Treatment for eczema, or atopic dermatitis (AD), can be tough to afford, particularly if you don’t have health insurance. And, just like the disease itself and its daily management, the financial burden of eczema can affect your emotional health.
“Eczema can be exhausting,” says Chicago-based dermatologist Peter Lio, MD, a clinical assistant professor at Northwestern University Feinberg School of Medicine in Chicago and codirector of the Chicago Integrative Eczema Center. “Patients may be dealing not only with itch, poor sleep, visible skin disease, and complicated treatment regimens but also repeated pharmacy calls, insurance denials, prior authorizations, and significant costs.”
If you have moderate to severe eczema, here’s what you need to know about the costs of treatment and how to navigate them.
How Much Does Eczema Cost?
What you pay depends in large part on what your health insurance plan won’t cover. According to a 2020 study, these out-of-pocket costs averaged $600 per year for doctor visits, medications, moisturizers, and more. But the study also notes that 4 in 10 people pay at least $1,000 annually.
Black patients, who are more likely to have moderate to severe eczema that’s tough to treat, face particularly high treatment costs. A 2021 study shows that their monthly costs average more than $200 a month.
If you don’t have insurance, the costs can be too high. A 2025 review of previously published studies estimates that adults with moderate to severe eczema who rely on systemic treatments such as dupilumab (Dupixent) are on the hook for approximately $50,000-$60,000 a year. While this figure also includes doctor visits, medications account for 99% of the cost. Phototherapy, another advanced treatment, is less costly but far from cheap. Its average yearly price tag is $17,549, according to a 2020 study.
Will I Need These Costly Treatments?
When first diagnosed, your doctor likely started you on topical therapies. These include moisturizers, topical steroids, and other treatments that you apply directly on your skin. If you have mild eczema, these may be all you require. Those with more serious AD may need more.
“Many patients, particularly those with moderate to severe eczema, do not achieve adequate disease control with first-line topical therapy and may require additional treatment with systemic medications and/or phototherapy,” says Rachel Kirven, MD, a dermatologist and assistant professor of medicine at the Ohio State University Wexner Medical Center.
What Are the Main Types of Advanced Treatment?
The common treatments typically target specific areas on your skin where eczema develops. The two main types of advanced therapies — biologics and JAK inhibitors — go to the source of your inflammation, Kirven says.
“These are ‘targeted’ therapies, meaning they act on specific parts of the overactive immune response that drives eczema rather than broadly suppressing the immune system as older medications do,” Kirven says.
Biologics
These injectable medications block a chemical called interleukin (IL). It prevents IL from binding to the surface of certain immune system cells. This lowers inflammation and helps with the symptoms. Biologics for eczema include:
JAK inhibitors
Taken as pills, these drugs go inside your immune cells. There they block certain signals involved in inflammation. The JAK inhibitors used to treat eczema are abrocitinib (Cibinqo) and upadacitinib (Rinvoq). These drugs are very effective, say both Kirven and Lio, but they’re not cheap.
“Biologics and oral JAK inhibitors can carry very high list prices,” Lio says. “Insurance coverage, deductibles, copays, manufacturer assistance programs, and other factors can dramatically affect the patient’s actual out-of-pocket cost.”
Phototherapy
Also known as light therapy, this nondrug treatment uses certain types of ultraviolet light to calm your immune system and ease the itching, inflammation, and other symptoms caused by eczema. It typically requires three weekly sessions for up to two months before you see improvements, though its results vary from patient to patient.
What Will It Take to Get My Insurance to Cover Advanced Eczema Treatments?
It’s not always easy and can take a considerable amount of time. That’s because treatments such as biologics and JAK inhibitors cost a lot, and you and your doctor may have to work to convince your insurer to pay for them.
“This can delay access to the most appropriate therapy,” Lio says.
The roadblocks you may run into include:
Prior authorization
This means your insurer will review your case before deciding whether they will pay for the medication your doctor has prescribed.
Lio says the requirements for prior authorization vary among insurers, and they also may depend on the medication you’ve been prescribed. Typically, your doctor will have to submit the following info:
- Your diagnosis and the severity of your eczema
- How much of your body is affected
- Which areas it affects most significantly (often the face, hands, or genitals)
- Which treatments you have already tried and for how long
- Why those treatments were ineffective, poorly tolerated, or inappropriate
- How your eczema affects your sleep, your daily activities, and your quality of life
It’s not always enough.
“Clinicians may provide what appears to be very thorough documentation and still receive a request for additional information or a denial requiring an appeal,” Lio says.
Step therapy
Also referred to as “fail first,” this process requires you to take one or more other, less costly drugs before your insurer will agree to cover a more expensive drug, such as a biologic. How long you must remain on those drugs varies from plan to plan. Only if those drugs do not control your eczema adequately — only if they fail first — will your insurer pay for more expensive treatments. Your doctor will need to document your response to the medications you initially try. It takes time and does not always go smoothly.
“There can be denials, requests for additional information, or apparent miscommunication that require repeated phone calls, resubmissions, or appeals,” Lio says.
Where Can I Get Help to Pay for My Eczema Treatment?
Even if you have insurance, it won’t cover all your treatment costs, and drug copays add up. But you can find assistance through a variety of resources. If you don’t have insurance, don’t give up. Programs exist that can help you afford the medications you need.
First, be warned. Lio says that eligibility requirements vary considerably among payment assistance programs, and government insurance programs such as Medicare generally have rules different from those of commercial insurance.
“It is incredibly complicated,” Lio says. “Worse, there is no single roadmap for navigating all of this.”
Where to start
Your dermatologist’s office. “Clinicians and their staff often try to keep track of changing drug formularies, assistance programs, prior authorization requirements, and preferred pharmacies,” Lio says.
Specialty pharmacies. These pharmacies handle complex medical conditions, such as eczema, that require navigating prior authorizations and financial assistance. Their resources and experience, Lio says, can make them a better option for finding help than a smaller neighborhood pharmacy.
Your drug’s manufacturer. The company that makes your medication may have a patient support program that offers discounts on your prescription. Visit the company’s website to learn what they offer.
Other resources
Nonprofits. Many nonprofit organizations offer different types of help, including:
- Rx Outreach, a nonprofit national mail order pharmacy
- NeedyMeds, a service that helps you find payment assistance programs offered by your state or local government
- TotalAssist, an organization that assists people meet the medication costs of chronic conditions such as eczema
- Medicine Assistance Tool, a search engine for finding payment assistance from drug makers as well as public sources of help
Online prescription discounts. Some websites offer drug discounts that may beat the price your insurance will pay. These include:
- BlinkRx
- Cost Plus Drugs
- GoodRx
Government agencies. If you qualify, Medicare and Medicaid may lower your prescription costs. The State Health Insurance Assistance Program, or SHIP (https://www.shiphelp.org/) offers counseling on how to navigate Medicare.
How Can I Manage the Emotional Toll of Eczema and Its Treatment?
Eczema can drain more than your wallet. Managing it on a daily basis and the financial stress of paying for treatment can affect your emotional health. Kirven says to watch out for the following:
- Frustration
- Hopelessness
- Anxiety, such as persistent worries about expenses
- Poor sleep
- Withdrawal from activities
Because of these, she says, “patients may skip treatments because they feel too exhausting or unaffordable.”
Talk with your dermatologist about both the emotional and financial burden of your eczema, Kirven says. In addition to helping you find ways to pay for your medications, they also may be able to simplify your treatment routine and improve how well it works. If you continue to struggle, try counseling and support groups.
“A successful long-term treatment plan needs to be effective, emotionally manageable, and financially sustainable for each patient,” Kirven says.
What Questions Should I Ask My Health Care Team About Managing My Treatment Costs?
Ask the following questions whenever your dermatologist recommends a new treatment:
