Many of our clients ask us about Dupixent, a common treatment for eczema that dermatologists often prescribe. Dupixent is a biological prescription medicine that treats moderate-to-severe eczema (atopic dermatitis or AD).

When considering your treatment options, make sure to understand both the benefits and the side effects.

Are you curious what the most common side effect is from using Dupixent for eczema?

In one of our Eczema Podcast episodes, we had a chance to speak with Dr. Matthew Zirwas to ask this very question. Some of the common side effects may surprise you.

Checkout this short clip from our podcast interview.

What is the most common side effect?

In the realm of medical treatments, it’s not uncommon for medications to come with a range of potential side effects.

One such side effect associated with Dupixent is DFR – also known as, Dupixent-induced Facial Erythema.

This side effect can present itself in intriguing ways, potentially impacting individuals who have experienced positive results from Dupixent treatment. Let’s delve into the intricacies of DFR, exploring its manifestations, underlying mechanisms, and its connection to the body’s immune response.

Discussing Dupixent-induced Facial Erythema (DFR)

Dupixent, a medication renowned for its effectiveness in treating eczema, sometimes brings about an unexpected and meaningful side effect: Dupixent-induced Facial Erythema (DFR). This condition can present itself in two distinct ways:

1. Shift in Eczema Localization: For some individuals, DFR emerges as a peculiar occurrence where eczema, which had previously affected other parts of the body, now makes its presence felt on the facial skin. In essence, the eczema migrates to the face following the administration of Dupixent.
   
2. Persistent Facial Eczema: Conversely, there are cases where eczema that was present on various parts of the body significantly improves with Dupixent treatment, but the facial region remains unaffected. This continued presence of eczema specifically on the face is also categorized as DFR.

Unraveling the Underlying Mechanisms

In the early stages of discovering DFR, the medical community faced uncertainty regarding its root causes. Initially, professionals considered possibilities such as rosacea, Demodex infestations, and contact dermatitis. However, as research progressed and data emerged, a clearer understanding began to take shape.

Malassezia and the Immune Response*

At the heart of DFR lies a fascinating interaction between Dupixent, the immune system, and a microorganism known as Malassezia. Dupixent is known to inhibit two key cytokines, namely IL-13 and IL-4, which play pivotal roles in immune cell communication. These cytokines are the messengers that immune cells use to convey information to one another.

Here’s where Malassezia comes into play. Individuals with eczema often exhibit an overproduction of a specific cytokine that leads to a type of immune response known as a th17 reaction. This reaction is the underlying cause of seborrheic dermatitis. Interestingly, IL-4, one of the cytokines blocked by Dupixent, acts as a suppressor of th17 reactions.

Thus, a remarkable connection emerges. Before Dupixent treatment, the heightened IL-4 levels in individuals with eczema were inadvertently protecting them from developing seborrheic dermatitis.

However, when Dupixent interferes with IL-4, it weakens the protective barrier. Consequently, individuals who would have otherwise been shielded from seborrheic dermatitis due to their elevated IL-4 levels now become susceptible to it. This, in essence, is the underlying mechanism that gives rise to DFR.

Conclusion

Dupixent, while offering remarkable relief to those suffering from eczema, unveils a complex interplay between immune responses, cytokines, and microorganisms that can lead to an unexpected side effect—Dupixent-induced Facial Erythema (DFR).

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A post shared by Abby – Eczema Nutritionist & Coach (@eczemaconquerors)

Check out this quick clip to learn more:

Want to learn more?

Learn more in this clip and tune into S6E14 on your favourite podcast player from the @eczemapodcast to listen to the full episode 🥰

We understand that navigating treatment options and potential side effects can be overwhelming. As always, we encourage you to consult with healthcare professionals for personalized advice based on your specific needs and circumstances.

With love and healing,

Abby