Western Treatments for Eczema (AD)

EMOLLIENTS

Emollients are a must-have for any eczema sufferer and should be

applied multiple times throughout the day to keep dry skin

moisturized. It is the most commonly used treatment for atopic

dermatitis and helps protect the skin's moisture barrier.

Some of my favorites include:

• Physiogel Calming Relief AI Lotion

• Cetaphil Eczema Calming Lotion

• Cetaphil Moisturizing Cream

• CeraVe Moisturizing Cream

• Aveeno Eczema Therapy Daily Moisturizing Cream

• La Roche-Posay Lipikar AP+ Lotion

• Vanicream Moisturizing Cream

TOPICAL STEROIDS

Topical steroids are immunosuppressant creams that are

recommended by most dermatologists for short-term itch relief for the

patient. However, there are many potential side effects if used for too

long or misused. Thinning of skin, fragile to bruising, prominent blood

vessels, and skin losing its elasticity can all accompany the itch-relief.

There are also cases in which patients go through topical steroid

withdrawal, which occurs when a patient suddenly stops their use of

steroids and goes through withdrawal because the skin is not strong

enough without continual use of these steroid creams. Often, this leads

to years of recovery.

CALCINEURIN INHIBITORS

Topical calcineurin inhibitors (TCIs) work by altering the immune

system, blocking one of the chemicals that can contribute to the

flaring of atopic eczema. Consistent, everyday application for 6-8

weeks is recommended, but doses should be gradually reduced over

the following months. While it can have side effects of increased

internal heat and in some cases, withdrawal, it is not as detrimental to

the skin as topical steroids.

Protopic and Elidel are examples of calcineurin inhibitors. Protopic comes in two dosages: 0.1% and 0.03% tacrolimus. Elidel has 1% pimecrolimus.

WET WRAPS AND PASTE BANDAGES

Warm/wet bandages are applied to the body over an emollient and

sometimes a mild topical steroid (topical steroid under wrapping

should only be used under the supervision of your healthcare

professional). A dry layer of bandage is then placed over the wet

layer. Wet wraps are particularly helpful at night (when overheating

can be a problem) as they also cool the skin.

PHOTOTHERAPY

Phototherapy includes the use of ultraviolet (UV) light to treat

moderate to severe eczema. The goal of phototherapy is to reduce

the growth of your skin cells and treat underlying skin

inflammation. Phototherapy, also known as light therapy, does this by

putting ultraviolet (UV) light on your skin. It must be administered for

several weeks, 2-3 times per week.

IMMUNOSUPPRESSANT DRUGS

In more moderate or severe cases of eczema, doctors might prescribe

immunosuppressant drugs to help control or suppress the immune

system in order to slow down the symptoms of eczema. It also helps

break the itch-scratch cycle in many patients. Some examples are:

azathioprine, ciclosporin, methotrexate, mycophenolate mofetil...etc.