Eczema Treatment (Part 2)

Many times the treatment decisions for different diseases are built not only on high quality evidence based on medicine, but also in combination with patient preference, so to say. It is also the case of treating eczema. There are many eczema treatments that are suggested by doctors, in accordance with the type of eczema in question in each patient’s case.

For this reason, doctors have come up with the treatment triangle. The three points of this treatment scheme for eczema are: evidence-based medicine, treatment based on evidence and clinical experience, and patient preference. In the first point of the treatment scheme, the elements used are: topical corticosteroids, topical immuno-modulators, interferon gamma, cyclosporine, UVB, and PUVA. The eczema treatments comprised by the second point are: moisturizers, avoidance of irritants, topical immuno-modulators (TIMS), topical antibiotics, oral antihistamines, and oral antibiotics.

In the resistant cases, oral or IM steroids, UVB, PUVA, cyclosporine, or methotrexate will be also used. When the patient preference scheme is applied, it is necessary for the doctor to discuss and work with the patient. Treatment has to be adapted to each individual patient in accordance to the findings after the discussion between the doctor and the patient. Through these talks significant aspects regarding the patient’s claims that certain medications simply do not have any effects on them will be discussed and dealt with. Here are some reasons why the different eczema treatments seem to be useless in some patients. Regarding moisturizers and cleansers, it has been found out that some patients are unable to tolerate sticky moisturizers, whereas others get itching or burning from certain brands. Another category of patients simply have a preference for certain cleansers over others. When cortisone is under discussion it has been noticed that there is a variable reaction to the same strength corticosteroid or base. There are patients with eczema who fear cortisone. Although many in this category have not had personal experience of side effects of cortisone, they have a fear of thinning the skin and worry about systemic effects.

Thinning of the skin and purpura are indeed some real side effects in some patients’ inappropriate use of cortisone. If it was not the strength of the drug, then it may have been used in the wrong place or it has been used too much for too long. The doctor should also discuss with the patients about the possible side effects of systemic drugs in detail. Among the eczema treatments on the market, some may inhibit the patients’ choice simply by their cost and length of use.

Eczema Treatment

There are numerous possibilities to approach eczema medically but before discussing eczema treatment, maybe it would be useful to know a few things with regard to this disease: what causes it; types of eczema; and, eczema treatment possibilities. The symptoms are equally important before establishing a course of action.

Eczema is a form of dermatitis or inflammation of the epidermis; the term eczema is used to refer to a broad range of skin conditions that are persistent. Among the common symptoms you might experience are: dryness of skin, repeated rashes, redness of the skin, skin swelling/edema, itching, crusting, blistering, flaking, oozing, cracking and even bleeding. Besides these, temporary skin discoloration might appear sometimes due to lesions that are healed. However scarring is a rare consequence.

The causes of eczema are not very well known but this condition is mainly an inherited one. Therefore, the causes lack relevancy for the type of eczema treatment a doctor will decide on. Without a correct identification of the typology, the treatment is not possible. A basic reference material here is the 2001 European Academy of Allergology and Clinical Immunology (EAACI)’s published position paper in which the nomenclature of allergy-related diseases including atopic and allergic contact eczemas are simplified and clarified. There are common eczemas like: atopic eczema, contact dermatitis, xerotic eczema, seborrhea dermatitis and less common types such as: dyshidrosis, discoid eczema, venous eczema, dermatitis herpetiformis, neurodermatitis, etc. Apparently there is no known cure for eczema, which means that the existing treatments are meant to control the symptoms, reduce the inflammation and relieve the itching.

Eczema treatment that has been tried so far includes both medications and natural remedies. The medicines used in controlling eczema belong to the corticosteroids family (ointments, pills or injections), immunomodulators, antibiotics, immunosuppressants, anti-hitch drugs, etc. Not only eczema treatment solutions proposed by medicine are important. You should not forget about the factors, the external ones, which can influence the development or evolution of eczema in one way or another. Maintaining the affected area moist, you can help skin healing and relieve the symptoms.