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Atopic dermatitis is a chronic ailment which affects millions worldwide. This ailment is characterized by itching and inflammation of the skin, which practically hinders everyday activities from sleeping, working, and mingling with people. To some, the management of eczema becomes a lifetime journey, especially when everything fails.Prescription drugs can effectively contain the flare-up; though lifestyle changes such as mild cleansing and constant moisturizing help toward managing it, nothing-from over-the-counter to home treatments has worked for many. There are so many treatments available that the question of which topical prescription creams will do the best relief to symptoms of eczema can be asked. New studies bring some answers to questions about what will now be the most useful topical medications for atopic dermatitis and a new way of looking at hopeful patients. Atopic dermatitis presents itself as a type of eczema, wherein the most superficial skin layers are affected. The facial areas, hands, feet, etc., and other areas, including skin folds such as the elbows and behind the knees, are the common manifestations of this condition. Indeed, the determining triggers for eczema are still unknown at this point; but some of the trigger factors may include genetics, environment, and, in most instances, an overactive immune system. In fact, it is the immune system response that leads to skin inflammation and to an uncontrollable itch.Finally, scratching may provide some short-term relief from itching, but over time, the condition is actually aggravated. The teeth of scratch continue to induce the development of productivity and inflammation pain. The rash is further induced by skin tearing and possible infection from ooze and crust.Recent Research Advancement?This year, the Journal of Allergy and Clinical Immunology released the results of more than 200 randomized controlled trials involving over 43,000 patients with atopic dermatitis. The experiments examined nearly 70 different topical agents, including corticosteroids, JAK inhibitors, phosphodiesterase 4 inhibitors, calcineurin inhibitors, and other topical agents.. Considerations for determining the most efficacious therapy included:Good quality of lifeControl of eczema symptoms (eg, itch, flare, or inability to sleep)Serious side effectsRates of discontinuation due to adverse effectsWhat Treatments Proved to Be Most Effective?The study pointed out a handful of therapy options that were very efficacious. According to the research, the most effective cream and ointments are:Calcineurin Inhibitors: Drugs such as pimecrolimus (Elidel) and tacrolimus (Protopic) had been deemed among the more effective medicines in the study by the investigators. In particular, pimecrolimus did best, achieving six out of seven objectives, including amelioration of sleep disturbance and eczema flare-ups. Additionally, high-dose tacrolimus (0.1%) showed efficacy in reducing itch and inflammation while improving five out of the seven outcomes evaluated.Moderate-Potency Corticosteroids: Moderately potent topical corticosteroids are rated quite high, including fluocinolone acetonide (Synalar cream 0.025%) and triamcinolone acetonide (Kenalog cream/ointment 0.1%). In particular, these steroids relieved itching and flares associated with eczema significantly less than stronger corticosteroids, but they were still effective. Such creams improved four to six of the seven outcomes evaluated in this study.So stated Dr. Connie Shi, a dermatologist at Brigham and Women’s Hospital, “What this essentially provides is in line with some of the therapies she prescribes.” According to her, the most potent topical steroid may be the most effective at lowering eczema severity. However, for long-term maintenance, she would also advise either moderate-potency steroids or non-steroid options to avoid any thinning of the skin due to the use of steroids.Surprising: Once or Twice DailyIndeed, the most surprising conclusion to draw from this study is the fact that topical creams applied once a day are as effective as ones applied twice. It is common practice to tell patients to apply their treatment twice a day; this study shows that applying it just once does not diminish its effectiveness. Most importantly, for many eczema patients, applying treatment just once a day may turn out to be a more practical and sustainable approach that will keep them compliant with their application habits.Which Treatment Remains to Be Less Effective?This study also mentioned treatments that are less effective in controlling atopic dermatitis. Among topical antibiotics, for instance, they were among the least effective treatments for reducing the symptoms of eczema. This is understandable, as eczema is not primarily caused by bacteria but rather by immunological malfunctions and skin barrier breakdown. Therefore, antibiotics may not actually provide the kind of relief needed for controlling eczema flare-ups.Should You Change Your Treatment Plan?Considering the many treatments available and the degree of individuality in eczema, it must be remembered that what may work for one patient does not necessarily work for another. Age of the patient, anatomical sites involved, severity of eczema, and possible adverse effects will all affect treatment choice.Continue maintaining whatever therapy regime works for you, should there arise a harmful side effect and should the therapy be irrelevant to the condition: “There is no point tampering with an effective kind of medication; however, if it does not prove satisfactory, then other alternatives should be discussed between you and your doctor or dermatologist for consideration.”If your treatment hasn’t brought results yet, or gives side effects, don’t hesitate to go to a health care provider who can help in going into the options, be it prescribing another cream, modifying the dosage or going for non-steroid treatments.Conclusion: Discovering What Is Right for YouEczema involves a battle, but there are weapons in that fight. Ideally, working with your health care provider should lead to the identification of an effective topical treatment that targets symptoms optimally while giving the best quality of life. Whether one discusses applicable treatments, some of the best in the business that research has recently gleaned or some other option, the goal is to break the itch-scratch cycle and to manage flare-ups with as little discomfort as possible.If you have not yet found the best eczema treatment for yourself, keep in mind that sticking it out really pays off as far as communication with your doctor is concerned. Keep trying different options until you find something that works.