Quelling the discomfort of atopic dermatitis, the most common form of eczema, can be a daily quest. This inflamed, itchy skin condition can interfere with sleeping, socializing, and many other activities.
If home remedies such as gentle cleansing and regular moisturizing don't provide relief, your doctor might recommend a prescription treatment to apply to your skin. Which prescription cream is most effective? A new study boils it down to a few overall winners.
What is atopic dermatitis and the itch-scratch cycle?
Atopic dermatitis is a chronic inflammatory skin disease. The areas commonly affected include the face, hands, feet, or the skin folds of the elbows or behind the knees.
We don't know exactly what causes atopic dermatitis. Genes, the environment, and an overactive immune system all seem to play a role in creating inflammation, which feels itchy. Scratching the itch creates more irritation and inflammation, which causes more itching.
As the itch-scratch cycle continues, the rash gets worse. The skin might tear, ooze, and crust over, which can be painful.
Which skin treatments were more effective in the study?
Some prescription topical skin treatments for atopic dermatitis are more effective than others, according to a 2023 study published online by The Journal of Allergy and Clinical Immunology.
Scientists evaluated more than 200 randomized trials involving more than 43,000 people with atopic dermatitis (average age 18). The researchers compared almost 70 different prescription creams or ointments, which are broadly called topical treatments and are designed to be applied to affected areas of skin.
These treatments fall into five categories. If you have eczema, their generic names may or may not be familiar to you, but your medical team is likely to know them well:
topical corticosteroids, divided into seven classes ranging from the most to the least potent, decrease the release of an inflammatory chemical called phospholipase A2
topical Janus kinase (JAK) inhibitors interrupt inflammatory signals as they enter cells
topical PDE4 inhibitors raise the production of a chemical called phosphodiesterase-4, or PDE4, and lower the body's inflammatory response
topical calcineurin inhibitors help suppress the production of chemical messengers that tell the body to ramp up its defenses
other topical treatments, including antibiotics and prescription moisturizers.
Researchers looked at which medications had outcomes important to patients, including which
were best at improving quality of life
were best at reducing eczema-related severity, itch, sleep disturbances, or flare-ups
caused the fewest serious side effects
were discontinued least often due to serious side effects.
Which atopic dermatitis medications proved to be most effective?
The study yielded some predictable results and a surprise. The overall winners were
two calcineurin inhibitors: pimecrolimus (Elidel) and tacrolimus (Protopic)
moderate-potency topical corticosteroids, a large group that includes fluocinolone acetonide (Synalar cream 0.025%) and triamcinolone acetonide (Kenalog cream/ointment 0.1%).
What did these medications improve?
Pimecrolimus improved six of seven outcomes, and was among the best at reducing sleep disturbances and eczema flares.
High-dose tacrolimus (0.1%) improved five outcomes, and was among the best at reducing itch and eczema flares.
Moderate-potency steroids improved four to six of the seven outcomes, and were best at reducing eczema itch, flares, and serious side effects.
"That's in line with what we often prescribe," says Dr. Connie Shi, a dermatologist who often treats people with eczema at Harvard-affiliated Brigham and Women's Hospital. "The strongest topical steroids appeared to be the most effective at reducing eczema severity in the study. However, for longer-term maintenance we may consider switching to a moderate-potency steroid, or one of the nonsteroid options, to minimize the risk of thinning the skin, which can occur with long-term use of topical steroids."
The surprise finding: the study found little to no effectiveness from using a topical cream twice daily versus just once daily. "The traditional advice is twice daily," Dr. Shi says. "Once a day would make it more convenient to use, and it may help people stay on their medication regimen without decreasing effectiveness."
Which treatments were less effective in this study? The researchers found that topical antibiotics were among the least effective treatments for eczema.
Should you change your treatment?
"While the study included more than 40,000 people, what worked for participants may not always work for you, as different people may respond differently to the same treatment," Dr. Shi explains. "There are many factors to consider when prescribing a treatment, including your age, the areas on your skin that are affected, the severity of the eczema, and potential side effects."
The bottom line? "If a treatment regimen is working for you, then continue it, as long as you don't have any serious side effects," she says. "If your current regimen isn't working well, talk with your doctor or a dermatologist to see if there's another prescription cream or ointment that you may want to try."
Burna Boy Responds To A Woman’s Claim That She Became Pregnant For Him And Later S¥ffered A Miscarriage In 2016
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Burna Boy has responded to a woman’s claim that she became pregnant for him and later s¥ffered a miscarriage in 2016.
He said she was one of the people that called him imp%tent and her charges that year was N20,000 which he paid. Anybody who knows her can enter the comment section to confirm what he said about her charges for that year.
Major U.S. equities indexes traded in positive territory on Tuesday, boosted by a resurgence among tech stocks. The S&P 500 jumped 1.0%, while the Dow added 0.3%. The tech sector's outperformance helped the Nasdaq surge by 1.5%.
Shares of data analytics firm Palantir Technologies (PLTR) jumped 6.6% on Tuesday, the strongest daily gain in the S&P 500. Asset management firm Ark Invest spotlighted software as an area with more room to benefit from artificial intelligence (AI) trends. Rahul Bhushan, managing director of Ark Invest Europe, said firms like Palantir could be poised to take market share from the mega-cap tech companies whose cloud-computing platforms have been a focal point in the emerging AI boom.
Edwards Lifesciences (EW) shares surged 6.2%. The medical device company could see increased momentum for its heart valve repair system after The Centers for Medicare and Medicaid Services (CMS) said it was evaluating the possibility of national Medicare reimbursement for transcatheter repair procedures.
Shares of cybersecurity provider Palo Alto Networks (PANW) were up 5.1% following positive commentary from several investment research firms. Goldman Sachs boosted its price target on Palo Alto, suggesting the company's strategy to upgrade to more advanced serviced offerings could drive growth. Meanwhile, BNP Paribas initiated coverage of the networking technology company's stock with an "outperform" rating.
Crude oil futures prices fell more than 4% amid reports of potentially easing tensions in the Middle East. The slip in prices pressured oil and gas stocks. Marathon Petroleum (MPC) shares plunged 7.7%, posting the steepest drop of any stock in the S&P 500. Shares of fellow refiner Valero Energy (VLO) closed the session down 5.3%.
Super Micro Computer (SMCI) shares slipped 5.0% on Tuesday, giving back a portion of the strong gains posted by the stock in the previous session after the company reported upbeat delivery figures for its graphics processing units. Challenges to Supermicro include reports emerging last month that the Department of Justice is conducting an investigation into the firm's accounting practices.
Analysts at KeyBanc downgraded their view on shares of industrial chemical maker Celanese (CE) to "sector weight" from "overweight," citing softness in the automotive end market and a cautious outlook for the near term. Celanese shares lost 4.6% on Tuesday.
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Just In: Fuel Price Reportedly Reaches N1,030 Per Litre At NNPC Outlets
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Petrol pump price rose to N1,030 per litre at various outlets of the Nigerian National Petroleum Company Limited (NNPC Ltd) in Abuja on Wednesday, Premium Times is reporting.
The recent development comes after the NNPC decided to terminate its exclusive purchase agreement with Dangote Refinery. Earlier on Monday, this newspaper exclusively reported that the Nigerian National Petroleum Company Limited (NNPC Ltd) is ending its exclusive purchase agreement with Dangote Refinery, opening up the market for other marketers to buy petrol directly from the refinery.
This means the NNPC will no longer be the sole off-taker, and marketers can now negotiate prices directly with Dangote Refinery. This development aligns with the current practices for fully deregulated products, where refineries can sell directly to marketers on a willing buyer, willing seller basis.
PREMIUM TIMES observed Wednesday morning that NNPC Ltd outlets in the Central area of Abuja, the Federal Capital Territory, adjusted the pump price of petroleum to N1,030.
At the station, Glory Okoye, a customer who spoke to PREMIUM TIMES, said: “This is funny; I just noticed that the pump price has changed from N897 to N1,030.” At several other outlets in the Wuse, Lugbe area of the capital city, this newspaper confirmed that the pump price equally jumped to N1,030 as motorists and commuters grumbled amid the uncertainty.
In Akute, Ogun State, this newspaper observed that the NNPC outlets were shut against motorists who formed a long queue along the Akute-Alagbole Road. A motorist told PREMIUM TIMES that the outlets sold petrol in the early hours of Wednesday but dropped midway, claiming that one of its generating sets was faulty.But attendants said they are waiting for a directive on prices from the top,” a frustrated customer said.