How is Eczema treated?

There is no permanent cure for Eczema, but there are lots of treatments available today for soothing the skin and reducing the irritation and itching associated with Eczema. The first line of treatment in Eczema is a topical (applied on the skin) cream or lotion. This can be emollients and moisturizers that keep the skin moist, steroidal creams to reduce the itching and discomfort and antibiotics to prevent a secondary infection due to repeated scratching of the skin. 

People suffering from Atopic Dermatitis almost always have very dry skin. The dry skin cracks and enables the irritants to reach the inside layers of the skin where it causes inflammation and itching. Therefore for treating Eczema doctors prescribe creams that keep the skin moist. It is also advised that the creams be applied soon after taking a bath as it helps in retaining the moisture in the skin. Emollients return moisture to the skin and often help relieve symptoms. Creams (such as Eucerin, Cetaphil, and Nutraderm) and ointments (such as petroleum jelly, Aquaphor, and Petrolatum) are very effective in treating Atopic dermatitis. Lotions should be avoided because they can actually worsen dry skin.

Since the most common symptom of Eczema is severe itching, most treatment is aimed at reducing the discomfort from itching. Minor episodes of itching can also be treated with a cold compress applied to the affected area. 

However in extreme cases of Eczema doctors often prescribe creams and ointments that contain corticosteroids. A corticosteroid is a compound that is related to a natural hormone and helps in reducing the inflammation and itching of the skin. In very severe cases the doctors may prescribe stronger doses of corticosteroids and sometimes even given an oral prescription of steroids. 

However steroid usage should always be limited and these medications should not be taken long-term as they have serious side effects. The constant scratching of the skin may lead to a bacterial infection; therefore sometimes the doctor may prescribe some local antibiotics as well. 

A person with severe Eczema may find it difficult to sleep due to the constant itching. For some cases of Eczema doctors also prescribe antihistamines such as Benadryl. These reduce the itching and inflammation of the skin. However antihistamines can make the patient drowsy therefore it is recommended that these syrups be taken in the nighttime. It is strongly recommended that patients taking antihistamines should not drive during the course of the treatment. Doctors nowadays prescribe non-sedating antihistamines such as Cetrizine and Loratidine to reduce itching. An antidepressant called Doxepin is also sometimes prescribed to reduce itching. It is very important to consult a doctor before taking any medication as these may have some side effects. 

In recent times the FDA has approved the use of two new topical ointments called tacrolimus and pimecrolimus. Both the drugs belong to a family of medicines called non-steroidal immunosuppressants or topical calcineurin inhibitors that reduce the over activity of the skin’s immune system that occurs in Eczema. These medicines are non-steroidal and have fewer side effects than corticosteroids, which can lead to skin thinning when used long term. These drugs are especially useful in treating sensitive areas of the body like eyelids, face and neck. However patients using these medicines are advised to wear sun protection creams as the two drugs suppress the immune system. 

In very severe cases, doctors may prescribe oral steroids such as Cyclosporine A and Azathioprine. Both are powerful immuno suppressants, which are used for organ transplant therapy. Both drugs have strong anti-inflammatory action on the skin and are prescribed for severe Atopic eczema. However the use of these drugs is not widely reported as it can cause serious side effects such as kidney damage and high blood pressure. These drugs are only approved for short-term treatments and must only be taken under close supervision. 

Many patients of long term Eczema report that their skin and Eczema gets better during warm sunny days. Doctors ascribe this to the ultraviolet (UV) rays emitted by the sun that reduce the over activity of the skin’s immune system providing relief from Eczema. Therefore sometimes doctors recommend UV therapy for treating Eczema patients. For the last three decades fluorescent lamps that emit UV have been used as an artificial form of sunlight therapy or “phototherapy” for Atopic Dermatitis. 

                                                              How do you manage Eczema