Treatment of different types of eczema is almost similar. Treatment can control symptoms but it does not cure the disease. If you have eczema the doctor may prescribe:
Emollient: These are non-cosmetic moisturisers which are used for application on skin. They are available in different form of creams, ointments, lotions and gels. Emollients moisturise the skin and help you to feel more comfortable and less itchy. They also help to prevent cracks by making the skin moist and flexible. In mild to moderate eczema, daily application of an emollient helps to keep it under control.
Soap Substitutes: Soap can cause drying of skin and is best avoided if you have eczema. The hands are especially prone to develop eczema as they are washed more frequently. Liquid soaps/cleansers and perfumed products can also irritate the skin if you have eczema. So avoid these products as well. Emollient soap substitutes are less irritating for the skin. They do not foam but clean the skin as effectively as a soap.
Topical corticosteroids: Topical steroids (medications for local application on skin) are the mainstay of treatment of eczema during flare-ups. Owing to their potent anti-inflammatory action they reduce inflammation (make the skin less red, hot, itchy and sore) and speed up the healing of the skin. However when used for long time, they can cause several side effects. Hence steroids should be used appropriately and under supervision. If you are using topical steroids follow up regularly with your doctor.
Calcineurin inhibitors: The calcineurin inhibitors (tacrolimus and pimecrolimus) like the steroids suppress the inflammation in the skin and control flare-ups. They work in a different way to steroids and do not have the potential side-effects of steroids. These drugs are an important advance in the treatment of eczema. They are mostly used when corticosteroids are effective or cause unacceptable side-effects.
Antihistamines: Itching can be a more bothersome symptom than the skin lesion in eczema.
Scratching can make itching worse and it increases the risk of skin becoming infected. Your doctor may prescribe antihistamines, which have a sedating effect, to control severe itching during acute flare-ups of eczema. These are effective as they cause sedation, and can help you to sleep without scratching when taken at bedtime.
Antimicrobials: Skin lesions in eczema may often become infected, particularly with the bacteria Staphyllococcus aureus (a germ found in large numbers on skin affected by eczema). Scratching increases the risk of skin becoming infected. In areas where the skin is moist (such as skin folds), it is more susceptible to fungal infections. Infection in eczema increases the severity of skin inflammation and may require treatment with antimicrobial medicines (such as antibiotics, antifungals or antivirals). The antimicrobial medicine may be given as topical application or to be taken by mouth depending on the severity of infection.
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