Treatments

Using emollients (medical moisturisers) to soothe, moisturise and soften dry, irritated skin, and barrier creams to protect skin from contact with every day things may be sufficient to control some mild cases of eczema. They are available either from your pharmacist, or on prescription from your doctor. More specific treatment is often needed in addition to emollients, as described below. To learn more about emollients please click here

Some emollients may leave your skin feeling greasy which some people find difficult to live with as they can be messy.

You can experiment to find an emollient that suits you and your skin. There are lots of emollients available so you can work with your doctor and/or pharmacist to get the right one for you.

Some emollients contain preservatives that stop them from going rancid but these preservatives can irritate your skin even further.

Choosing an emollient that is preservative-free is good advice but it also means the emollient tends to be greasier as the preservatives are used in the less greasy ones to stop the water going off.

Greasier emollients contain less or no water, hence less or no preservatives can mean less irritation.

You may need to replace your soap with an emollient soap substitiute which may seem strange at first but because soaps and detergents are a common cause or trigger of eczema the switch can be very beneficial and prevent the use of stronger treatments.

Topical corticosteroids, topical steroids for short, are used to treat all types of eczema, in particular the inflamed (swollen and/or red) skin and the itching. Topical steroids come in various strengths and in various formulations such as creams, ointments and lotions which will be matched with your eczema type and severity by your doctor, dermatologist or nurse.

If not used properly, topical steroids can cause the skin to become thinner, although this is rare and only occurs when a strong topical steroid is used for a long period of time. It is important to talk with your doctor to make sure you are using the right quantity of topical steroid for the right length of time.

For the reason above you may be given a milder topical steroid to treat your face and neck where the skin is more delicate and a stronger topical steroid one given to treat your body, arms and legs where the skin tends to be less delicate.

Topical steroids are very good at reducing the redness and itching of eczema and have been used to treat eczema for more than 50 years! They are a very important step in improving eczema.

Topical calcineurin inhibitors, TCIs for short, are a fairly new type of medicine to treat atopic eczema. They are designed to treat the inflammation (redness and/or swelling) and itch of atopic eczema as an alternative to topical steroids,if topical steroids haven't worked.

When first applied, these medicines may sting or give a sensation of burning and/or itching for a few minutes. After several applications, and as the skin heals, the discomfort usually fades.

Doctors have reported that if patients using TCIs are told that a burning sensation, stinging or itching may occur then they tend to be better at keeping going with the medicine through the discomfort.

Because these medicines are fairly new it will not be totally clear for a few years what all the side effects might be. However, TCIs have been subjected to rigorous research which will continue for many years to come. They are not experimental medicines, they are established in the treatment of atopic eczema when topical steroids do not work or when topical steroids are not suitable.

The introduction of TCIs means that people who don't respond to topical steroids have an alternative to try for their atopic eczema

Systemic treatments for very severe eczema:
Sometimes eczema, particularly atopic eczema, can get very severe and require very strong medicines that suppress the immune system from the inside. Taken by mouth as tablets these medicines are reserved for patients that do not respond to the more conventional treatments such as topical steroids. These are usually only prescribed by a specialist doctor such as a dermatologist and are kept for eczema that is very difficult to treat.

These medicines tend to get the eczema under control rapidly.

Because this type of treatment is taken by mouth entering the blood stream where it is delivered to the site of eczema from the inside of the body it brings with it a greater risk of side effects. However, these medicines are an essential part of treatment in severe cases and short-term use usually reduces the side effect risk of these medicines to an acceptable level.

These may be needed if the skin becomes infected with bacteria. This can happen if the skin becomes damaged from the eczema and scratching fingernails, making it possible for infection-causing bacteria to enter the damaged area of skin.

If antibiotics are used too much, bacteria can become resistant to them so they are no longer as effective.