Key takeaways
- Biologic drugs improve eczema symptoms by targeting specific parts of your immune system, while steroids reduce the activity of your entire immune system.
- Biologics can be a good option for people who have widespread eczema or those who have found other eczema treatments ineffective.
- If you’re switching from a steroid medication to a biologic, a dermatologist may recommend overlapping the two treatments to reduce the chances of an eczema flare-up.
Biologics for eczema are injectable medications that are taken every 2 to 4 weeks. They are antibody medications that are engineered from living organisms.
They work by “turning down” specific parts of the immune system that are overactive in people with eczema. By blocking these inflammatory pathways, biologic medications improve the itch and rash that people with eczema experience.
Steroids, on the other hand, work to suppress inflammation by lowering the immune system’s activity as a whole. They are much less targeted than biologic treatments.
A person may be a good candidate for biologic treatment if their eczema involves several different areas of their body, if their eczema has not responded well to prior topical treatments, or if their symptoms are having a significant impact on their quality of life.
Biologic medications for eczema are an effective treatment in people who may have tried other medications that have not worked, as well as in people whose eczema is too widespread to manage with topical medications alone.
Most people who use biologics experience a meaningful decrease in both itch and rash symptoms and thus an improvement in their overall quality of life.
Unlike some other systemic eczema medications, biologics do not broadly suppress the immune system, so they are a relatively safer treatment option.
Negative effects from biologic treatments for eczema tend to be rare but may include a skin reaction at the site of injection, eye irritation, joint pain, and cold sores or shingles. These medications are generally considered safe and well tolerated by most people.
If someone is taking an oral steroid to manage their eczema, their dermatologist may recommend overlapping treatment when starting a biologic to prevent a flare of their symptoms when they stop taking the oral steroid.
If a person is using a topical steroid, their dermatologist will likely recommend continuing to use that medication to treat any residual rash or future flares while they are taking the biologic medication.
Dr. Paul A. Regan is an ABMS board certified dermatologist who practices general medical and surgical dermatology in a private practice setting in Pennsylvania. His clinical interests include inflammatory skin diseases and skin cancer, and he is a fellow of the American Academy of Dermatology.