Getting the Right Eczema Treatment

There is no treatment for atopic eczema that completely prevents a flare of symptoms and there are no eczema cures.

Remedies for eczema follow a step process and depend on whether the disease is mild, moderate or severe.

1st line therapy - Combat dry skin.

Avoid soap as it has a drying effect on the skin by removing its natural oils. Instead use a soap substitute such as aqueous cream to wash with. Other options for washing include bath or shower emollients such as (Aqueous Cream, Balneum Plus, Dermol, Diprobase).

Use emollient creams on the skin at least twice a day.

Use steroid cream on the skin (as well as your usual emollient) where there is active inflammation. There are different strengths of steroid cream, so it’s important to use the right one at the right time. This is something your doctor or specialist will guide you with.

Take antibiotics or antivirals for a skin infection if you get one. Broken skin can sometimes lead to an infection if bugs (microorganisms) get in.

Take antihistamines for itching. This will help to break the itch-scratch-itch cycle but should only be used for short periods.

Wet wrapping involves putting a damp layer of thin bandage over the skin which has had emollient or steroid cream applied to it. A dry layer of bandage is put over the top. This is popular for babies and children with eczema. Your doctor or nurse will teach you how to do it and when to avoid it (eg, during a skin infection).

Coal tar and icthamol (eg Clinitar) can be used as a cream or bandage. It is sometimes combined with zinc paste and has a characteristic smell. This isn’t suitable for use on the face.

Second line therapy. More serious eczema needs specialist advice and treatment.

Phototherapy. UV or PUVA treatment at a specialist centre can greatly improve the skin’s condition by mimicking the sun’s benefits. However the side effects are similar to sunbathing (burning, eye damage, increased risk of skin cancer) so is used under specialist guidance.

Psoralens tablets sensitise the skin to the PUVA but can cause nausea and the patient needs to wear sunglasses for a time after treatment to prevent cataracts.

Immunosuppressant drugs work to dampen down the body’s response to what it thinks is an ‘attack’ by an eczema trigger. Steroids (eg prednisolone 30mg for a week) or other immunosuppressants such as azathiaprine or cyclosporine may be used.

Gamolenic acid has had limited success in helping patients with atopic eczema.

Tacrolimus is an immunosuppressant used on the skin and has been found to be helpful for greater numbers of people.

Read all you can about eczema and become well informed about treatment, diet and your triggers, and discuss this with your health care professional so that you get the right treatment at the right time for you.

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