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What are immunosuppressant medications?

While the exact cause of eczema is not known, researchers understand that that the immune system is involved. In eczema, the immune system “misfires” causing inflammation, which leads to symptoms such as itching, redness and skin barrier problems.

If you have severe eczema, your doctor may prescribe you a type medication called an immunosuppressant. An immunosuppressant drug helps control, or suppress, the immune system in order to slow down the symptoms of severe eczema.

This class of medication is considered “off-label,” which means that it’s not approved by the Food and Drug Administration (FDA) to specifically treat atopic dermatitis and other forms of eczema.

How do immunosuppressants work?

Immunosuppressants help to stop the itch-scratch cycle of eczema; allow the skin to heal; and reduce the risk of skin infection.

There are a number of immunosuppressants, but the three most commonly used for treating eczema are:

  • Cyclosporine is a medication first used to prevent the body from rejecting a transplanted organ, such as a kidney or the heart.
  • Methotrexate is a medication used frequently in psoriasis and different types of arthritis.
  • Mycophenolate mofetil is used in transplant patients and for other diseases of the immune system.

What are the side effects of immunosuppressants?

Immunosuppressants have some potential side effects, including

  • Increased risk of infections
  • Upset stomach and vomiting
  • Increased risk for certain types of cancers
  • Increased blood pressure with cyclosporine
  • Increased risk of kidney damage with cyclosporine and methotrexate
  • Risk of liver damage with methotrexate

In general, immunosuppressants are used for some months to get the eczema under control, and then are tapered off. For many people, the improvement in their eczema on immunosuppressants helps to control symptoms with topical medications in the long term.