Eczema Treatment Abroad: Atopic Dermatitis Guide 2025

Understanding Atopic Dermatitis

Atopic dermatitis, commonly known as eczema, is a chronic inflammatory skin condition that affects approximately 230 million people worldwide, making it one of the most prevalent skin diseases globally. The condition is characterized by intensely itchy, dry, inflamed skin that can appear anywhere on the body but most commonly affects the face, hands, inner elbows, and backs of the knees. Atopic dermatitis typically begins in infancy or early childhood, with approximately 60 percent of cases developing before age one and 90 percent before age five. While many children outgrow the condition, approximately 10 to 30 percent of cases persist into adulthood, and adult-onset atopic dermatitis is increasingly recognized as a distinct entity that can be severe and difficult to manage.

The pathophysiology of atopic dermatitis involves a complex interplay between genetic predisposition, immune dysregulation, and environmental factors. Mutations in the filaggrin gene, which is essential for maintaining the skin barrier, are present in approximately 30 percent of atopic dermatitis patients and contribute to increased skin permeability, water loss, and allergen penetration. The immune response in atopic dermatitis is dominated by type 2 inflammation, with elevated levels of interleukins 4, 13, and 31 driving the inflammatory cascade that produces the characteristic itching, redness, and swelling. Understanding these mechanisms has led to the development of targeted therapies that specifically address the underlying immunological processes.

The impact of atopic dermatitis on quality of life is substantial and often disproportionate to the perceived severity of the visible skin changes. Chronic, intense itching is the hallmark symptom and causes sleep disruption that affects daytime functioning, concentration, and productivity. Studies show that atopic dermatitis patients lose an average of one to two hours of sleep per night during flares, leading to fatigue, irritability, and impaired cognitive performance. The psychological burden includes anxiety, depression, social isolation, and in children, bullying and academic difficulties. At international dermatology centers like Acıbadem Maslak Hospital, comprehensive assessment addresses not only the skin manifestations but also the systemic impact of the disease, including sleep quality, psychological well-being, and quality of life measures.

Treatment Options for Eczema Abroad

Topical therapy forms the foundation of eczema management at all severity levels. Emollients and moisturizers are the most important daily treatment, restoring the damaged skin barrier and reducing water loss. Topical corticosteroids of varying potencies are used to control inflammation during flares, while topical calcineurin inhibitors such as tacrolimus and pimecrolimus provide steroid-free anti-inflammatory options suitable for sensitive areas including the face and skin folds. Crisaborole, a topical phosphodiesterase-4 inhibitor, and ruxolitinib cream, a topical JAK inhibitor, represent newer additions to the topical armamentarium. These medications cost significantly less at international pharmacies, with savings of 70 to 90 percent compared to US retail prices for many topical treatments.

Phototherapy with narrowband UVB light is an effective second-line treatment for moderate atopic dermatitis that has not responded adequately to topical therapy alone. NB-UVB phototherapy works by reducing skin inflammation, modulating the local immune response, and promoting healing of eczematous lesions. A typical course involves two to three sessions per week for eight to twelve weeks, with maintenance sessions as needed. At international centers like Estethica Ataşehir Hospital, phototherapy is available at a fraction of US costs, and the concentrated treatment schedule is well-suited to medical tourists who can commit to several weeks of treatment abroad.

Traditional systemic immunosuppressants including cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil are used for severe atopic dermatitis that is refractory to topical therapy and phototherapy. These medications have been used for decades and have well-established efficacy and safety profiles, though they require regular monitoring for potential side effects. They are significantly less expensive than biologic medications and represent a cost-effective treatment option for many patients. International dermatologists at centers like Acıbadem Maslak Hospital have extensive experience with these medications and can initiate and monitor treatment for international patients, providing detailed management plans that local physicians can follow after the patient returns home.

• Emollients and skin barrier repair — daily foundation of eczema management
• Topical corticosteroids — first-line anti-inflammatory for flares
• Topical calcineurin inhibitors — steroid-free option for sensitive areas
• Topical JAK inhibitors — newest topical option for itch and inflammation
• NB-UVB phototherapy — effective second-line for moderate disease
• Dupilumab — first biologic approved for moderate-severe atopic dermatitis
• JAK inhibitors (oral) — abrocitinib, upadacitinib, baricitinib
• Tralokinumab — IL-13 inhibitor biologic for moderate-severe disease

Cost Comparison by Country

Eczema Treatment Cost Comparison 2025

Costs vary by severity and specific medications. Biologic costs reflect out-of-pocket expenses. Insurance coverage varies by country.

The cost differential for eczema treatment abroad is particularly striking for biologic and JAK inhibitor therapies. Dupilumab, the most widely prescribed biologic for atopic dermatitis, costs approximately $37,000 to $45,000 per year in the United States at list price. In Turkey, the same medication from the same manufacturer is available for $8,000 to $12,000 per year, representing savings of up to 75 percent. JAK inhibitors including abrocitinib and upadacitinib, which offer the convenience of oral dosing, cost $50,000 to $65,000 per year in the US compared to $10,000 to $18,000 in Turkey. These savings can be life-changing for patients who have been unable to afford effective treatment due to the prohibitive cost of advanced therapies in their home countries.

Biologics & JAK Inhibitors for Eczema

Dupilumab, a monoclonal antibody that blocks interleukins 4 and 13, was the first biologic approved for moderate to severe atopic dermatitis and has transformed the treatment landscape. Administered as a subcutaneous injection every two weeks, dupilumab achieves EASI-75 response (75 percent improvement in eczema severity) in approximately 50 to 70 percent of patients, with significant improvements in itch, sleep quality, and overall quality of life. The medication has a favorable safety profile with conjunctivitis being the most common side effect. At centers like Acıbadem Maslak Hospital, dupilumab is available for initiation and ongoing treatment at dramatically lower cost than in the US, with dermatologists experienced in managing both the medication and its potential side effects.

Oral JAK inhibitors represent the newest class of systemic therapies for atopic dermatitis and offer several advantages including rapid onset of action, oral dosing convenience, and the ability to achieve high response rates across multiple outcome measures. Abrocitinib and upadacitinib have demonstrated superior efficacy compared to dupilumab in head-to-head clinical trials, with faster onset of itch relief and higher rates of clear or almost clear skin. Baricitinib offers a moderate-efficacy option with a well-established safety profile from its prior approval for rheumatoid arthritis. However, JAK inhibitors require careful patient selection and monitoring due to potential cardiovascular and thromboembolic risks, and their high cost in the US ($50,000-$65,000/year) has limited access for many patients.

Top Treatment Centers for Eczema Abroad

Acıbadem Maslak Hospital offers comprehensive atopic dermatitis management through its dermatology department, which includes allergy testing, patch testing for contact allergens, phototherapy, and access to the full range of systemic and biologic therapies. The department's approach emphasizes accurate diagnosis, identification of triggering factors, optimization of skin barrier care, and selection of the most appropriate systemic therapy based on individual patient characteristics and preferences. Estethica Ataşehir Hospital provides another excellent option with its combined medical and cosmetic dermatology approach that addresses both disease control and the aesthetic impact of eczema scarring and discoloration.

Acıbadem Taksim Hospital and Yanhee Hospital in Bangkok extend the geographic options for eczema patients seeking treatment abroad. The Klinik Stephanshorn in Switzerland provides a European option for patients who prefer treatment within the EU/Swiss healthcare system. All these centers maintain international accreditation and employ dermatologists with expertise in managing complex inflammatory skin diseases.

Long-Term Eczema Management Plan

Successful long-term management of atopic dermatitis requires a comprehensive approach that goes beyond prescription medications to include skin care optimization, trigger avoidance, and ongoing monitoring. The cornerstone of daily management is a robust skin care routine that includes bathing in lukewarm water for 10 to 15 minutes, immediate application of a thick emollient within three minutes of bathing (the soak and seal approach), and consistent use of moisturizers throughout the day. Identifying and avoiding individual triggers such as specific allergens, irritants, stress, temperature extremes, and certain fabrics helps prevent flares and reduces the need for medication.

Patients who initiate treatment abroad should establish a long-term management plan with their international dermatologist that can be continued by their local healthcare team. This plan should include specific medications with dosages and monitoring schedules, criteria for escalation or de-escalation of therapy, a flare action plan detailing how to manage disease worsening, follow-up laboratory test schedules for systemic medications, and clear communication pathways between the patient, international dermatologist, and local physician. Many international centers like Acıbadem Maslak Hospital offer telemedicine follow-up services that allow ongoing consultation and treatment adjustment without the need for additional travel.

My severe eczema was destroying my quality of life, and dupilumab was too expensive at $37,000 a year. In Istanbul, I started the same treatment for a third of the cost. The dermatology team was thorough and compassionate, and for the first time in years, my skin is clear.

Hannah M., atopic dermatitis patient from the US

Frequently Asked Questions