Treatment of Eczema

ID-10092116Eczema (also known as atopic dermatitis and both the terms eczema and atopic dermatitis are sometimes used synonymously) is a chronic inflammatory condition of skin. In many cases eczema may be accompanied by chronic inflammatory and allergic conditions such as bronchial asthma, hay fever etc.

Management of eczema (atopic dermatitis) includes use of medications such as corticosteroids, immunosuppressant drugs (also known as immuno modulators), antihistaminics, antibiotics, and moisturizers. Sometimes phototherapy is also used for treatment of eczema.

Corticosteroids in treatment of eczema:

Corticosteroids are the mainstay of treatment of eczema. Depending on the severity of eczema, different types of corticosteroids are used. For mild eczema, low potency steroids (such as mometasone) are used and for moderate to severe eczema, high potency steroids (such as clobetasol propionate) are used. These are mainly used as topical agents. For very severe eczema, oral or injectable steroids may be used, but they have high risk of potentially serious side effects.

Immunosuppressant drugs in treatment of eczema:

Immunosuppressant (also known as immuno modulators) drugs such as tacrolimus, pimecrolimus etc. are commonly used for treatment of eczema. These drugs can modulate the immune system of the body and help in maintaining the normal texture of skin and increase (to normal) the turn around time of epidermal layer of skin, which is reduced in eczema. These drugs are used in children above 2 years of age and in adults. These drugs should be used only when other medications (e.g. steroids) have failed, because they can affect immune system and prolonged use should be avoided.

Antihistaminics in treatment of eczema:

Antihistaminics are used to provide relief from itching, which is a common symptom of eczema. Any antihistaminic can be used for itching. Second generation antihistaminics such as cetirizine, fexofenadine (Allegra) etc. can be used because they are non sedative in nature and do not induce drowsiness or sleeping. If sedation is not a problem, first generation antihistaminics such as promethazine (Phenergan) or diphenhydramine (Benadryl) etc. can be used.

Antibiotics in management of eczema:

Antibiotics do not have any direct role in treatment of eczema. Antibiotics may have to be used if there is bacterial skin infection over the eczematous lesions or there is sore or fissure due to scratching.

Role of moisturizers in management of eczema:

Eczema may lead to excessive dryness of skin, which may make it difficult for topical medications (such as corticosteroids and immuno modulators) to penetrate the skin layers and act. Moisturizers help in softening the skin and moisturizing the skin, which helps the medications to enter and act locally.

Phototherapy in treatment of eczema:

Exposure to natural sunlight (as well as artificial ultra violet light) can be helpful in treating eczema.

“Image courtesy of Jomphong / FreeDigitalPhotos.net”.

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