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Eczema - Tips and Treatments

Tips and Treatments

There are a number of ways to manage eczema, all of which begin with an effective skin care routine. Having access to accurate information is important as this allows the person with eczema, or their carer, to make informed choices when managing the condition. The following are the more commonly used treatments. Further information on any of these can be obtained through the National Eczema Society.

Emollients

Emollients are necessary to reduce water loss from the skin, preventing the dryness normally associated with eczema. By providing a seal or barrier, the skin is less dry, itchy and more comfortable. Emollients are safe to use as often as is necessary and are available in various forms: ointments for very dry skin, creams and lotions for mild to moderate or wet' eczema and gels for eczema under hair. Some are applied directly to the skin, whilst others are used as soap substitutes or can be added to the bath. The range of emollients available is enormous and it may be necessary to try several before the most suitable one is found. Testing a small amount on the skin first is advisable, as emollients contain substances to which some people are sensitive.

Topical steroids

When eczema is under control only emollients need to be used. However in flare-ups, when the skin becomes inflamed, a steroid cream may be needed. Steroids act by reducing inflammation and are used in most types of eczema. Topical steroids come in four different strengths, mild, moderately potent, potent and very potent. The strength of steroid cream that a doctor prescribes depends on the age of the patient, the severity of the condition and, the size of the area and part of the body to be treated. Topical steroids are applied thinly to the affected area, as directed by the prescribing doctor. Your eczema should be reviewed regularly if topical steroids are being applied. It is important to use only the steroid cream prescribed for yourself and not to lend or borrow (what may be) an unsuitable cream from someone else. Many people have concerns regarding the use of topical steroids and their side-effects. As long as steroids are used appropriately and as directed by your doctor, the likelihood of side effects is very rare. Reported side-effects have been largely due to the use of very potent steroid preparations over long periods of time.

Oral steroids

are sometimes prescribed in very severe cases and usually under the direction of a consultant dermatologist, when topical steroids have been found to be ineffective. These can have possible side-effects and the doctor should ensure close monitoring when prescribed.

Other treatments

that your doctor may discuss are anti-histamines to reduce inflammation and wet wrap bandaging to soothe dry itchy skin. Ultra Violet light treatment and stronger medication may be considered for very severe eczema.

As well as using emollients and steroids there are several other ways which may help to reduce the severity of atopic eczema. It should be stressed, however, that what works for one person, will not always work for another. Eczema is a highly individual condition, which is why it is so difficult to find a "cure-all".

Reducing the itch

For children in particular, the itchiness of eczema can be very distressing. There are many methods of reducing the itchiness of the skin and minimising the damage from scratching. Cotton clothing and bedding keep the skin cool and allow it to breathe, whereas synthetic fabrics and wool can irritate. The use of a non-biological washing powder and avoidance of fabric softeners, can also help to reduce the itchiness of the skin. Children's nails should be kept short. During the day, distraction is often the best way of reducing the amount of scratching. At night-time, cotton mittens over children's hands can be helpful in reducing damage to the skin occurring during sleep.

Reducing the effect of the house dust mite

It is thought that people who have atopic eczema may be affected by allergens in the droppings of the house dust mite. This mite thrives in warm and moist environments and unfortunately likes to live in bedding, mattresses, curtains and carpets. It is believed that reducing the amount of house dust mites in the home may improve the condition of the skin. This can be achieved in a number of ways, from effective and regular vacuuming, to damp dusting and airing of bedding.

The role of diet in the management of eczema has not been ascertained. Generally changes in diet are only considered in severe cases, when conventional treatments are failing. Dietary changes can be quite helpful in babies and young children, though the effects on older children and adults are less conclusive. When considering altering the diet of a baby or child it is important to seek advice from a dietitian, or a nutritional therapist, in order to ensure that the child continues to receive adequate nutrients. Sometimes it can be useful to keep an accurate diary of foods eaten and the condition of the eczema and, when weaning babies, to do so very slowly observing for skin reactions. This is a large and complex topic. Further information can be obtained from the National Eczema Society.

Many people prefer to explore the use of complementary therapies in addition, or as an alternative, to conventional treatments. Complementary therapists offer a holistic approach which is usually based upon the individual's needs. Evening primrose oil is now commonly used and other treatments such as aromatherapy, relaxation and homeopathy are readily available. Chinese herbal treatments may be used, but should only be tried after consultation with your doctor or dermatologist.

Though many people have found the use of complementary therapies helpful, there has only been limited scientific evaluation of complementary treatments and so it is important to consider the following:

It is essential to let your doctor know if you are starting another course of treatment, since interactions can occur between certain medications. Conventional treatments should not be stopped suddenly, without consulting your doctor.

Ensure that the practitioner is properly qualified and registered with the appropriate regulatory body.

Remember that a treatment which is described as natural or herbal is not guaranteed to be safe.

What works for one person will often not work for another.

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