When creams are no longer enough: internal therapy for atopic dermatitis
In some cases, local therapy for atopic dermatitis with externally applied ointments and creams is not sufficient. If patients continue to experience skin inflammation and itching, an internally acting treatment may be advisable.
In a so-called systemic therapy, medications are administered in the form of tablets or injections, thereby acting internally throughout the entire body. They influence or suppress specific reactions of the immune system. Depending on the severity and type of symptoms, various preparations may be used.
Immunosuppressive medications
In cases of severe skin inflammation, a doctor may prescribe internal therapy that suppresses the immune system.
Glucocorticoids
During an acute flare-up, for example, glucocorticoids (which are also known in the form of creams or ointments for external use) may be prescribed in tablet form. However, due to potential side effects, they are used only for a short duration and are not suitable for long-term therapy.
Such classical immunosuppressants have a very broad effect and suppress the immune system in a non-specific manner. What they have in common is that by inhibiting the body’s own defense system, they increase susceptibility to infections.
Newer treatment options
A relatively new treatment option for atopic dermatitis involves substances from the group of biologics. Monoclonal antibodies, known as biologics, act specifically on the immune system by directly inhibiting the effects of various inflammatory mediators and the associated reactions in the body. The biologics available for the treatment of atopic dermatitis are not taken as tablets but are injected under the skin. They can also be used in combination with topically applied glucocorticoid preparations.
Biologics
What are biologics?
Biologics represent a relatively new treatment concept. They are genetically engineered drugs that resemble substances or messengers of the immune system. As a result, they can intervene in the processes of the immune system in a targeted manner and inhibit inflammation-triggering signaling cascades. Many of these biologics are directed against specific inflammatory mediators or their binding sites in the organism.
Janus kinase inhibitors (JAK inhibitors), medications belonging to the class of ‘small molecules,’ have also been used for some time in the treatment of atopic dermatitis. JAK inhibitors work by interfering with the cell signaling pathway. They can be taken as tablets, similar to classical immunosuppressants. Due to potential side effects, preliminary examinations and laboratory checks are necessary before and during the use of JAK inhibitors.
Note:
The use of systemic medications is always determined according to the severity of the condition and is assessed individually by the doctor.
