Eczema is a broad term for a number of inflammatory skin diseases with the most prominent being Atopic Dermatitis. Eczema is not curable, so treatments are designed to bring relief or to put the disease into temporary remission. Even the common childhood variety that seems to be outgrown with time leaves a person with tendencies towards several other conditions of the skin and eyes.
Since symptoms and causes vary it is necessary to define the problem as it affects the patient and seek methods of controlling possible contributing factors. Including stress and allergies. Since the disease is familial in nature it is helpful to access the other members of the family with similar problems.
As with most conditions, the least invasive and harsh treatments should be considered first, since some of the more severe treatments have side effects and create problems of their own.
One of the most important factors in the treatment either alone or in combination with other measures is to keep the skin barrier intact. This can be done with ample applications of moisturizers. These are often most effective when applied following a warm bath or soak. Since lotions contain water, they may actually be drying to the skin so it is recommended that ointments be used instead. Although messier, they are preferable for moisturizing.
Consider stress factors and try to avoid or control them. Practice relaxation and coping exercises to reduce stress and avoid unnecessarily stressful situations when most vulnerable. In more severe situations the services of a doctor or mental health professional may be necessary to reduce these factors.
Watch for food allergies. Try to eat a basic diet and add back items slowly to see if you can pinpoint the offending item. Suspect items can include nuts, milk, eggs, soy, wheat and seafood. If the condition does seem to have a large allergic component that you are unable to assess or control, your doctor can perform blood skin or tests to narrow the offending items for you.
Wear loose fitting breathable clothing to avoid rubbing and excessive sweating that can increase the inflammation and discomfort.
Try not to scratch or rub the area at any time and learn to recognize the signs of infection. These infections may not be as noticeable at first glance because the skin is already inflamed and hard. They can, however, be dangerous.
If more natural methods do not keep the condition under control your doctor can prescribe medications. Keep in mind that medications do have side effects and can cause problems of their own.
The doctor may prescribe cortisone creams but they are potent steroids and can cause problems with long term use. In extreme cases cortisone may be administered in shots or pills. It is important to remember that these are potent drugs and should be used only as directed by a physician. Overuse can be extremely damaging.
Ultraviolet light is also used in some cases. It should only be used under a doctor’s care and needs to be carefully moderated.
Tar baths, antibiotics, and antihistamines are sometime used but are limited in their success. Antibiotics are most successful in controlling infections caused by scratching and breaking the skin. Antihistamines cause drowsiness and are therefore somewhat helpful in keeping children from scratching.
There is a new family of drugs called topical immunomodulators (TIMs). They are non-steroid drugs and do not cause thinning of the skin. They are used with caution because they do suppress the immune system in the skin. They should be used with sun protection. There are two that have been approved by the FDA. They are tacrolimus and pipecuroniums.
Whatever treatment is decided upon it is important that it fit the severity of the problem and not put undue risk or stress on the patient. As with any treatment it is best to start with the mildest and move toward the more sever as conditions warrant. The most important factor is that the patient gain control of the condition and has an understanding of the causes and interventions that are available.