Eczema Treatment: Systemic Drugs
Systemic drugs may produce rapid results. They affect the entire body, not just the eczema, and are among the most toxic forms of therapy.
Systemic drugs act on the entire body. They may be injected, injested, inhaled, or delivered through eye drops. Several drugs discussed may be incorporated into topical preparations to limit the body's exposure to the drug, targeting a more localized effect. Systemic drugs can carry significant side effects if used for too long or in the wrong areas, if used in too potent a dosage, or if stopped abruptly. Systemic drugs, if used as directed, can provide rapid relief from symptoms, and in many cases are a required part of a treatment program.
One common feature of eczema is a reduced skin barrier function. The skin is more susceptible to irritation and infection from environmental stimulus. In cases where eczema presents with an additional infection, such as from Staphylococcus aureus (bacterial), Pityrosporum ovale (fungal), or as eczema herpeticum (viral), systemic antibiotic / antimycotic / antiviral medication is often indicated.
In severe eczema, systemic drugs administered can include glucocorticoids, cyclosporin A (CyA), methotrexate, azathioprine (AZT), interferon gamma (INF-y), intravenous immunoglobulin (IVIG), and mycophenolate mofetile (MMF).
Biologic drugs have been administered for treatment of eczema, although this course of treatment for eczema is in much earlier stages of investigation than in its use for psoriasis. Reviews of the literature suggest that biologics are safe treatment for eczema, but that more research is required to prove efficacy and safety.
Traditional systemic drugs tend to have one or more of the following side effects:
- Decreased kidney function
- High cholesterol
- High blood pressure
- Upset stomach or nausea
- Skin sensitivity
- Dry or peeling skin
- Burning sensations
- Excessive hair growth
- Hair loss
Traditional systemic drugs are typically not administered to:
- Pregnant or nursing mothers due to birth defect risks
- Men or women attempting pregnancy
- Those with uncontrolled cholesterol levels
- Those with liver disease, or liver-affecting medications or behaviors such as alcoholism
- Individuals with compromised immune systems
- Those with a history of malignant cancer
- Those with kidney disease
Several other contraindications exist depending on the type of systemic.