need help with my current treatment plan. I don’t like the side effects.”
  • “I would like to talk about potential allergens.”

Get the Support You Need

You deserve a doctor who will listen to you. One MyEczemaTeam member said, “Let them know you want to talk to a doctor who will respect your wishes. That’s what I had to do for years!”

You may want to ask your primary care physician for a referral for a specialist if you’re not getting the care you need. “I will ask for a referral to see a dermatologist,” wrote a member.

In some cases it may be advisable to seek a second opinion or find a new doctor. “Saw my third dermatologist. He was wonderful and listened,” a member said.

Another member shared this uplifting message: “There is hope. New treatments are emerging that are helping. There is no panacea for eczema, but reading from folks on this site is encouraging. Find a physician/care provider who listens and is proactive regarding your concerns. Don’t give up.”

Talk With Others Who Understand

On MyEczemaTeam, the social network for people with eczema and their loved ones, more than 44,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Do you have questions or tips about talking to your doctor about prescription eczema topicals? Share your experiences in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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