If you’ve been diagnosed with eczema, you might wonder how soon you will get relief from the flaking, scaling, and itching caused by this chronic skin condition. Some eczema treatments work faster than others, and it’s important to allow enough time before you decide whether a treatment is effective for you.
Your treatment plan will likely include some lifestyle changes, such as keeping your skin moisturized and avoiding triggers (e.g., dyes and fragrances). Usually, prescription medications will also be a foundation of your treatment plan. There are three general ways to treat eczema symptoms:
Here’s what you can expect after starting eczema treatments and using them consistently for different periods of time.
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The first day is generally too soon to see any effects of eczema treatment. However, it’s a good idea to start watching for adverse reactions and taking steps against sun damage and other possible sensitivities.
People with eczema often use topical corticosteroids (like cortisone cream) or other medicated creams to reduce skin inflammation and repair the skin barrier. Although most topicals work quickly and you might notice less itchiness, it’s unrealistic to expect significant visible improvements on the first day. Nonetheless, it can help to know that relief is on the way.
Often, topical steroids are more potent in ointment form, so be sure to ask your provider if an ointment is the right choice for you. It’s not unusual to feel a slight stinging or burning sensation the first few times you use a topical treatment, especially if you have sensitive skin. Storing the ointment in a refrigerator or other cool place might help reduce stinging.
You may be asked to do “soak and smear” or “wet to dry” wraps to enhance your skin’s moisturization and protective barriers. After a 15-minute soak in a lukewarm bath or shower, gently dab your skin with a towel so it isn’t dripping, and apply your topical corticosteroid to the affected areas. Cover the area with damp clothing, such as pajamas or a wrap, then put on dry pajamas. It’s typically recommended that you keep the wet wrap in place overnight but for at least four hours.
Cortisone creams and topical calcineurin inhibitors — tacrolimus (Protopic) and pimecrolimus (Elidel) — can increase your skin’s sensitivity to the sun. It’s important to wear sunscreen, sun-protective clothing, or a hat and avoid tanning once you’ve begun treatment. These actions also help lower your risk of skin cancer.
It’s rare but possible to have an allergic reaction to a topical corticosteroid or other skin cream. A mild reaction may consist of a rash and irritation, along with discoloration that could last a while after your flare has healed. A severe reaction may cause serious side effects like wheezing and chest tightness. If you experience symptoms that suggest a severe allergic reaction, stop using the medication, and call your doctor or seek emergency services right away.
Your first day on an oral medication for eczema involves developing new routines. Setting a reminder on your phone or pairing your dosage with other daily habits, like brushing your teeth, can make it easier to remember to take your meds as prescribed.
Many prescription oral medications, including cyclosporine, methotrexate, and upadacitinib (Rinvoq), also require ongoing blood work. On day one, it’s a good idea to set reminders on your calendar for upcoming lab work and dermatology appointments.
You won’t see improvements in your eczema from a single day of taking an oral medication, but you might experience some side effects. Medications like antibiotics or methotrexate, for example, can cause nausea shortly after they’re taken. If you notice side effects like an upset stomach, ask your doctor about anti-nausea pills or other strategies to help you feel better, such as taking your medication at night. Also talk with your dermatologist if you are or might become pregnant, because many of these medications can be harmful to a fetus.
Injectable medications are sometimes prescribed for more moderate to severe eczema. Injectables like dupilumab (Dupixent) are biologics, or genetically engineered molecules, that affect how the immune system functions. Newer agents like dupilumab and tralokinumab (Adbry) may have fewer systemic side effects and don’t require blood work. Dupilumab is typically used for severe eczema that doesn’t respond to other topical treatments in adults.
Injecting medication into yourself can feel intimidating, especially if you don’t work in the health care field. Your doctor may suggest you get your first dose in their office so that they can show you how to administer the injection properly. If you feel comfortable, you can administer the remaining doses to yourself at home — typically, every 2 weeks. Injectable medications should also come with an information sheet and a video tutorial to help reinforce your health care provider’s guidance.
Most topical treatments will give you results within a few days, but systemic eczema treatments usually take a bit longer to start working.
You should start to see and feel improvement in your eczema symptoms after the first week of topical treatment. You may notice less redness, dryness, and itchiness. Any initial sensitive skin reactions to the topical should have subsided by now.
Once an eczema flare clears up, the use of most topicals is discontinued. For instance, over-the-counter hydrocortisone creams shouldn’t be applied for more than one week without checking in with your doctor because longer-term use can be harmful. Don’t use your topical treatment any longer than your doctor advises.
Oral medications may work faster in some people than in others. According to results of clinical trials for upadacitinib, some people experience itch relief after just two days of treatment. The full effects of oral medications like upadacitinib and methotrexate may take a few months. Cyclosporine generally helps improve eczema symptoms within one to two weeks.
Everyone responds differently to eczema treatment, so try to be patient if you don’t see significant improvements after a week. Your provider might suggest other therapies to keep your symptoms from getting worse while you’re waiting for pills to reach their maximum effect.
After giving yourself a dose or two, you’ll have some experience with self-injection and should feel more confident about administering your treatment at home. If you do have questions or concerns, don’t hesitate to ask your dermatologist for another tutorial.
You may not notice any improvements in your eczema symptoms after just one week on an injectable medication. However, if you have new or worsening symptoms, be sure to tell your doctor about them.
Most eczema medications should start working within one month of treatment. Talk to your doctor if you don’t see any improvement in your symptoms. You may need to try a higher dose or a different type of medication.
Topical treatments, including calcineurin inhibitors and steroids, are usually meant for only short-term use on affected areas. Although some research suggests that long-term use can be safe and effective for treating eczema, talk to your doctor before you try using these medications for longer than a couple of weeks.
If your eczema symptoms didn’t ease up after short-term use of a topical medication, ask your dermatologist about trying a different topical or another type of treatment.
Although oral medications may start working within one to two weeks, your skin might continue to improve for up to three or four months after starting treatment. For example, it might take at least two months for methotrexate to start producing noticeable improvements. Even if you don’t see or feel a change after one month, keep following your doctor’s instructions and check in with your provider if you have any concerns.
For dupilumab, clinical trials showed significant improvements in itchy skin in as little as two weeks. While you should see some improvement in the first month of treatment, it typically takes three or four months to see maximum benefit. If not, talk to your doctor, and keep in mind that improvements can continue through the 16-week mark and even one year into treatment.
Eczema is a chronic condition that requires ongoing management. Because there’s no cure, many people remain on a lifetime treatment plan. Fortunately, by six months, you should have a good idea of whether your treatment is working for you. If it’s not managing flares and your skin’s health, it’s time to ask about clinical trials or explore other options to get your skin under control. For example, your dermatologist might suggest you try phototherapy (treatment with specific types of light) two or three times a week if you have severe eczema and a low risk of skin cancer.
People on long-term systemic treatments for eczema may require ongoing monitoring. For instance, if you’re taking methotrexate, you should get blood work every two to three months to check your blood cell counts and see how your liver and kidneys are handling treatment. It’s a good idea to stay away from alcohol (which can contribute to liver damage), and let your doctor know if you’re planning to have surgery or dental work or to travel, since you’re at higher risk of infection while on treatment. It’s easy to become complacent after six months or more of treatment, but taking extra steps to improve your skin care is still essential.
Medications like dupilumab can require at least four months to produce significant results. Staying consistent with your injectable eczema treatment for at least six months will help you determine if it’s a good fit for you.
Because eczema is a chronic condition, and your treatment journey may have ups and downs, it can be helpful to talk to other people who understand what you’re going through.
MyEczemaTeam is the social network for people with eczema (such as atopic dermatitis) and their loved ones. Here, more than 46,000 members from around the world come together to ask questions, offer support and advice, and connect with others who understand life with different types of eczema.
What are some eczema treatments you’ve tried? How long did it take until you noticed any results? Did you have side effects? Share your experience in the comments below, or start a discussion on MyEczemaTeam.