Treating Eczema

Even with careful moisturizing, outbreaks can happen. For relief, keep moisturizing and try the following:

• Cool compress: Wet a soft cloth with cool water and gently hold it against the itchy skin.
• Oral antihistamine: Take an over-the-counter oral antihistamine to help stop severe itching. It can cause drowsiness, so take it at bedtime.
• Corticosteroid cream: With a dermatologist’s direction, use a corticosteroid cream to reduce inflammation in the skin. The creams are effective but frequent use can cause problems, such as thinning of the skin and bruising.

If outbreaks can’t be controlled, or the eczema is severe and frequent, it’s a good idea to see a dermatologist. The dermatologist may prescribe one of the following treatments:

• Corticosteroid creams or oral medications: Prescription creams or pills are effective but may cause side effects, such as thinning of the skin when used for a long time. Since the oral version of the medication can lead to weight gain and potentially increase the risk of diabetes and ulcers, the pills are rarely used with children. Both corticosteroid treatments can be safe when used short-term and as directed by a dermatologist.
• Immune modifying creams: Two newer medicines called tacrolimus and pimecrolimus help keep the immune system in check so it doesn’t overreact to irritating things. Pimecrolimus is prescribed for mild to moderate atopic dermatitis while tacrolimus is used to treat moderate to severe atopic dermatitis.
• Antibiotics: If an infection develops from excess scratching, an oral antibiotic can treat it.
• Coal Tar: This common treatment from the old days is just what it sounds like. It can be very effective, stopping itching and redness. Coal tar does not have any serious side effects but it sometimes smells bad, is messy and can stain the skin.

For especially severe cases of eczema, the dermatologist might suggest one of the following treatments:

• Light therapy: This therapy suppresses the overactive immune system response often related to eczema.
• Cyclosporine: This potent medication also suppresses the immune system.

In addition to these treatments, dermatologists may suggest other therapies as well. You also may see information about using supplements such as primrose oil, borage oil, zinc, B6 and vitamin E for eczema; studies do not show that they work. Some research has shown that certain Chinese herbs can control atopic dermatitis. However, they can cause serious liver and kidney problems in some people. Consult a dermatologist before trying any alternative treatments.

If the eczema is really bothersome, talk to the dermatologist about help with coping. Some things to ask about are:

• Behavior modification therapy
• Support groups
• Camps for kids with eczema such as the American Academy of Dermatology’s Camp Discovery.

The dermatologist may ask questions to help find out what is triggering the eczema. In extreme cases, the dermatologist also may suggest testing to see if an allergy is triggering the outbreaks. Allergy tests that may be performed are:

• Patch test: The dermatologist will apply strips of tape that contain tiny amounts of common allergens to the skin on the back. The strips must be worn for 48 hours. You’ll have to visit the dermatologist twice in those two days to see if there is a reaction on the skin. If a red spot appears when the dermatologist removes the tape, an allergen may be the culprit.
• Blood test: A special type of blood test can identify some allergies.
• Skin prick test or scratch test: During this test, the dermatologist applies a small amount of a suspected allergen with a scratch or prick to the arm or back. If a red welt or hive appears, it’s a likely sign of an allergy to that substance.

Even with these tests, it’s often very difficult to find out what triggers an outbreak. Don’t be disappointed, though. With prevention and treatment, you can help keep eczema under control.

 

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