Immunisations:
Routine childhood immunisations should be given. Consult your doctor if you have any concerns about these immunisations.Future Career
Young adults should decide on a career that is less likely to expose them to irritant chemicals and should probably avoid nursing, hairdressing, catering, motor mechanics, or the building industry. Protective gloves with cotton inner-linings will help prevent irritant contact dermatitis that is so very common in eczema sufferers.Treatment
Emollients:
These skin moisturising creams and ointments, the mainstay of eczema treatment, are completely safe and should be applied liberally at least three or more times per day to hydrate and protect the skin. Some people may find that a few of these preparations irritate their skin; if this occurs another product should be tried. Different emollients include Emulsifying Ointment (HEB), White Soft Paraffin, Aqueous cream (UEA), Diprobase or Lipobase with Cetomacrogol, Epaderm, and Oilatum cream. Sometimes coal tar is applied to treat thickened skin. Oilatum Plus is an excellent bath emollient. Aveeno is an oatmeal based emollient for very dry skin while Balneum is Soya oil based.Cortisone or Steroid Creams:
These produce rapid relief and are used for short periods to settle eczema flare-ups. They may also be used for longer periods when diluted in an emollient in which case treatment should be tapered off slowly. However, their long-term use may lead to thinning of the skin. Some of the newer steroid preparations seem to be much safer. Cortisone tablets or injections are very rarely, if ever, used in eczema.Wet Wraps:
These are applied at night to keep moisture in the skin, aid absorption of creams and to protected against scratching. First of all, emollients and steroid creams are applied to the eczematous areas. Elasticated cotton-based tubular dressings are soaked in luke-warm water and then cut to size so that they cover the affected areas. These can be applied overnight to the limbs, trunk, neck and even face (holes are cut in the dressing to allow apertures for eyes, ears, nose and mouth). This treatment is highly successful for severe weepy eczema, which is non-responsive to emollients and steroid creams.Antibiotics:
Eczema sufferers are more prone to skin infections such as bacterial, fungal and viral infections, including the common wart). Antibiotic creams and occasionally oral antibiotics are prescribed to treat infected eczema, which may present with sudden development of crusting, oozing and redness of the skin.Antihistamines:
The older sedating type antihistamine tablets or syrup such as Piriton will reduce itching especially at night. Antihistamine creams may sensitise the skin and should be avoided. Newer long acting anti-histamines such as Cetirizine have also proved to be very good for reducing skin inflammation if used for extended periods of up to 6 months.Other Therapies
Evening Primrose oil (or gamolenic acid) has been tried with minimal success in the past. Extracts of Chinese herbal teas seem to reduce inflammation although they are quite unpalatable. Tacrolimus (Protopic) and Pimecrolimus (Elidel) cream has just become available in the UK and results so far have been very encouraging, although chronic use has been associated with skin cancers in animals.(published with permission in writing from:http://www.allergy-clinic.co.uk/)
