Q I'm a 35-year-old office worker who was diagnosed with severe atopic dermatitis and recommended dupilumab injections by a dermatologist. What role can Korean medicine play in this situation?
A In severe atopy, prioritizing rapid inflammation suppression with biologics like dupilumab comes first. At this stage, Korean medicine is not a standalone replacement but a complementary role for immune recovery, constitutional improvement, and side effect minimization. As the condition enters a stable phase, the proportion of Korean medicine treatment can be increased to aid relapse prevention and long-term management.
Detailed Answer
Severe atopy (EASI 23+ points, severely disturbed sleep, more than 30% body involvement) is now treated with biologics or JAK inhibitors as the standard of care. Dupilumab blocks IL-4 and IL-13 to suppress Th2 immune overactivation, and most show clear improvement within 4-16 weeks.
Role of Korean medicine at this stage: ①Side effect mitigation — helping with side effects like conjunctivitis and headaches in the early phase of dupilumab, ②Vital energy recovery — constitutional strengthening through immune imbalance improvement, ③Preparation for dose reduction — complementary Korean medicine treatment for relapse prevention during biologic tapering, ④Sleep improvement — Anshin (安神) prescriptions for sleep disturbance due to itching. However, replacing or discontinuing biologic treatment with Korean medicine is dangerous.
Korean Medicine Perspective
At Dongjedang, we follow a co-management principle for severe patients using biologics. We share treatment plans with the attending dermatologist, monitor liver function, and use blood-nourishing and skin-moisturizing prescriptions (Si-mul-tang, Dangguiyeumja) and external treatments (herbal washes, Mapunggo). After the biologic brings stability, we strengthen constitutional improvement prescriptions to help maintain long-term remission.
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