Treating Eczema

 

Treatment options for Eczema

Emollients

Moisturising ointments or emollients are the most important treatment for eczema as they work by making an oily layer on top of the skin, preventing the water from getting out and the skin from becoming dry. Emollients are the single most effective regular treatment for eczema and should be applied in large quantities and frequently.7,10 A moisturiser, such as an emollient, can improve dry skin and help prevent flares. You can carry on using an emollient, even during a flare.7,13

Topical calcineurin inhibitors (TCIs)

Topical calcineurin inhibitors (TCIs) are a steroid-free, anti-inflammatory topical therapy for eczema.14 They improve AD symptoms and itching. TCIs reduce the number and severity of the flares, and can prolong the time between major flares. When used at the first sign of a flare, TCIs can help prevent it from getting worse.4,7 As TCIs do not cause skin thinning, it can be used on sensitive skin areas, such as the face and skin folds.7,14

Topical corticosteroids (TCS)

Topical corticosteroid (“steroid”) creams and ointments can quickly help to calm the redness and itching of inflamed skin, particularly for severe flares.7 They are not intended for long-term use (more than a couple of weeks).4,7 When steroids are used for long periods of time, side effects such as skin thinning can become apparent. Be aware that even mild steroids should not be used for an extended period of time on a child’s skin particularly in sensitive areas such as the face, neck and other skin folds.7

Phototherapy

Phototherapy is the use of UV light to treat eczema. It has been shown to be effective as a short-term treatment in adults and adolescents, but it is not to be used in children. Phototherapy needs to be administered by trained personnel to ensure it is delivered safely and effectively.14,15

Antihistamines

Antihistamines are available in topical (put on the skin) and oral (taken by mouth) formulations. Oral antihistamines are used to relieve itching, but can cause sleepiness.13  Topical antihistamines do not have much use in eczema and are not recommended.7

Wet-wrap therapy (WWT)

Wet-wrap therapy is recommended for patients with moderate to severe eczema to decrease symptoms during flares. A topical agent is put on the skin and covered by a layer of wet bandages, gauze or a cotton suit, followed by a second dry layer. The aim of the therapy is to increase the penetration of the topical treatment, decrease water loss through the skin, and provide a barrier against itching. The wrap can be worn for up to 24 hours at time.7

Assessing the skin zones and what treatment to use

Adapted from Luger T, et al 1 and Eichenfeld L, et al 7