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Eczema Treatment



Patients with atopic dermatitis have dry skin even when they don't have much obvious inflammation. The dry skin is itchy and uncomfortable and if left untreated predisposes to more dermatitis. It is important that patients are taught to keep their skins moist and supple. They should use some emollient preparation as often as this is necessary for their comfort. The particular emollient chosen should be the one that they find most helpful and least unpleasant to use. The most efficient emollients contain more white soft paraffin but these tend to be the most greasy. Apart from emollient applications they should use a soap substitute with an emollient effect. Bath oils are also helpful in many patients (e.g. Oilatum bath emollient or Balneum).

Typical atopic dermatitis is frequently accompanied by dry scaling skin (xeroderma).This causes considerable discomfort in some patients.

Chronic persistent lichenified dermatitis. This type of dermatitic rash frequently benefits from applications containing tar

Topical corticosteroids

For the dermatitis patches themselves the mainstays of treatment are the topical corticosteroids. The least potent preparations that produce improvement should be chosen. Atopic dermatitis tends to last for some years and there are serious dangers from the absorption of the corticosteroid if its application is continued. For this reason corticosteroids should only be used when the dermatitis is active.

Dry skin in atopic dermatitis

Hydrocortisone preparations are the most suitable but other weak corticosteroids, such as clobetasone butyrate (Eumovate) or 1 per cent hydrocortisone and 10 per cent urea (Alphaderm), may also be used. More potent corticosteroids should only be used for stubborn areas if needed, and then only for short periods.

Traditional treatments

Some of the older remedies should be given a chance. Weak tar preparations quite often exert a beneficial effect, especially on the more persistent thickened patches. Even zinc cream and oily calamine lotion can help some patients. Bandaging may be helpful if it's a matter of preventing the creams or ointments from soiling the clothes or bed linen. They should not be used to restrain a child - the frustration of not being able to scratch an itch is worse than the damage to the skin caused by scratching.


There is no place for topical antihistamines in the treatment of atopic dermatitis. They are not antipruritic in eczema and may irritate or even cause sensitization reactions. Systemic antihistamines of the older type are often prescribed to allay the itching. In fact the antihistamines seem to have very little effect on itching when pharmacological tests are made but agents such as dipthenhydramine; trimeprazine and chlorpheniramine cause drowsiness and relieve symptoms in this way. Newer non-sedating antihistamines such as terfenadine are not of much help to patients with atopic dermatitis.

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