Within the niche of eczema treatment, immunosuppressants are commonly prescribed and used to suppress extreme eczema flare-ups. Most eczema sufferers have a few periods of exacerbated symptoms wherein their usual medical aids don't seem to work. At such times, immunosuppressants are recommended.
Immunosuppressants are potent drugs aimed at damping the immune system of the individual for a limited interval. They are used in very limited scenarios when every conventional treatment has failed, including topical steroids. Immunosuppressants cannot be self-used or obtained through usual prescriptions. These drugs are administered under expert medical supervision by designated specialists. Some of the most common immunosuppressants prescribed in this niche include:
For treating severe eczema, the immunosuppressants used are systemic in nature. This essentially means that the immunosuppressants are able to impact the overall immune system. While immunomodulators are aimed only at impairing the immune activity with the skin cells, immunosuppressants are a bit more comprehensive and can impair the overall immune system. However, this also increases the risks associated with the use of immunosuppressants.
Features of Immunosuppressant Regimen
Immunosuppressant medications are prescribed as the last resort. The potency of the medication delivered through an injection or a tablet is determined after examining the current status and recent medical history of the patient. Chances of contraindicative reactions are so high that most medical staffs delivering immunosuppressant medications tend to prepare neutralizing agents that are needed for reducing the impact of immunosuppressants. It is common among physicians to put the patient on a short course of high-potency oral corticosteroids, like prednisolone rather than use immunosuppressants, fearing such side-effects. Even in the most extreme cases of eczema, most immunosuppressant regimens are not prescribed for more than eight weeks.
Precautions in Eczema Treatment
Patients administered these drugs need continuous monitoring. Blood pressure is repeatedly checked along with periodic kidney function and liver function testing. People prescribed Azathioprine are likely to be checked for an initial worsening of symptoms before they subside. Regular blood testing during an immunosuppressant regimen is common since decreased bone marrow activity can make the individual susceptible to other diseases or worsen an existing medical condition beyond control.
The patient is asked to report any change in body temperature, signs of infection and any kind of unexplained bleeding/bruising during this time. It is vital the patient shares any other medical condition or medication that could possibly react with immunosuppressant medications.
An integral part of this regimen is avoiding foods that can contra-react with immunosuppressants. This includes avoiding grapefruit and other foods that might interrupt with the uniform uptake of medications. Usually, high-potassium foods like dried fruits, tomatoes and bananas are avoided.
The possible side effects of immunosuppressants include:
- Kidney problems
- High blood pressure
- Gastrointestinal upset
- Increased risk of infections
- Decreased bone marrow cellular activity
- Reduced numbers white blood cell count/red blood cell count
Risk of Relapse
Due to the extreme immune impairment caused by immunosuppressants, there is a greater likelihood of some form of relapse of symptoms when the medication is stopped.
Risk of Cancer
Perhaps the most disturbing aspect of using immunosuppressants is the risk of developing lymphomas. This usually happens when the regimen exceeds the recommended period and regular testing is neglected. Skin cancer is known to a common type of cancer in such scenarios. This is why some health care facilities handling immunotherapy recommend that patients avoid exposure to UV light, to avoid chances of skin cancer initiating. Activities like tanning, use of sun beds and UV-based therapies like PUVA should be avoided during a typical immunosuppressant regimen.