ECZEMA
Eczema
is a very common condition of the skin. It causes itching, dryness and
thickening of the skin. There are no
sudden permanent cures for eczema, though it can be controlled by regular use of treatments. For many people with
eczema, it is only necessary to use the treatments during infrequent flare-ups.
Why
do I get eczema?
·
Many people
with eczema are born with the genes to get a dry skin. This tends to go with a
tendency towards hay fever and asthma in the family.
·
Many babies
and toddlers are troubled by it for a few years, but it becomes far less of a
problem as they get older- though it can come on at any age, out of the blue.
·
It can be
flared up by infections, in particular with a particular bug called Staphylococcus aureus, which is everywhere around us, to a certain
extent.
·
Eczema is
made worse when the skin loses it’s natural oils- it becomes less supple,
dried out and starts to itch. Because of this, it is
critical to avoid hot soapy water and detergents that will demoisturise and
dry out the skin.
·
Many
sufferers find they have an allergy to the house dust mite. This is everywhere
around us. It lives on carpets, clothes, bedding etc.
·
It tends
to be worse in winter, easier during the sunny summer
·
Breast-fed
children tend to have less of a problem with eczema. Because of this, women with
a tendency to asthma, eczema or hay-fever should try to exclusively breast-feed
till at least four months old. Children
in hard-water areas have a little more problem with eczema
·
Most people
with eczema don’t find looking for food allergies very helpful
What
can I do about eczema?
Again, we cannot totally cure it- but we can give
you treatments which, used regularly, will control
your eczema.
·
Avoid soaps
and detergents like the plague. Wash shampoo off hair in the basin
·
Instead of
soap, use aqueous cream (or greasy emulsifying
ointment) as a substitute, every day. This will moisturise your skin. During
flare-ups in, aim to use a 500g. tub each week for children- this will reduce
the need for steroid ointments.
·
Rub in
moiturisers such as aqueous cream or oily
cream into dry areas, frequently and liberally
·
Use an emollient
bath oil (such as Oilatum, Emulsiderm, Ashbourne emollient etc) regularly in
your bath- similarly,
there are emollient shower gels available. Beware- it makes the water very
slippery
·
use the mildest
steroid ointment that controls your eczema when it is flared up. Use sparingly, but enough to control the eczema- the skin should glimmer
slightly in the light after gently rubbing the ointment in. An ointment is
better than a cream as it puts back the grease and oils that eczema skin lacks.
Sometimes, it is worth swapping between
steroid ointments of similar strengths, as the body can get used - or even
allergic- to one particular preparation. Occasionally, you can become allergic
to some of the constituents of ointments, so we have to switch to creams
instead.
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Proper name
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Trade name
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Similar alternatives
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 Mildest, least side-effects
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hydrocortisone
(various strengths)
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(Efcortelan)
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clobetasone
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(Eumovate)
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Trimovate,(with anti-biotic)
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mometasone
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(Elocon)
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fluticasone
(Cutivate)
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betamethasone
valerate
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(Betnovate)
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Synalar
Fucibet, BetnovateC- with
anti-biotics
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Strongest, most side-effects
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clobetasol
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(Dermovate)
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Nerisone forte, Dermovate NN,(with anti-biotic)
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never use anything stronger
than hydrocortisone on the face, unless your doctor has told
you to do so
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How
much steroid should I use? For advise on using finger tip units to measure the
amount of steroid cream to use, click on http://www.dermatology.co.uk/topicalsteroids/measuringsteroidsbyfingertipunit/index.asp
for more severely affected people with eczema
·
consider
trying to reduce the staph. aureus bug
by-
using Oilatum Plus (or similar), an emollient bath oil
which can reduce the staph. aureus
on your skin
-using
Dermol 500 - an anti-septic- all over the body each day
-discuss
with your doctor using anti-biotics during flare-ups of your eczema
·
reduce your
exposure to house dust mite by - using synthetic bedding (Dacron pillows and
duvet)
-covering
mattresses and pillows with (expensive!) Goretex covers (available without
prescription at Boots)
-daily
vacuuming with a Hoover with good filters (not by the sufferer!)
-using
rugs and bare floor-boards as far as possible, rather than fitted carpets
Additional
treatments
Most people do very well just by avoiding soaps and
detergents and occasionally using steroid ointments. However, occasionally some
other treatments are necessary. These include
·
sometimes, sedation
at night is necessary for a crying fretful baby with eczema
·
evening
primrose oil capsules- takes at least eight weeks to work, but
can help reduce the itch of eczema in some people
·
some sensitizers make eczema flare up in a few
people. Many contain lanolin. Your doctor may advise you
·
steroid
pills by mouth and immunosuppressant
treatments- which dampen the body’s inappropriate
defences down- best avoided, if at all possible
·
coal
tar paste bandages
are messy and a faff to put on, but can help, especially with itch in children
·
sometimes, Ultra-violet light treatment
·
research continues into the role of Chinese herbal
medicines- effective, but doubts over safety
·
some people have found relaxation therapy and
hypnotherapy helps
Summary
·
we can’t
cure it, but we can control it
·
avoid soaps and detergents
like the plague
·
use soap
substitutes, moisturisers and emollients
regularly
·
use the mildest
steroid ointment that controls your eczema during flare ups
