NYU Langone doctors may prescribe one or more medications to reduce inflammation in the skin and muscles and help you manage the symptoms of dermatomyositis. Medication can’t cure the condition, but it can control the rash and prevent further damage to muscle fibers.
Our doctors choose the appropriate medication based on whether your symptoms tend to involve rash and itching or muscle weakness as well. They also consider the severity of the condition when creating a treatment plan.
In some people, dermatomyositis may go away after five years or so. In others, symptoms persist for longer—sometimes for the rest of their lives. Your doctor may adjust the dose or frequency of the medication in response to any changes in your symptoms or health.
After symptoms are under control, doctors recommend people with muscle weakness begin physical therapy in order to rebuild strength in muscles affected by inflammation and tissue damage.
If symptoms of dermatomyositis remain under control, your doctor may gradually decrease the amount of medication he or she prescribes.
Corticosteroid medications reduce inflammation in muscle tissue, which can prevent further damage to muscle fibers. Corticosteroids do not heal damaged muscle tissue, but they may slow or stop the degenerative process. They are often effective in managing muscle symptoms, and are frequently part of a long-term treatment plan for those with muscle weakness.
Your doctor may also recommend a topical corticosteroid or noncorticosteroid cream to relieve the redness and itchiness of a skin rash. He or she determines the appropriate dose depending on the severity of the rash and the intensity of the itch.
Antimalarial medications reduce inflammation in the skin. They lessen the rash and relieve burning, itching, swelling, and redness. With regular use, antimalarial medications may prevent a rash from returning.
Often, antimalarial medications don’t take effect for six weeks or more. During this time, your doctor may prescribe topical corticosteroids and anti-itch medications to relieve symptoms. Antimalarials are part of a long-term treatment plan for many people.
For some, a side effect of antimalarial medication is a red skin rash separate from the rash associated with dermatomyositis. If this occurs, your doctor discontinues antimalarial therapy. Rarely, this medication may damage the retina, the light-sensitive membrane in the back of the eye. This can result in blurry vision. If you take antimalarials, our doctors recommend regular eye examinations.
Smoking cigarettes reduces the effectiveness of antimalarial medications, so doctors encourage people who take them to stop smoking. NYU Langone’s Tobacco Cessation Programs can help you quit.
Your doctor may recommend immunosuppressants, sometimes called immunomodulators, to reduce inflammation throughout the body. These medications suppress or regulate the body’s overactive immune system, relieving the redness, swelling, burning, and itchiness associated with a skin rash. They also reduce inflammation in muscles and may prevent dermatomyositis from progressing.
There are several different types of immunosuppressants, and your dermatologist can discuss the treatment options with you. Most are available as pills taken by mouth once a day. Other medications may be injected, either by a dermatologist in a doctor’s office or by yourself at home.
It may take two to six months for immunosuppressant medications to take effect. During this time, your doctor monitors how well the medication is working in periodic follow-up visits. If this medication alleviates your symptoms, therapy may continue for years.
Because immunosuppressants suppress the immune system, the medications can lead to potentially serious side effects. Your doctor can explain the risks before treatment begins.
Intravenous immunoglobulin therapy is a type of immunomodulator medication that reduces inflammation in the muscles and skin. Immunoglobulin consists of antibodies, which detect harmful substances in the body, such as viruses and bacteria. The antibodies come from healthy donors. When infused into the bloodstream, the antibodies prevent your body’s overactive immune cells from attacking skin and muscle tissues.
A doctor or nurse administers the medication through a vein with intravenous (IV) infusion.
Immunosuppressant medications are given at one of our infusion centers. Your doctor determines the appropriate treatment schedule.