The treatment of eczema is multifaceted.
The first line of defense is controlling the skin disease by improving the skin barrier and the overall health of the skin. This is achieved with regular use of mild or gentle cleansers, followed by application of an emollient moisturizing cream or ointment.
Many top brands cater to eczema-prone or “sensitive” skin, and remove fragrance or unnecessary dyes from the products in an effort to minimize possible irritants. Application of these moisturizers within five minutes of getting out of a bath or shower is most helpful in protecting the skin barrier.
Furthermore, reducing the heat of the water and taking showers or baths that last less than ten minutes will minimize the water loss in the skin. Colloidal products, such as those that contain oatmeal, can be very helpful for the skin to retain moisture.
Lastly, minimizing any imposing known irritant to the skin will help in decreasing the potential eczema response.
The second line of defense in management of the condition is the treatment of flares if and when they occur. Initial treatments would consist of use of a topical steroid cream or ointment to decrease inflammation.
These prescription topicals are usually applied by the patient to the affected area twice daily during a flare-up.
Some steroid prescription creams are too strong or potent to use on areas that are more delicate, such as the face, axilla or groin. Your provider should explain to you exactly where you are to apply the ointment or cream that he or she has prescribed for you, as well as discuss areas that you might need to avoid.
In some instances, two different topicals might need to be prescribed in order to safely treat two separate areas, especially if the affected areas include both the face and the back.
Other treatment options are the use of non-steroid topical ointments or creams. These can help by decreasing inflammation of the skin by a different method from that seen with use of topical steroid creams.
Some patients might find it useful to take a daily antihistamine to help decrease the histamine response seen in the allergic cascade. Most of the antihistamine medications can be purchased over the counter by a patient.
Very severe cases of eczema might warrant use of oral steroids, injectable steroids or even some immune modulating drugs that help control the overactive immune response.
Most cases are not this severe, and your dermatologist will discuss the appropriate treatment option best for your disease.
Kristina A. Ford, MS, PA-C is an associate with May River Dermatology.