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Eczema Treatment: Treatment, Procedure, Cost and Side Effects

Last Updated: Jan 05, 2022

What is the treatment?

Eczema is a kind of disease that results in inflammation of the skin. It is actually a group of skin conditions that includes atopic dermatitis, contact dermatitis, dyshidrotic eczema, hand eczema, neurodermatitis, nummular eczema and stasis dermatitis.This disease is characterized by itchiness, red skin, and rashes. In cases of short duration there may appear small blisters on the skin while in long-term cases the skin usually becomes thickened. This disease can occur only in a small part or an entire body.

In order to treat eczema, a good skin must be maintained. The skin must be kept moisturised with the use of emollients (medical moisturisers). This is the key to managing all types of eczema. Topical steroids of medicinal therapy is commonly used to bring the flare ups under control.

In case of acute eczema where there is significant weeping and oozing from the skin, the treatment requires repeated cycles of application of dilute solutions of vinegar or tap water often in the form of a compress followed by evaporation. Once the acute weeping has diminished, then topical steroids (such as triamcinolone cream) can be applied to make the treatment more effective.In extensive disease, systemic steroids are used either orally or by an injection (shot).

How is the treatment done?

Before treatment, it is important to diagnose the disease properly. Diagnosis of eczema is based mostly on the history of the patient and physical examination. In uncertain cases, skin biopsy is prescribed. In the diagnosis of allergic contact dermatitis, patch tests are used.

Unfortunately, there is no known cure for some types of dermatitis. The treatments aim to control symptoms by reducing inflammation and relieving itching. When symptoms of eczema are mild, a good skin care and nourishment with proper life style habits will be effective. Moisturizers are essential as they keep the skin from becoming dry.

Medicinal therapy is used to treat severe eczema symptoms. Hydrocortisone is a type of over-the-counter cream or ointment that help to cure mild eczema. Antihistamines are also used to help relieve symptoms. The doctor may prescribe corticosteroids if the other treatments do not work. Ultraviolet light therapy may be applied if the skin condition is severe. But overexposure to these light rays is harmful. To improve upon the immune system, the doctor may consider medicines such as azathioprine, cyclosporine, or methotrexate. There are also prescription creams and ointments that aid to treat eczema.Examples of such are pimecrolimus (Elidel), which is a cream, and crisaborole (Eucrisa) and tacrolimus (Protopic), which are ointments. These help to control inflammation and reduce immune system reactions. Also, doctors may use injectable medicines like Dupilumab (Dupixent) for moderate to severe atopic dermatitis. Only prescribed for adults these injection shots are applied every two weeks which control the body’s inflammatory response.

Who is eligible for the treatment? (When is the treatment done?)

People with symptoms of atopic dermatitis or eczema should visit a doctor immediately for confirmation. The symptoms include itching that becomes extremely irritating and interferes with daily activities or with sleep, crusting or oozing sores, severe scratch marks, widespread rash, painful cracks, severe discoloration of the skin, signs of bacterial infection or a fever that is accompanied by rashes on the body.

Who is not eligible for the treatment?

People with redness and itchiness on skin can visit a doctor for advice. But when these are not so disturbing and fade away in two days, it can be said to be caused by some other causes rather than being eczema. In such cases, people do not need to undergo any medical treatment.

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Are there any side effects?

Short courses of topical steroids for eczema are usually safe and usually have no side effects. But long term usage of cream and ointments can have severe side effects on individuals. The side effects of using steroids include thinning of the skin when high-strength steroids are used under airtight dressings, change of skin colour, high blood pressure. Some topical steroid gets through the skin and into the bloodstream and can trigger or worsen other skin disorders such as acne, rosacea and perioral dermatitis. The steroid can have an effect on growth. Cushing's syndrome, although rare, is caused by high levels of a hormone (chemical messenger) in the blood. Side effects of eczema anti-itch cream include severe symptoms like inflammation of hair follicle, thin fragile skin, hives, insufficiency of the hypothalamus and pituitary glands etc.

Why does Eczema get worse at night?

During the night, our body goes to rest mode, which means most of the daytime functioning slows down giving the body time to rest and rejuvenate. One of them is the production of the anti-inflammatory hormone cortisol. In the day cortisol prevents Eczema to go crazy, but at night its production slowed down leading to irritation and itching.

Summary: During the night slow down the production of the anti-inflammatory hormone cortisol which can increase the irritation caused by Eczema.

How do you stop Eczema from spreading?

Any disease can be prevented with adequate care. Here are some tips that will help you prevent your Eczema to spread to flaring up in the future:

  • Avoid trigger foods: foods that cause excessive itching and irritation after 24hrs of consumption should be avoided. Also, consult your doctor and have an allergy test to verify its effectiveness.
  • Keep your skin hydrated: use moisturizer, vaseline, and other suitable products which help you hydrate your skin. Use it especially during dry seasons and bathing.
  • Keep it cool and sweat-free: while dry skin can be itchy, sweaty heat-up skin can also be irritated. Avoid getting into places with humidity or try to keep your skin clean and dry as much as you can.
Summary: Any disease can be prevented with adequate care. Some tips can help you prevent your Eczema from flaring up in the future.

Does Eczema get worse with age?

As per the research and studies, Eczema loses its strength as you age. Most of the intense flare-ups have been seen in 2- 4 years of age which fade its effects as you grow. However, some of the patients in the rare cases also showed some serious flare-ups and spread even in the adulthood stage.

Summary: As per the research and studies, Eczema loses its strength as you age. So your Eczema will decrease as you age.

What are the post-treatment guidelines?

After the treatment, the patient should regularly take the medicines as prescribed by the doctor. It is essential to keep the affected area very clean, dry, and protected to avoid further breakdown of the skin and also to prevent infections. With continuous application of steroid cream, the person will show gradual improvement as the rashes fade away. If no such improvement is noted, the doctor should be contacted again.

How long does it take to recover?

Mild eczema is likely to respond to low potency topical steroids within a few days. It gets completely treated within one or two weeks. Moderate eczema may require several weeks of treatment. Severe eczema is a long term disease and may show only partial improvement with potent topical steroids even after several months of use.

What is the price of the treatment in India?

Average money spent for the treatment of eczema depends on the type, severity and duration of treatment. On an average, it ranges from Rs 500- Rs 3000 including doctor's consultation fees, any tests, medicines etc. Longer treatments may cost more.

Are the results of the treatment permanent?

Treatment is permanent only to certain types of eczemas like those caused by fungi and scabies. Allergic contact eczema can also be cured permanently if a specific allergenic substance can be identified and avoided. But, there are certain other types of eczemas which can not be cured permanently. In those cases, the treatment mainly aims at reducing the inflammations, itching and redness and also removing the rashes and blisters.

Is Vaseline good for Eczema?

During Eczema, one may experience harsh skin irritated and flaky skin. Vaseline contains petroleum jelly creates a protective barrier for the exposed skin to repair. It also moisturizes your skin which aids in the treatment of Eczema. Vaseline also has hypoallergenic, anti-inflammatory, anti-bacterial, and antifungal properties which makes it even better for the sink allergy.

Summary Vaseline contains petroleum jelly which creates a protective barrier for the exposed skin to repair. Which can be beneficial for your skin during Eczema.

What foods should you avoid if you have Eczema?

Even though Eczema is an external disease, internal body reactions can also cause a flare-up. Food that can trigger your Eczema usually takes 6- 24 hrs to show its reaction. The duration of this reaction depends on how sensitive your body is towards the particular food item:

  • Citrus fruits
  • Eggs
  • Spices, such as vanilla, cloves, and cinnamon
  • Gluten or wheat
  • Some types of nuts
  • Soy
  • Dairy
  • Tomatoes

Apart from common food items, there are some other food items that may trigger your Eczema in case a person is diagnosed with dyshidrotic Eczema. This type of Eczema is triggered by food items that are high in nickel:

  • beans
  • black tea
  • canned meats
  • chocolate
  • lentils
  • nuts
  • peas
  • seeds
  • shellfish
  • soybeans

Also, if a person is having oral allergy syndrome or sensitivity to birch pollen the list can be different. Here is the list of food items that one should avoid:

  • green apples
  • carrot
  • celery
  • hazelnuts
  • pears
Summary: There are many consumables that can flare up your itch during Eczema. Check the list of items as they affect a person at a slow pace and cause Eczema to flare up.

What nuts are bad for Eczema?

Generally, nuts fall under the list of food items that one should avoid during Eczema. But it is important to have proper allergy testing and confirmation of medical professionals before coming to any conclusion.

Summary: There are many cases where people have a nut allergy which can cause an Eczema flare-up. But it is not the case with everyone so it's important to consult your medical expert for the same.

What are the alternatives to the treatment?

Severe cases of eczema require medical treatment as otherwise, situations may get worse. But mild symptoms can be brought under control by some home remedies. Applying a cool, wet compress can lessen the itching sensation for some individuals with eczema. Vitamin D is also essential to treat eczema in children and adolescents. In addition to increasing exposure to the sun, supplementing with vitamin D rich foods and foods rich in Omega-3s like cod liver oil, sardines, salmon, eggs, and raw milk may help prevent eczema. Witch hazel, due to its anti-inflammatory and antioxidant properties, fastens healing when rashes start to ooze. Also, moisturizing creams and oils must be used to prevent the skin from drying up.

Conclusion: It can be described as irritation and itchiness in the skin. The cause of Eczema is can be temperature, food, any other existing allergy, and many more. It can be easily treated with consulted diet and medication. You can also have some home care as well to boost yu the recovery process.

References

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Written ByDr. Ashish DavalbhaktaMBBS Bachelor of Medicine and Bachelor of Surgery,FRCS (UK),FRCS,MS General Surgery,Mch (Plastic Surgery)Cosmetology
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