There are several different types of eczema. The best treatment for you in an attack of eczema often depends on the type and severity of eczema involved.
Therefore, there is no single best treatment modality for eczema in adults.
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The most common approaches to the treatment of an attack of eczema in an adult include the following:
A plain moisturizer is used to keep the skin moist in people with dry skins.
The tendency to have dry skins occurs in atopic dermatitis and makes such people more susceptible to having flares of eczema.
This tendency is due to the deficiency of a naturally occurring structural skin protein called filaggrin which increases the moisture-conserving property of the skin.
If you suffer from dry skin due to atopic dermatitis, a very effective plain moisturizer for you to use is plain petroleum jelly which has a very high oil content. It can be applied to the skin frequently throughout the day to keep your skin moist.
These are moisturizer formulations which also have organic compounds like lipids and vitamin precursors which are expertly blended by experts to help increase the barrier function of the human skin. When you use them properly, they make your skin more able to withstand common environmental allergens. Some recommended specialized moisturizers include the following:
This contains dimethicone, glyceryl, Cyclomethicone, ethylpropanediol.
3. Corticosteroid creams
These are used to treat the inflammation that is present in eczema. They reduce the symptoms of itching, redness and rashes.
You should not use corticosteroids for prolonged periods because they can cause thinning of the skin as a side effect.
A corticosteroid cream that you can use in eczema is hydrocortisone ointment, which comes in different strengths.
Use corticosteroid creams as directed by your physician. Avoid using them on the skin of your eyelids because the skin of your eyelids is quite thin.
4. Topical Non steroidal anti inflammatory drugs (NSAIDS)
Non steroidal anti-inflammatory drugs are a group of medicines which reduce inflammation. A few of them are available as ointments for the treatment of eczema.
These drugs reduce the symptoms of inflammation such as redness, itching and rashes which are associated with eczema.
An example of an NSAID cream which is available for the treatment of eczema is Eucrisa, which can be applied twice daily for the management of the inflammatory symptoms of eczema.
5. Calcineurin inhibitors
These are a class of drugs which have the effect of reducing the immune response.
When applied to the skin, they reduce the redness, itching and rash.
Examples of these drugs include tacrolimus cream and pimecrolimus cream.
When you use them as directed by your doctor, they can be effective in relieving the symptoms of eczema.
However, prolonged use of these drugs is discouraged. There are strong concerns that the prolonged use of calcineurin inhibitors may predispose to some kinds of skin cancer.
6. Antibiotic creams
Antibiotics are used when bacteria invade the skin during an attack of eczema.
This invasion of the skin can occur as a result of the scratching which can enable bacteria to enter your skin. This usually manifests as a copious discharge from the eczema lesion.
There are many different antibiotic ointment medications available, and the particular medication to use is sometimes determined from the result of a skin sensitivity test.
This test is done by your doctor after he dabs your eczema lesions with a cotton swab stick as he examines you in the clinic.
7. Antifungal creams
This is usually indicated if you have seborrhoeic dermatitis where there is an overgrowth of naturally occurring skin fungi.
This occurs as a result of excessive secretion of sebum(oil) by the sebaceous glands of your skin.
This form of eczema usually occurs in hair bearing areas of the body such as your scalp, your face or your chest.
8. Oral steroid drugs
Oral steroids are used when the ointments and creams fail to control the symptoms of eczema.
This mostly occurs in an attack of severe eczema. The oral steroids are taken by mouth, and they reduce the inflammatory response thereby helping to control the symptoms of eczema.
Oral steroids should only be used under the close supervision of a physician because they have potentially serious side effects if they are used for prolonged periods of time. Some of the effects of steroids include an increased blood pressure leading to hypertension, an increased blood sugar leading to diabetes, fat redistribution in the body etc.
9. Oral immune suppressant drugs
These medications suppress the overall immunity of the body, thereby reducing the symptoms in a severe attack of eczema. They are to be used only on prescription by a physician and under close medical supervision. These include drugs such as azathioprine, ciclosporin, etc. they are reserved for cases of severe eczema which have refused to respond to other drugs and which have defied all other treatment modalities.
Antihistamines are drugs that block the effect of histamine in the body. They include drugs like chlorpheniramine or piriton, brompheniramine, loratadine, etc.
They are primarily used to aid sleep in severe eczema due to their ability to cause drowsiness. They are therefore best taken during the evening or at night after the days work to facilitate sleep in severe eczema.
11. Ultraviolet light
The use of ultraviolet light can relieve the symptoms of eczema. This occurs because ultraviolet light can reduce inflammation. It may therefore relieve the itching rashes and redness in severe eczema.
This treatment is to be administered by suitably qualified dermatologists. Caution should be exercised in exposure to ultraviolet light because such exposure could possibly predispose to the formation of some cancers.
- Nicole Yi Zhen Chiang, Julian Verbov. Dermatology, a handbook for medical students and junior doctors. 2nd edition. London, UK: British Association of Dermatologists; 2014.
- Australasian society of clinical immunology and allergy. Eczema ( atopic dermatitis). www.allergy.org.au. Accessed 4th January 2019.