Treatment for eczema is directed at reducing inflammation, relieving itching and preventing future flare-ups. Over-the-counter anti-itch creams and other self-care methods can help control mild eczema. Although eczema is associated with allergies, eliminating allergens rarely helps. Its virtually impossible to eliminate all dust and allergens. Feather pillows and mattresses, down comforters, carpets and curtains are traps for dust and allergens which cannot be entirely eliminated and can make eczema worse. Allergy desensitization shots dont usually improve eczema.
Medications may be of benefit:
Corticosteroid creams or ointments: may be prescribed in moderate to high-potency concentrations, to relieve itching and ease scaling. Low-potency corticosteroid creams or ointments are available without a prescription, but talk to your doctor before you use any corticosteroid products. There may be long-term effects such as skin irritation or discoloration, thinning of the skin, infections and stretch marks.
Antibiotics: may be needed if breaks in the skin allow bacteria to infect the wound. Sometimes antibiotics are used to lower the number of bacteria usually present on skin, to reduce the risk of infection.
Oral antihistamines: may be useful when itching is severe. Dyphenhydramine (Benadryl and others) can cause drowsiness and may be helpful at bedtime.
Oral or injected corticosteroids: may be used in severe cases, such as prednisone or injected corticosteroids to reduce inflammation and relieve itching. The medications are very effective but cannot be used long-term because of the side effects which can be serious, such as cataracts, loss of bone strength (osteoporosis), muscle weakening, decreased resistance to infection, and high blood pressure and thinning of the skin.
Immunomodulators: are a class of medications, such as tacrolimus (Protopic) and pimecrolimus (Elidel) with effects on the immune system that help to maintain normal skin texture and reduce flare-ups. They are prescription drugs approved for people older than 2 years. Long-term effects are not known, thus the Food and Drug Administration recommends that they be used only when all other treatments have failed or the subject cant tolerate other treatments.
Light Therapy: (phototherapy) uses natural and artificial light. Natural sunlight, artificial ultraviolet A (UVA) or ultraviolate B (UVB) light therapy are effective, but there are long-term harmful effects, such as premature aging of the skin and an increased risk of skin cancer. Consult your doctor before using light treatment.
Self-care methods for reducing itching and soothing inflammation include:
Identify and avoid triggers you know affect you adversely.
Use anti-itch cream or calamine lotion on affected areas, such as over-the-counter hydrocortisone creams.
Avoid scratching, keep nails trimmed and wear gloves to bed.
Avoid potentially harmful substances found in cosmetic products.
Apply cool, wet compresses to areas of intense itching.
Take a warm bath. Sprinkle the water with baking soda, uncooked oatmeal or colloidal oatmeal, which is a finely ground oatmeal used for baths (Aveeno and others).
Use mild soaps without artificial dyes or fragrances. Take care to rinse off all the soap. Moisturize your skin by applying a natural ointment after a bath when skin is still moist.
Use a humidifier. Keep it clean to prevent the growth of bacteria and fungi.
Wear smooth-textured cotton clothing.
Claims have been made that chamomile, evening-primrose oil, witch hazel extract and borage-seed oil may be of benefit as eczema treatments, but there is no evidence that these alternative methods are effective. Consult with your doctor about these and any other alternative substances or dietary supplements before you use them.
More Facts About Eczema
You cannot infect people with eczema because it is not an infection. It is not uncommon for a person with eczema to have other types of skin problems. Your doctor can help you with managing multiple skin problems.
Eczema is not curable. Be careful about taking good care of your skin and following your doctors instructions to minimize active disease. When vigorous scratching causes breaks in the skin, bacteria can set up an infection. You may need antibiotics. Gently wash off the honey-colored crusts and apply an antibiotic ointment, such as Neosporine. If it doesn't heal, see your doctor.
Eczema present in childhood may improve with age, but there is still risk of flare-ups. A mild soap should be used, either as bars or liquid. Purpose, Dove, and Aveeno are nonirritating. Avoid deodorant and antibacterial soaps, or products with artificial colors and fragrances.
Being diabetic does not make eczema worse, but people with diabetes must be very careful about not breaking the skin, which increases risk of infection. Any sign of infection should be seen by a physician. Allergies and hay fever can be associated with eczema. Be aware of, and avoid, foods and substances that irritate your skin or cause other symptoms. No association between eczema and skin cancer has been identified.
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