How to Treat Eczema

General Approach to the Management of Different Types of Dermatitis

Feb 12, 2009 Hanish Babu

General approach on how to treat eczema depends upon certain general and specific measures of management of different types of dermatitis.

Eczema encompasses a wide range of skin inflammatory diseases characterized by itchy skin rash. The specific treatment of eczema differs according to the type, causes and individual variations.

General Approach to the Management of Different Types of Eczema

Treating eczema is not just applying a cream, as is generally believed. It needs a comprehensive care from a dermatologist or physician trained in diagnosing and managing skin diseases.

General measures in the treatment of eczema involve certain principles. The following is the model approach that your dermatologist will take when you approach him or her with your itchy skin condition:

1. Establish the underlying cause: Careful history and examination of the itchy skin rashes.
2. Assess the aggravating factors like food, climate, stress, contactants etc from the patient’s history and provide necessary directions to avoid those.
3. Observe the complicating factors like super added bacterial infection; which, if present, should be treated before the eczema medication is prescribed. If topical steroids are applied in the presence of infection (without first controlling the infection), the situation may actually worsen.
4. Treating the patient as a whole person, taking into account the general physical and mental health, occupation, domestic and social environment and personality, is the golden standard of treating eczema.
5. How much has the eczema interfered with the patient’s family and social life?
6. Previous treatment history is another important part of the history taking in eczema patients. How effective were they? Was there any worsening? Were there any side effects?
7. Assess how much time and effort the patient or parent (if patient is child) is ready to devote to take care of their itchy skin problem.
8. Determining the attitude of the patient or parent towards the risks and side effects of prolonged therapies is also important in charting out the eczema treatment.

Your dermatologist will assess all the above information and prescribe a treatment strategy for you. Hence it is important that you prepare yourself with all the above information before you step into the consultation room.

Treatment of Eczema According to the Stages

Whatever be the cause, there are certain principles in treating the eczema according to the stage of the disease activity, i.e. acute, sub acute or chronic.

1. Acute eczema treatment involves rest, sedating antihistamines, wet soaks, moderately potent topical steroids, aqueous emollient creams, and, if necessary a short course of systemic steroids.
2. In sub acute eczema treatment, bland emollients alternating with moderate to mid-potency topical steroids are used on the rashes. Steroids are replaced with steroid sparing creams like tacrolimus or pimecrolimus if prolonged use is required. The aggravating or sustaining factors should actively be sought for and eliminated.
3. Chronic eczema treatment involves paste bandages, potent or super potent steroid ointments, tar ointments, immune suppressant and systemic steroids, ultraviolet therapy and habit reversal therapies.

Along with the above measures specific treatments for individual eczemas have to be undertaken. In all stages and types of eczema psychological support, avoidance of irritants and protection of skin from further damage are of paramount importance in arresting the disease progress and providing relief for the itchy skin rash.

Reference

• Rook’s Textbook of Dermatology, 7th Edition, 2004

Disclaimer: The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.

The copyright of the article How to Treat Eczema in General Medicine is owned by Hanish Babu. Permission to republish How to Treat Eczema in print or online must be granted by the author in writing.

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