Robert F. Kennedy Jr., Soon to Announce White House Run, Sows ...
What To Know About Calcineurin Inhibitors
Calcineurin inhibitors are topical and systemic immunosuppressants. They can help treat atopic dermatitis and autoimmune disorders such as lupus and psoriasis. They may also help prevent organ transplant rejection.
Examples of topical calcineurin inhibitors include pimecrolimus and tacrolimus ointments. Systemic calcineurin inhibitors include tacrolimus, cyclosporine, and voclosporin.
Calcineurin inhibitors work by blocking the protein calcineurin. Calcineurin plays a role in activating immune cells, such as T cells. By blocking calcineurin, the drugs prevent the activation of the immune cells, which in turn can help manage autoimmune conditions.
Read on to learn more about some common types of calcineurin inhibitors, the conditions they can treat, possible side effects, and more.
Cyclosporine can help treat conditions such as:
Cyclosporine is also used off-label for certain conditions. "Off-label" use is when a drug is approved for one purpose but is prescribed for a different purpose. Off-label uses for cyclosporine include:
Doctors may recommend cyclosporine on its own or alongside other medications.
Doctors may also administer cyclosporine to help prevent organ transplant rejection. In particular, you may require cyclosporine if you have one of the following transplants:
You typically need to take oral cyclosporine daily. It's available as a pill or in a liquid.
Cyclosporine is also available as eye drops to treat eye conditions such as dry eyes.
Doctors may recommend oral or intravenous (IV) tacrolimus alongside other immunosuppressants, such as azathioprine and mycophenolate, to help prevent organ transplant rejection.
In particular, doctors may recommend tacrolimus in cases of the following transplants:
Off-label use of tacrolimus can help prevent rejection of the following transplants:
It may also help lower the risk of pancreatitis following a liver transplant.
Topical tacrolimus in a 0.1% concentration can help treat atopic dermatitis in adults. Doctors may recommend topical tacrolimus in a 0.03% concentration for children ages 2 to 15 years.
Other conditions tacrolimus can help treat include:
Off-label, the medication may also help treat pediatric psoriasis that affects the face or genitals.
Topical pimecrolimus can help manage symptoms of mild or moderate atopic dermatitis. In the United States, it may be suitable for people over 2 years old.
Pimecrolimus can also help treat:
Voclosporin is an oral calcineurin inhibitor. In 2021, the Food and Drug Administration (FDA) approved it for the treatment of active lupus nephritis in adults.
Your doctor may recommend voclosporin alongside other immunosuppressants.
The side effects of calcineurin inhibitors can depend on the type of drug and whether it's topical or systemic.
Topical calcineurin inhibitors
Skin irritation is the most common side effect of topical calcineurin inhibitors.
Other side effects of topical calcineurin inhibitors can include:
Systemic calcineurin inhibitors
Systemic or oral calcineurin inhibitors may cause skin-based side effects such as:
It's important to let your doctor know about any side effects you experience. If side effects are severe, your doctor may recommend changing the type or dosage of medication.
Can calcineurin inhibitors be used to treat autoimmune disorders?Yes, calcineurin inhibitors can help treat autoimmune disorders. These include conditions such as lupus, rheumatoid arthritis, and psoriasis.
Yes, calcineurin inhibitors can help treat autoimmune disorders. These include conditions such as lupus, rheumatoid arthritis, and psoriasis.
What role do calcineurin inhibitors play in organ transplantation?T cells can play a role in organ transplant rejection. By blocking calcineurin, a protein that plays a role in activating T cells, calcineurin inhibitors can help reduce the likelihood of transplant rejection.
T cells can play a role in organ transplant rejection. By blocking calcineurin, a protein that plays a role in activating T cells, calcineurin inhibitors can help reduce the likelihood of transplant rejection.
How do calcineurin inhibitors affect T cells?T cells are a type of white blood cell, which is part of the immune system. The protein calcineurin plays a role in activating these cells. By blocking calcineurin, the protein is unable to activate the T cells, which in turn can help manage autoimmune conditions.
Learn about T-cell counts.
T cells are a type of white blood cell, which is part of the immune system. The protein calcineurin plays a role in activating these cells. By blocking calcineurin, the protein is unable to activate the T cells, which in turn can help manage autoimmune conditions.
Learn about T-cell counts.
Are calcineurin inhibitors used to treat skin conditions?Yes, calcineurin inhibitors can treat some skin conditions. They can help manage symptoms of autoimmune skin conditions such as psoriasis and vitiligo. They can also treat atopic dermatitis, which develops from an overreaction of the immune system.
Yes, calcineurin inhibitors can treat some skin conditions. They can help manage symptoms of autoimmune skin conditions such as psoriasis and vitiligo. They can also treat atopic dermatitis, which develops from an overreaction of the immune system.
Calcineurin inhibitors are a type of immunosuppressant. Topical calcineurin inhibitors include tacrolimus and pimecrolimus. Systemic calcineurin inhibitors include cyclosporine, tacrolimus, and voclosporin.
Calcineurin inhibitors can help treat atopic dermatitis. They may also be suitable for autoimmune conditions such as lupus, psoriasis, and rheumatoid arthritis.
Doctors may recommend calcineurin inhibitors to help prevent transplant rejection.
As with any drug, calcineurin inhibitors can cause side effects. These can include skin irritation, acne, and contact dermatitis. Systemic calcineurin inhibitors can also cause side effects such as diarrhea, muscle or joint pain, cramps, and more.
Speak with your doctor for information about whether they recommend calcineurin inhibitors based on your individual circumstances. They can advise on the possible benefits and risks.
How To Soothe Dry, Itchy Skin During An Eczema Flare-up
Your browser is not supportedusatoday.Com
usatoday.Com wants to ensure the best experience for all of our readers, so we built our site to take advantage of the latest technology, making it faster and easier to use.
Unfortunately, your browser is not supported. Please download one of these browsers for the best experience on usatoday.Com
Eczema: What Does It Look Like & How Can I Treat It?
Mariia Vitkovska / iStock
Eczema: What Does It Look Like & How Can I Treat It?This article was reviewed by Addie Ganik, MD, FAAD.
Eczema/Atopic DermatitisEczema is an umbrella term for a group of conditions that result in skin irritation and inflammation. The most common form of eczema, known as atopic dermatitis, is characterized by persistent itching, dryness, and inflammation that can flare up periodically.
When dermatologists talk about eczema, they're typically referring to atopic dermatitis, sometimes also called atopic eczema.
Researchers estimate that atopic eczema affects over 200 million people worldwide. In the United States, roughly 16.5 million adults and 9.6 million children are living with atopic dermatitis.
dragana991 / iStock
What Is Eczema/Atopic Dermatitis?Atopic eczema is a chronic skin condition that causes patches of skin to become dry, itchy, and inflamed. It most often has an early onset, with about 80 percent of cases developing in infancy and childhood. But it can also show up for the first time in teens and adults.
The condition tends to be chronic, though the majority of children with topic eczema grow out of it.
As mentioned, the term eczemaactually covers a group of conditions that lead to itchy, inflamed skin, with atopic eczema being the most common type.
Other eczema types include:
Contact dermatitis
Dyshidrotic eczema
Neurodermatitis
Nummular eczema
Seborrheic dermatitis
Stasis dermatitis
Though these conditions may result in similar-looking skin inflammation (dermatitis), they have different underlying causes and may require different treatments.
The conditions do have a shared feature, though: an overactive immune system, which makes someone more reactive to environmental triggers.
People with atopic eczema have an increased likelihood of developing allergic rhinitis (hay fever), asthma, and food allergies.
tylim / iStock
What Are the Symptoms of Eczema/Atopic Dermatitis?What does eczema look like? Symptoms of atopic eczema vary widely in terms of signs and severity. One person may have a single patch, while another might have large areas of their body flaring up.
Atopic dermatitis symptoms include:
Itchiness, often intense (the primary symptom)
Very dry skin (due to a weakened skin barrier), sometimes with scaly patches
Red, inflamed skin, sometimes with raised eczema bumps (due to the immune response)
Crusting or oozing (from scratching and inflammation)
Thickened, leathery skin (from chronic, long-term scratching)
Discoloration (over time, healed patches from acute eczema can look lighter or darker than the rest of the skin)
Patches of skin affected by atopic eczema are intensely itchy, often making it hard to sleep. This leads to persistent scratching, which can be hard to control. As a result, the skin becomes inflamed and may ooze, crust over, or bleed.
It's different for everyone, but on light skin tones, eczema appears red, while on darker skin tones, it can look purple, dark brown, or gray. Over the long term, repeated scratching can cause the skin to thicken and discolor.
Itching is the primary symptom, with many of the other signs resulting from the scratching. That's why atopic eczema is sometimes referred to as "the itch that rashes."
Not everyone with atopic eczema will experience all the symptoms. The condition is typically classified as mild, moderate, or severe, depending on the extent of symptoms, their intensity, and their impact on a person's daily life.
Moreover, atopic eczema typically follows a pattern of "waxing and waning," meaning the symptoms fluctuate over time. During periods of relative calm, the skin may appear clear or show only mild symptoms like slight dryness or itching. These periods can last days, months, or even years. However, atopic eczema can suddenly "flare," with symptoms worsening significantly and the itch-scratch cycle repeating.
Irina Esau / iStock
Where Does Eczema Show Up on the Body?Atopic eczema often affects specific areas of the body, which vary depending on age:
In infants and children up to two years old, eczema typically affects the cheeks, forehead, and scalp. They might also get patches on their arms and legs.
During childhood until puberty, eczema patches often appear on the neck, ankles, bends of the elbows, and back of the knees.
In teens and adults, eczema on the face can occur, as well as flare-ups on the arms, legs, knees, elbows, and hands. Some might see what they think is stress-related eczema on their hands, but the cause of hand eczema may be unknown.
Last but certainly not least, eczema can have a significant impact on quality of life. Its symptoms can be disruptive, interfering with sleep and other daily activities. It can also have profound effects on a person's self-esteem, particularly in severe cases.
Researchers have found that people with eczema are at a higher risk of anxiety and depression.
Prostock-Studio / iStock
What Causes Eczema/Atopic Dermatitis?The exact underlying cause of atopic eczema remains unknown, but it's thought to be a multifactorial condition. Factors like skin barrier disruption, immune system dysfunction, and microbiome alterations all contribute to the development and exacerbation of eczema.
And each of these factors is further influenced by genetics and environmental effects, making the condition a challenging puzzle to fully understand.
Delmaine Donson/istockphoto
Skin Barrier DisruptionPeople with atopic eczema often have a weakened skin barrier, making the skin more prone to dryness and irritation. This allows irritants, allergens, and bacteria to penetrate the skin more easily, leading to inflammation.
DepositPhotos.Com
Genes Contributing to EczemaResearchers have identified variations in several genes that contribute to eczema.
One notable example is the filaggrin gene, which codes for a protein essential for maintaining the skin's protective barrier — dysfunction in this gene results in an impaired barrier. Up to 30 percent of people with eczema have this variation in the filaggrin gene.
There's also a genetic component linked to an imbalance in lipids like ceramides. These lipids are crucial for the skin barrier's moisture retention. When they're out of whack, the skin barrier can weaken.
Kiwis/Istockphoto
Immune DysfunctionImmune dysfunction is another important piece of the atopic eczema puzzle. In folks with atopic dermatitis, the immune system tends to overreact to environmental factors.
This contributes to the chronic itchiness and redness seen with eczema.
AndreyPopov/Istockphoto
Skin MicrobiomeThe normal balance of microbes (tiny organisms unseen by the naked eye) on the skin is often disrupted in people with atopic eczema.
Some research suggests that those with eczema have a lower diversity of microbes on their skin and in their gut. They're also more likely to have Staphylococcus aureus(staph) on their skin.
Whether this is a cause or an effect of an impaired skin barrier and inflammation remains unclear.
insta_photos / iStock
Is Eczema Contagious?No, eczema isn't contagious — it's not passed through skin-to-skin contact.
nensuria / iStock
What Increases the Risk for Eczema/Atopic Dermatitis?Though the exact cause of atopic eczema isn't known, several factors can increase your risk of developing it. These are known as risk factors.
MonkeyBusinessImages
Risk Factors for Eczema/Atopic DermatitisThe three main well-established risk factors for atopic eczema are:
Family history. A family history of atopic disease — atopic eczema, asthma, or allergic rhinitis (hay fever) — significantly increases the risk of developing atopic eczema. The risk for a child is even higher if both parents have atopic conditions.
Personal history. People who have one atopic condition are more likely to develop another one.
Filaggrin gene mutation. Filaggrin is a protein involved in skin barrier function. As noted, about 30 percent of those with atopic eczema produce a faulty protein due to a mutation in the gene. This leads to a weaker skin barrier and contributes to the risk of developing atopic eczema.
nortonrsx / iStock
How Is Eczema/Atopic Dermatitis Diagnosed?It's always a good idea to see a healthcare provider if you develop one or more patches of itchy, inflamed skin — especially if the symptoms are severe, recurring, or persistent.
It's possible your healthcare provider will refer you to a dermatologist.
DepositPhotos.Com
Diagnosing Eczema/Atopic DermatitisWhen you see your healthcare provider, they'll want to get a detailed medical history to help diagnose what's causing your symptoms. They'll ask you questions about:
Your symptoms, when they started, and if anything seems to trigger them
If you have a personal or family history of any skin conditions
Whether you have a personal or family history of other atopic conditions like allergic rhinitis, food allergies, or asthma
What prescription medications and over-the-counter medications you're taking
Your provider will then examine your skin to see the appearance and location of the affected areas.
Often, a diagnosis of atopic eczema can be made based on a patient's medical history and a skin exam. However, your medical provider may choose to take a skin biopsy to help confirm the diagnosis.
DepositPhotos.Com
What Are the Treatment Options for Eczema/Atopic Dermatitis?There's no cure for atopic eczema. However, for some people who get eczema in childhood, the condition goes away by their teenage years.
While the condition isn't curable, it can be managed with treatment. Available treatments for atopic eczema have significantly expanded over the past 20 years, thanks to advancements in medical research.
The recommended treatment for eczema depends on several factors, including the severity of your condition, the areas affected, and your triggers, as well as your age, lifestyle, overall health, and other medications you may be taking.
The goals of eczema treatment are to:
Ease symptoms such as itching and dryness
Reduce inflammation
Keep the skin well-moisturized and hydrated
Minimize the frequency and severity of eczema flare-ups
Prevent the condition from worsening
Lower the risk of complications like skin thickening or infections
A critical aspect of treatment is paying close attention to how your skin reacts to various conditions, situations, and products. This helps you avoid triggers and better manage your atopic eczema.
AtlasStudio / istockphoto
Home Remedies and Lifestyle Changes for Eczema/Atopic DermatitisThe first approach to atopic eczema treatment usually involves home remedies and lifestyle changes.
Your healthcare provider will probably advise you to avoid triggers — factors that can cause your eczema symptoms to flare. This might include advice about potential irritants like soaps and detergents, along with potential allergens like dust mites, pollen, or pet dander.
You'll also be coached on skincare practices to keep your skin well-moisturized and hydrated. This includes keeping showers short and not too hot, moisturizing while your skin is still damp, and using gentle, fragrance-free personal-care products.
Another treatment your healthcare provider may recommend for managing atopic eczema — especially in more severe cases where skin infections are a concern — is a diluted bleach bath. Adding a tiny amount of bleach to your bath can help lower inflammation and reduce bacteria on your skin.
Ridofranz / istockphoto
Topical Medications for Eczema/Atopic DermatitisMedications are another component of an atopic eczema treatment plan.
For mild to moderate eczema, topical medications — those applied directly to the skin — are often used as a first-line treatment. These medications can reduce inflammation while helping the skin stay moisturized.
Examples of topical medications for atopic eczema:
Topical corticosteroids in the form of creams or ointments
Topical calcineurin inhibitorcreams or ointments, such as those containing pimecrolimus or tacrolimus
Phosphodiesterase 4 (PDE4) inhibitors, such as crisaborole ointment
Janus kinase (JAK) inhibitors, such as ruxolitinib cream
Besides using moisturizers and topical medication, your provider may recommend "wet-wrap therapy" if your eczema is more severe. This involves wrapping the treated skin with wet bandages after you've put on moisturizer and topical medication. It can work well to calm and rehydrate the skin while enhancing the absorption of medication.
DepositPhotos.Com
Systemic Medications for Eczema/Atopic DermatitisModerate to severe eczema may not respond well to topical medications. In that case, systemic medications (which work throughout your body) might be prescribed.
Types of systemic medications that may be used to treat atopic eczema include:
Oral corticosteroids. Prednisone and other drugs from this class of medications reduce inflammation. They're typically used for short-term relief because there can be significant side effects with long-term use.
Oral immunosuppressants. Drugs like azathioprine and methotrexate suppress the immune system to reduce inflammation and prevent flares.
Biologics. This class of drugs — such as dupilumab (Dupixent) — targets specific parts of the immune system, like certain proteins involved in inflammation. Biologics are often administered by self-injection and can be used long-term with minimal risk since they don't suppress the entire immune system.
Oral JAK inhibitors. JAK (janus kinase) inhibitors, such as abrocitinib (Cibinqo) and upadacitinib (Rinvoq), work by blocking specific pathways involved in the inflammatory process.
DepositPhotos.Com
Phototherapy for Eczema/Atopic DermatitisPhototherapy, or light therapy, is another treatment option for atopic eczema. This approach most often uses a special type of ultraviolet (UV) light called narrowband UVB therapy.
Phototherapy typically involves multiple sessions a week for several weeks or months.
Due to the frequent office visits required, phototherapy may not be ideal for people who can't commit to the regular appointments.
Andrey Zhuraviev / iStock
Can Eczema/Atopic Dermatitis Be Prevented?While there's no definitive way to prevent atopic eczema from developing, researchers are exploring various possibilities.
If you've already been diagnosed with eczema, there are steps you can take to help reduce your risk of flare-ups.
svetikd
Eczema/Atopic Dermatitis Current Research on PreventionMost people develop atopic eczema during childhood. If you're concerned about your child's risk, the American Academy of Dermatology (AAD) highlights current research on lifestyle changes that may potentially impact the risk of developing atopic eczema:
Eating a healthy diet during pregnancy. A diet rich in fresh fruits, vegetables, fish, and vitamin D may reduce the risk of eczema — though the reason is unclear.
Moisturizing your baby's skin.This has been found to benefit babies with a high risk of developing atopic eczema (strong family history).
Probiotics. Several studies have been conducted in which probiotics were administered to the mother during pregnancy and to the infant in the first few months. Results have been encouraging, but there's no uniform consensus on type, dose, or timing of administration. More research is needed.
Having a dog in the home. A recent meta-analysis found that owning dogs (but not cats) may reduce the risk of childhood atopic eczema.
If you already have atopic eczema, you can help prevent flare-ups by:
Using moisturizers and any prescribed medications as directed by your healthcare provider
Showering in warm (not hot) water and applying moisturizer right after patting yourself dry
Reducing exposure to allergens like pollen, dust mites, or pet dander that may trigger flare-ups
Opting for products formulated for sensitive skin while avoiding soaps, lotions, detergents, dyes, or fragrances that aggravate eczema
Taking steps to reduce stress, which can trigger atopic eczema flares
Wearing clothing made from gentle, breathable fabrics
Keeping your living space at a consistent humidity and temperature (not too cold or too hot)
If you continue to experience eczema flares despite making lifestyle changes and using medications as directed, make an appointment with your healthcare provider. It's possible your treatment plan may need to be adjusted.
This article originally appeared on ForHers.Com and was syndicated by MediaFeed.Org.
Comments
Post a Comment