Eczema is a skin condition which is characterized by the appearance of rashes or inflammation on the surface of the skin. It is a fairly widespread disease and is found to be more common in younger children and infants than in adults. Eczema is not a serious or a life threatening condition, but it may prove to cause a great deal of discomfort to a sufferer, primarily due to excessive itching and scratching. Eczema is also linked to some allergic diseases and seasonal allergies such as asthma and hay fever.

Eczema can manifest itself in a different variety of forms as per the age group of the individual as also the specific location of the body which proves to be affected by the rashes. As such, the treatment of eczema depends on the type of eczema which an individual is suffering from. There is no complete cure for eczema and the treatment is limited to only managing the signs and symptoms of the skin condition and one of the best ways to treat the condition is to prevent the exposure of the skin to any stimulus or irritant that facilitates a reaction causing eczema. Some eczema cases resolve spontaneously while some may need intensive medical therapy and even hospitalization.

In most cases, eczema proves to be a temporary condition and the signs and symptoms of the disease subside after the duration of the course of the disease. However, in certain cases where the disease cannot be controlled by means of bathing, moisturizing, rapid temperature changes or sweat control, the use of medication may be necessary. The medications that are used to control such severe cases of eczema include immunosuppressant drugs, corticosteroids and topical calcinueurin inhibitors.

Treatment for Eczema

The time required to cure eczema depends on the intensity of the disease, the potency of the medication and also the dedication and compliance of the patient. Eczema can be irritating to deal with as there is a massive urge to itch and scratch the rashes, but this must be avoided at all costs.

Some of the common treatment options that may prove to be effective in the treatment of eczema include the following:

Topical corticosteroids

Ointments and creams containing hydrocortisone steroids are quick to provide relief from itching and in the reduction of inflammation. Such creams are available in various strengths ranging from mild to strong. Over the counter medication is often mild in nature and can be used to treat mild eczema. However, depending on the severity of the rash, you might need creams and ointments of higher strengths. While such topical creams and ointments are thought to be associated with side effects, if used as directed, side effects like thinning skin and stretch marks are rarely found.

Some individuals prove to be allergic to corticosteroid drugs and as such, if they suffer from eczema, this treatment option should be avoided as it will only result in a worsening of the signs and symptoms of the condition.

Barrier repair moisturizers

Barrier repair moisturizers are available both over the counter and also on the basis of a medical prescription as well. These moisturizing lotions help water to lock into the skin and also help repair any damaged skin tissue. Considerable reduction of dryness, redness and itching is noticed with the use of a good repair moisturizer. However, these should be taken with case as it is possible that some products may have irritable fragrance or such ingredients, which can prove to aggravate the signs and symptoms of the disease.

Topical immodulators

Examples of topical Immunomodulators include pimecrolimus and tacrolimus. When they are applied on the surface of the skin, they can prove to be helpful in the treatment of mild to moderate forms of eczema. While topical Immunomodulators are not classified as steroids, they do increase the risk of developing skin cancer in some certain individuals.

Systemic corticosteroids

Systemic corticosteroids come in relief when there is a presence of severe eczema. However, these drugs are considered only for a shorter period of time as they have long term adverse effects if used improperly ranging from skin damage to bone loss. Systemic corticosteroids are administered by mouth or by injecting the drug and are to be used only if topical corticosteroids have proved to be ineffective in controlling the signs and symptoms of the condition.

Immunosuppressants

Sometimes, eczema can be caused by the immune reaction of the body to specific allergens and in such cases, immunosuppressant drugs such as cyclosporine, methotrexate and mycophenolate mofetil are all useful in suppressing the overreaction of the immune system. These drugs can be given as pills or injections or liquids and are available across different forms. However, these drugs can also prove to cause some serious side effects in the body, including high blood pressure and organ problems such as kidney problems and as such, they are typically only administered for a shorter period of time.

Antihistamines

Antihistamines are known to induce drowsiness in indivuals and are often prescribed to eczema sufferers so as to provide relief from scratching and itching while sleeping.

Topical Calcineurin Inhibitor Drugs

These Calcineurin inhibitor drugs also prove to suppress the activity of the immune system of the body. They may prove to help in prevention of flares and also helps in the decrease of inflammation of the skin surface.

Phototherapy

Mild to average forms of eczema can be treated with the help of phototherapy [2]. This treatment procedure involves the exposure of the surface of the skin to ultraviolet A or ultraviolet B type light. However, the use of ultra violet light can be considered to be dangerous to some extent and as such, the effect of phototherapy on the skin surface is always monitored closely. Ultra violet light can cause premature aging of the skin and greatly increases the chances of the development of skin cancer. As such, phototherapy is rarely administered to infants or younger children.

Eczema is also often accompanies with skin infection as caused by the staphylococcus aurues bacteria and the simplex herpes virus. As such, alongside other medications, antibiotics and other specific medication in order to treat fungal and viral infections may also be prescribed by a doctor.

Home remedies for Eczema

Home remedies and life style techniques can also prove to be quite helpful in controlling the signs and symptoms of eczema. Eczema rash can be controlled by preventing the triggering action of the agents causing it.

Various natural materials available at the convenience of most households can help prevent and relieve eczema. Coconut oil is widely considered to be a very effective option for symptomatic relief from eczema flares. Aloe Vera gels mixed with vitamin E can also help reduce the rash and inflammation. One can also apply a paste of carrots or cucumber on the affected area for relief. A diet rich in omega 3 fatty acids also helps prevent the symptoms of eczema. Omega 3 is commonly found in flax or chia seeds, organic nuts specials walnuts, fish, egg, cod liver oil and sea fish. The consumption of chamomile tea before going to sleep significantly helps in the prevention of scratching and itching during the sleep.

Some of the other recommended home remedies and life style measures that can help in the treatment of eczema include the following:

  • It is recommended to take baths on a regular basis
  • It is recommended to apply a moisturizing lotion on the skin surface at least twice a day
  • It is recommended to avoid heavy garments ad ornaments and to resort to wearing soft cotton fabrics
  • Soaps, solvents, detergents and cleaners should be avoided on the site of the rashes
  • After washing the skin surface, the area of the rashes should be dried by patting with the use of a soft towel, without rubbing across the area
  • Any rapid changes of temperature or humidity should not be subject by the body
  • Activities which involve excessive sweating should always be avoided
  • Dry and cold weather in winters should be avoided and it is recommended to use a humidifier indoors during such conditions
  • The fingernails should be kept short and clean and scratching the skin surface should be as limited as possible
  • It is also important for people to try and identify the possible triggers or allergens that may prove to cause eczema bouts
  • Wet dressings involving topical corticosteroids may also be wrapped around affected regions in order to provide relief and can help contain the signs and symptoms of eczema
  • Stress can prove to harm the immunological function of the body and it is advised that counseling or treatment for stress be undertaken
  • Biofeedback, behavior modification and also relaxation techniques are recommended for child sufferers of eczema

Signs and symptoms of eczema in infants can be treated by identifying the cause of and by avoiding skin irritants, by avoiding exposing the child to extreme temperatures and by regularly lubricating the body of the infant with the help of moisturizer creams, oils, lotions and ointments. While conditions can be managed by following these measures, sometimes, the condition may prove to be severe and in such cases, a doctor’s medical prescription medication may be required in order to contain the rash or any associated infections with eczema.

Home remedies can prove to be quite effective in controlling the signs and symptoms of eczema [3]. However, sometimes the degree of severity of the skin condition is so high that normal home remedies and life style options are not adequate in controlling the skin condition. In such cases, it is important to identify whether the remedies are proving to have any noticeable effect or not and if symptoms persist, then it is best to seek professional medical attention at the earliest. Even if the signs and symptoms of eczema can be contained with the help of home remedies, it is advised to always seek medical guidance and counseling in order to understand more about the specific condition and also in order to identify possible allergens and irritants in order to avoid exposing the skin to these in the future.

Complications

The dermatitis caused due to eczema can lead to various super imposed infections. They make the person vulnerable to bacterial and viral skin diseases due to colonization of the affected skin areas by bacteria. This super imposed infection leads to higher severity of the disease. Most of these infections are caused by bacteria staphylococcus aureus.  Certain viral infections such as eczema herpaticum and eczema vaccinatum can be caused due to virus herpes simplex and exposure to the small pox vaccine.

Eczema occurring around the eye region can also prove to cause a lot of discomfort due to excessive itching and watering of the eyes. If ignored, these conditions may lead to conjunctivitis or blepharitis in individuals.

Neurodermatitis, or a condition characterized by dry, leathery and scaly skin is also a resulting complication of eczema which is cause by excessively scratching the surface of the skin, causing it to become thick and hard.

Infants who suffer from eczema have also shown some kind of correlation to developing attention deficit hyperactivity disorder syndrome, a possible complication associated with the skin condition [4].

Cost of Eczema medication

The high prevalence of eczema raises the economic burden on individuals as well as the state. At the individual level, the cost of a single pimecrolimus tube costs around $76. It increases the economic burden by approximately $2.6 billion in the U.S.

Can you get Eczema twice?

Eczema is a chronic disease of the skin. The remission of the disease depends on the type of eczema, age of patient, preventive measures taken and immune status of the body [5]. Studies have demonstrated that more often than not, individuals go on to have a recurring bout of eczema skin flares in case they are exposed to certain irritants. It is important that people who have suffered from an episode of the disease try and identify the possible trigger factors and allergens in order to prevent a future recurring episode of the skin condition.

 

References


[1] Prevention and regression of atopic dermatitis by ointment containing NF-kB decoy oligodeoxynucleotides in NC/Nga atopic mouse model, Nakamura H, Aoki M, Tamai K, Oishi M, Ogihara T; 9(18):1221-1229]-2002- DOI: 10.1038/sj.gt.3301724, http://europepmc.org/abstract/med/12215889


[2] Management of Atopic Dermatitis in the Pediatric Population, Andrew C. Krakowski, Lawrence F. Eichenfield, Magdalene A. Dohil; pp. 812 -824- October 1, 2008- DOI: 10.1542/peds.2007-2232, http://pediatrics.aappublications.org/content/122/4/812.short


[3] Good news, but when and how to use tacrolimus and pimecrolimus is a muddle, Hywel Williams; 324(7353): 1533–1534- 2002 Jun 29- DOI: 10.1136/bmj.327.7421.942, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123485/citedby/


[4] Pimecrolimus Cream 1% in the Management of Atopic Dermatitis in Pediatric Patients: A Meta-Analysis, Chunyun Huang, Youyu Sheng; 9(4): e93095, DOI:10.1371/journal.pone.0093095, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972203/


[5] Efficacy and tolerability of topical pimecrolimus and tacrolimus in the treatment of atopic dermatitis: meta-analysis of randomised controlled trials, Darren M Ashcroft, Paul Dimmock, Ruth Garside; 330(7490): 516-2005 Mar 5- DOI: 1136/bmj.38376.439653.D3, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC552812/