What is the best medicine for Eczema?

February 1, 2019

There are many different drugs which you can use if you have an attack of eczema. Some of these drugs are best for mild cases, while you will need some other drugs in more serious cases of eczema.

 These drugs which can be used for eczema are of different types with different mechanisms of action. They also appear under many different brands in the market, and different doctors tend to have their favourite drugs which they believe are effective in their patients.

Therefore, there is no single drug that may be termed as the best drug for eczema. Each drug has its own indication for which it is best used.

MILD ECZEMA

In mild cases of eczema, the frequent use of moisturizers is highly recommended. Moisturizers are used to help conserve moisture on your skin and they are very helpful in eczema. This is because eczema is associated with skins that are always dry.

If you always keep your skin moist through the use of moisturizers, the frequency of attacks by eczema will be reduced.

There are different kinds of moisturizers that you can use to keep your skin moist. Some of them are prepared as ointments with high oil content. Others are prepared as creams with higher water content than the ointments. Some also come in the form of lotions which have the highest water content.

The best type of moisturizers for you to use are the ointments which have a very high oil content and less water. The high amount of oil which the ointments contain helps to conserve water on your skin. The higher the oil content, the better the moisturizing effect.

It is best for you to use moisturizers which do not have extra chemicals like fragrances or artificial colourings or preservatives. This is because these chemicals can also irritate your skin, thereby worsening the effects of your eczema. Preparations such as watery creams and lotions are best avoided.

A very common and highly effective moisturizer is plain petroleum jelly. This has a powerful moisturizing effect. It can be applied all over your body shortly after bathing. The thicker the layer you apply, the higher the moisturizing effect. You can also apply it on your hands after washing.

You can carry a tube of petroleum jelly about, and apply it to your body from time to time throughout the day.

MODERATE ECZEMA

If your attacks of eczema are more marked, the first line of drugs usually used are the steroid ointments. These are ointments which contain steroid drugs such as betamethasone or prednisolone.

 These steroids reduce the effects of inflammation at the site of application. By reducing the inflammation, the rashes, redness and itching can be relieved.

 You should always exercise some care when using steroid ointments. You should not apply them more than two times a day. If you use them excessively, they may have side effects such as making your skin more prone to infections or making your skin thinner.

There are also some specially prepared moisturizers or emollients which help strengthen your skin’s natural barrier function. The skin barrier is weak in many people with eczema making their skins unable to adequately resist environmental allergens.

These emollient ointments which help strengthen the skin barrier further may contain added components such as naturally occurring lipids and ceramides which fortify the skin, in addition to their moisturizing effects.

 Some doctors may choose to use an immunosuppressant cream such as pimecrolimus cream or tacrolimus cream instead of a steroid cream. These drugs are known as calcineurin inhibitors, and they help reduce inflammation thereby reducing the redness, the itch and the rashes.

SEVERE ECZEMA

When eczema is severe, the rashes are very widely spread over the body, and there may be much itching. In some cases, bacteria or viruses may invade the skin, resulting in added symptoms. These symptoms include watery blisters, a copious discharge from the affected area, excoriations and eventual scarring of the skin.

Viral infection following eczema can spread to affect other parts of the body and make you feel very unwell, and be in need of hospitalization.

 There is no single best medication for the treatment of severe eczema, but management depends on your response to the medications employed. The different drugs have different uses, and several different types of drugs may be tried out by your doctor, before one that properly controls the symptoms is found.

Oral steroids:

These can be used for a short period of time in an attempt to reduce the inflammation by suppressing the immunity. Caution should be exercised in their use because they can have side effects such as blood glucose or blood pressure elevation, and fat redistribution.

Antibiotics:

Your doctor will usually consider giving you these if there is additional infection by bacterial organisms. There is no single best antibiotic to use because the organisms involved may differ. It is best to determine the actual offending agent through a swab test to determine the antibiotic medication that would be most effective.

Antivirals:

Sometimes viruses may invade your skin during an attack of severe eczema. The most common virus implicated is the herpes virus.

If an attack of eczema is complicated by the herpes virus, your doctor may decide to give you an antiviral drug such as acyclovir to help manage your disease.

Antihistamines:

Antihistamines such as chlorpheniramine, brompheniramine, loratadine, etc may be prescribed by your doctor in cases of severe eczema. The main aim of these drugs will be to help you sleep better at night, and reduce the effect of the strong itch. You will usually take these drugs in the evening after the days work, because they will make you feel drowsy.

Other drugs

Some other medications such as ciclosporin and azathioprine may also be considered by your doctor, if your eczema refuses to respond adequately to all the other forms of treatment listed above. These drugs will be administered to you under very close supervision and monitoring.

REFERENCES

  1. National Eczema Association. Controlling Eczema by moisturizing. National eczema.org. Accessed 7th January 2019.
  2. Nicole Yi Zhen Chiang, Julian Verbov. Dermatology, a handbook for medical students and junior doctors. 2nd edition. London, UK: British Association of Dermatologists; 2014.
  3. Australasian society of clinical immunology and allergy. Eczema ( atopic dermatitis). www.allergy.org.au. Accessed 4th January 2019.

 

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