Treatments for Eczema
Treatments for Eczema:
Eczema is a chronic condition that is not curable. However, with a well integrated, medically monitored plan of care, symptoms can be effectively controlled, and people with eczema can lead active, comfortable lives. A good treatment plan is individualized to a person's medical history, specific type and severity of eczema, the specific cause, and other factors.
A combination of treatments that include lifestyle changes with medications and other treatments as appropriate is the most effective way to best control eczema.
Treatment of eczema includes prevention of flare-ups by avoiding exposure to irritants and allergens and minimizing skin dryness. Typical skin irritants and allergens include soaps, chemicals, cleaning products, weeds, and some metals, such as nickel. Skin dryness can be avoided or treated by using a perfume-free moisturizer, avoiding scratchy clothes, and using a home humidifier. Other important steps include avoiding alcohol and caffeine, using mild soaps, not over washing or scrubbing skin, and avoiding hot tubs, steam baths, saunas and chlorinated swimming pools.
Ice bags or cool wet compresses may be helpful to help relieve itching. Therapy can also include taking an oatmeal bath and using oatmeal soap, such as Aveeno. More severe cases of itching and eczema may be treated with a corticosteroid cream, which reduces inflammation and an antihistamine, which reduces itching. These medications can have side effects, so they should only be taken under the direction of a health care clinician.
Antibiotics may be prescribed to treat secondary bacterial infections. Another type of treatment that may be effective for some people with eczema is phototherapy.
Treatment is aimed primarily at identifying and avoiding the irritant. Identification and avoidance of triggering irritant is the most effective treatment but sometimes the allergen can't be identified or is not completely avoidable so other measures need to be utilized: protective measures such as gloves prevent direct contact, moisturising the skin stops it from drying out and corticosteroid creams can reduce inflammation (various strengths may be used depending on the severity of the condition).
Treatment List for Eczema
The list of treatments mentioned in various sources
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Watchful waiting - many children grow out of the condition.
- Symptomatic treatments
- Hydrocortisone creams
- Sedatives - only for severe itching
- Coal tar ointment - for discoid eczema
- Bathing routine changes
- Lubricants after bathing - such as creams or ointments
- Lukewarm bathing
- Avoid lengthy bathing
- Limit or avoid soap
- Non-soap cleanser
- Air-dry skin
- Gently pat dry skin
- Avoid scratching or rubbing
- Distract child when scratching
- Wear soft cotton fabrics
- Maintain a cool environment - sweating or overheating is unhelpful.
- Keep fingernails filed - prevents a child from scratching.
- Treat skin infections promptly
- Avoid skin infections
- Corticosteroid creams and ointments
- Oral corticosteroids
- Injected corticosteroids
- Phototherapy (UV A and B light)
- Photochemotherapy (light and psoralen)
- Immunosuppressive drugs - used to treat adults
- Diet changes - to try to find a suspect and then later to avoid a suspected food allergy.
- Allergy exposure reduction - various methods to reduce exposures to potential allergens such as dust or pollen.
- Stress reduction
- Biotin - possibly used for treatment of related severe biotin deficiency
- There is no cure but various measures can be helpful:
- Topical corticosteroid
- Warm olive oil on infant scalps may loosen scales
- Shampoos containing zinc or ketoconazole
- Antidandruff shampoos
- Salicyclic acid shampoos
- Antifungal creams
- Aloe vera gel
- Adding essential fatty acids and methylsulfonylmethane supplements to diet may help in some cases
- There is a wide range of treatments that can be utilised and various methods will have different levels of efficacy depending on the underlying cause
- Avoid triggering or exacerbating factors
- Topical steroids
- Adequate diet to address nutritional deficiencies
- Condy's crystals solution
- Soaking in salty water
- Soaking in white vinegar
- Where gloves if protection from irritants is required
- Reduce nickel in diet
- Avoid alcohol and caffeine
- Light treatment
- Wear cotton gloves to prevent scratching and limit exposure to germs
- Avoid chemical irritants such as soaps and detergents
- Leg swelling can be controlled by using the following measures:
- Avoid standing for long periods
- Do regular exercise
- Elevate feet when possible (especially while sleeping)
- Wear compression stockings once skin condition is under control
- Measures to treat skin condition include:
- Antibiotics if infection develops
- Avoid scratching or rubbing the affected area
- Avoid further damage or injury to the skin
- Dry oozing patches with Condy's solution or dilute vinegar
- Varicose veins may require surgical removal or scleropathy
- Treatment is aimed at reducing itching and inflammation. Identification and avoidance of triggering allergens is the most effective treatment but sometimes the allergen can't be identified or is not completely avoidable so other measures need to be utilized: moisturising the skin stops it from drying out, corticosteroid creams reduce inflammation (various strengths may be used depending on the severity of the condition) and antihistamines alleviate itching. Severe outbreaks may require oral corticosteroids. UV light therapy may benefit some cases. Newer topical medications such as tacrolimus and pimecrolimus may be used in some cases but their link to certain cancers is still under scrutiny. An example of a detailed treatment plan is outlined below but obviously these requirements may vary depending on various individual factors:
- Steps for Managing Eczema:
- Bathe only once every 1-2 days - over-bathing can dry the skin.
- Use bath oil to help moisturise skin e.g. Dermaveen, Hamilton's Alpha Ker or QV
- If skin is weeping, avoid bathing with other people to reduce risk of infection
- Oatmeal baths may sooth the skin - plain rolled oats in a stocking placed in the bath may be used instead of commercial oatmeal based bath products.
- Keep the nails short and wear a covering over the hands (gloves or socks) to avoid night-time scratching as the patient is often unaware that they are scratching
- Using low-allergenic washing powders
- Wear cotton clothing as other materials increase sweating and rubbing on the skin
- Moisturise twice a day. It may take some experimentation to find a cream that doesn't irritate the skin. Avoid creams with mineral oils. Commonly used brands include: Alpha Keri, Cetaphil, QV, Dermaveen and Hamiltons
- Oils such as olive oil (extra-virgin) may be used as a moisturizer. Nut oils may be problematic for some people as they may contain protein allergens
- A topical cream called Pimecrolimus may be used to treat eczema - it is non-steroidal and doesn't cause thinning of the skin. Strong steroid-based topical creams may be needed for more resistant patches.
- Use 1-3 Condy's crystals in the bath to dry out weeping eczema lesions - NB these crystals can stain porcelain baths and towels pink. Very red dry skin may benefit from using QV Flare Up Bath Oil.
- Use topical antibacterial cream for infected eczema - oral antibiotics may be recommended in more severe cases.
- Avoid environments that are excessively hot, cold or dry as they can exacerbate skin symptoms
- Avoid any food, chemical or other triggers that may cause or exacerbate symptoms
- Skin lesions may be wrapped in cotton bandages to reduce scratching and allow topical moisturizers and steroid creams to stay on the skin and absorb better
- Avoid or reduce exposure to allergens such as dust mites and moulds. Measures may include: dust mite protective bedding; wash bedding in hot water; air mattress on hot or dry days; dust room with a wet rag; use a dust mite filter on the vaccum cleaner and vacuum regularly; use mould resistant paint on bathroom walls; remove obvious mould which can grow in dark, warm, damp areas; be aware of other sources of mould e.g. pot plants, grasses, compost and water-based air conditioners
- If eczema doesn't respond to treatment, trial an elimination diet (supervised by a medical professional) to try to identify possible food triggers
- Treat acute hives with an antihistamine such as Zyrtec
- Dieticians may be utilised to devise an appropriate diet of food has a large implication on the condition
- Immunotherapy may be used to desensitise and individual who has a specific allergy
- Identify and avoid contact with irritants or triggers where possible. Consider use of gloves etc
- Bathe in tepid water using a PH neutral soap or soap substitute. Avoid prolonged bathing
- Soaking baths with bath oil or colloidal oatmeal for moderate to severe disease or disease flares
- Moisturise promptly after bathing. Non - perfumed products are preferred
- Wet compresses - aluminium acetate or potassium permanganate for infected eczema, or tap water after emollient and/or topical steroids for 15-60 minutes to increase benefits of topical therapy
- Topical steroids in acute exacerbations to control symptoms. Avoid high strength steroids on the face and neck
- Topical immunomodulators - Pimecrolimus and Tacrolimus - may be used as an alternative to topical steroids, but long term side effects have not been fully elucidated
- Tar and ichthammol - useful for chronic or lichenified lesions
- Antihistamines for control of itching - probably little help with awake patients, but sedating antihistamines may have some benefits at night
- Oral steroids - reserved for acute severe exacerbations and widespread disease. Avoid in children. Disease may rebound on cessation
- Systemic immunomodulators - cyclosporine, azathioprine - used for severe disabling disease unresponsive to other treatments
- Phototherapy - UVB and PUVA used in unresponsive eczema, but expensive and concerns exist about long term safety
- Dietary manipulation - unknown efficacy, but need to be cautious of vitamin deficiency, especially in children
Alternative Treatments for Eczema
Alternative treatments or home remedies that have been listed as possibly helpful for Eczema may include:
Eczema: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Eczema may include:
Hidden causes of Eczema may be incorrectly diagnosed:
Eczema: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for Eczema:
Eczema: Research Doctors & Specialists
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Drugs and Medications used to treat Eczema:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Eczema include:
- Advair Diskus
- Embeline E
- Cordran SP
- Iodoquinol and Hyrdocortisone
- Lidocaine and Hydrocortisone
- Lida-Mantle HC
- Egoderm Cream
- Ichthammol Ointment
- Eogerm Ointment
Latest treatments for Eczema:
The following are some of the latest treatments for Eczema:
Hospital statistics for Eczema:
These medical statistics relate to hospitals, hospitalization and Eczema:
- 0.08% (10,251) of hospital episodes were for dermatitis and eczema in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 93% of hospital consultations for dermatitis and eczema required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 49% of hospital episodes for dermatitis and eczema were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 51% of hospital episodes for dermatitis and eczema were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Hospitals & Medical Clinics: Eczema
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Medical news summaries about treatments for Eczema:
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