Eczema News

ECZEMA IS PERSISTENT.

In treating it, you need to be persistent, too.
Some straight talk about persevering with your treatment.

Eczema isn’t something that’s just going to go away. Unfortunately, it’s a chronic, long-term inflammation of the skin and because of that, it needs long-term care and treatment. There is no cure for eczema.

The unpredictable nature of eczema makes it difficult to manage and some people simply give up with their treatment. What they don’t know is that there are things they can do to get the most from their treatment and to reduce the discomfort and severity of their eczema.

Keeping eczema under control is a daily challenge. Even when it subsides and skin rashes have resolved, it can flare-up again at any time. The good news is, eczema can be controlled. By understanding the irritants that can trigger a flare-up, by practicing a good skin care routine and by strictly adhering to the medication for as long as your doctor has prescribed, you can do a lot to reduce the discomfort and irritation that eczema causes.

Although there is no cure for eczema, there are medications to treat it. Traditional treatments work to relieve the symptoms after they have appeared and their effectiveness varies from patient to patient and with the severity of the eczema being treated. More recent treatments work at the origin of the inflammation and itching, before symptoms appear, and these may offer a better option for some patients.

Any long-term treatment has to have properties that will make you want to continue using it. That means it must be:

• Effective and provide relief of symptoms.
• Safe, with few unwanted side effects.
• Easy to use.

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Some of the treatments currently used to relieve eczema include:

Emollients

The basic management of eczema starts with keeping your skin moist. Emollients (sometimes called moisturizers) help skin retain water to prevent dryness and itching. They work as a barrier to reduce water escaping from skin while at the same time, they protect against outside irritants that can trigger eczema flare-ups. Use emollients after you shower or wash or any time your skin feels dry or itchy.

Cortisone creams

Traditionally, these have been the most frequently used agents to treat eczema. Cortisone creams are anti-inflammatory treatments that are applied directly to the skin to help relieve the itch and control the eczema. Cortisone creams contain steroids that can cause side effects such as thinning and discolouration of the skin and fine hair growth. They may also become less effective if used continuously over a long period of time. For that reason, cortisone creams are only prescribed for short periods of time (i.e., during flare-ups).

Topical Calcineurin Inhibitors

This new class of medications work at the origin of the inflammation and itching. Like cortisone creams, they are applied directly to the skin but unlike cortisone creams, they do not contain steroids. Topical calcineurin inhibitors provide relief very quickly (within a few days) and they been approved by Health Canada for use on all parts of the body, including the face. There have been reports of some mild to moderate burning when applied, but this usually resolves quickly and may be more frequent in more severe eczema.

Antibiotics

These are used to treat the skin infections that result from skin that has been broken and damaged by the eczema. Although they are effective, they can cause nausea, diarrhea and allergic skin rashes.

Antihistamines

These may help to relieve itching, even though histamine is not a major contributing factor in eczema. Antihistamines should be used with caution because they can cause excessive drowsiness.

Herbal and alternative treatments

Many people prefer "natural" remedies such as herbal therapies, dietary supplements, over-the-counter treatments and/or homeopathy. At the present time, herbal treatments are not subject to strict government regulations. None of these have been scientifically proven to be effective against eczema. You should always tell your doctor about any non-prescription treatments you are using for your eczema.

If your doctor has prescribed or recommended any of the above, it’s a good idea to monitor the progress of your treatment. You can refer to the TREATMENT PROGRESS CHART featured in the www.eczemacanada.ca website for help. The chart will provide you with a record of your progress so you can discuss how well your treatment is working with your doctor.

You also have to do your part to help your treatment be its most effective. You can’t expect any treatment to fight your eczema alone. Start with the basics:

Moisturize

Eczema dries skin and moisturizers retain the water within it. Moisturizers block the escape of water from your skin and protect it against the irritants that can trigger a flare-up. Always use a moisturizer after you wash or whenever your skin feels dry or itchy.

Bathe or shower often

Both help the outer skin to absorb water. Use cool or warm water, pat dry with a towel (don’t rub) and immediately use a moisturizer to seal in the water.

Don’t scratch!

This is the hard part. But you can help to reduce the itch. Here’s how:

• Rub or pinch the itchy area instead of scratching.
• Keep cool. Heat aggravates the itch.
• Moisturize the itch. Better yet, keep your moisturizer in the fridge, so that it cools your skin as it soothes it.
• Keep nails short to reduce the risk of damaging your skin if you do scratch.

Know your triggers

Many things can cause eczema to flare-up:

• Certain foods
• Pollen
• Air pollution
• Animal dander
• Mould
• Dust and dust mites

Knowing your triggers helps you to avoid the irritants that can cause a flare-up.

Unlike adults, children lack the ability to understand and cope with their eczema. You can help them by preventing and managing their symptoms.

Learn what triggers your child’s flare-ups

Soap, certain fabrics, heat and sweat are just some of the things that can trigger a child’s flare-up.

Help stop them from scratching

• Keep nails short.
• Cover hands with cotton mittens.
• Apply moisturizer to areas they want to scratch and use it regularly on your child’s skin.
• Bathe children frequently and always apply moisturizer afterward.
• Tell your child that he or she may feel some burning or stinging the first time treatment is applied. Reassure your child that this will be short-lived and that it will go away as the skin heals.
• Gently apply treatment or moisturizer to affected areas when your child is resting or asleep, to help further reduce any possible discomfort.
• Keep children cool. Use light bedding and cotton clothes.
• Launder bedding in hot water, rinse twice and avoid scented fabric softeners.
• Keep children away from pets.
• Vacuum and clean often to reduce dust, mould and other possible irritants.
• Some foods, like nuts and dairy products, may make your child’s eczema worse. Watch for the foods that can trigger a flare-up and avoid giving those foods to your child. Remember, avoiding food allergens is not a substitute for the skin care treatment your doctor has advised.
• Establish a reward program as a way of motivating your child to accept and adhere to treatment.

Your doctor and the medication he or she prescribes will give you the best possible chance at keeping your eczema under control. However, successful treatment ultimately relies on you. Follow your doctor’s advice, continue to use your treatment as prescribed for as long as you need to, and practice the self-help suggestions outlined here. Should you continue to have concerns about the effectiveness or side effects of the treatment you’ve been prescribed, call your doctor for advice. Do not stop or change your therapy without talking to your doctor first.

Remember, you’re the one who can control your eczema. It doesn’t have to control you.

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This information can help you take control of eczema right now!