Last Updated on December 1, 2020 by Alice Pien, MD & Asher Milgrom, PhD
For one thing, most over-the-counter and doctor-prescribed treatments for eczema have been proven to be ineffective – not to mention expensive and laced with side effects.
That being said, it’s important to know how to prevent the evolution of mild cases of eczema and alleviate the pain caused by the more severe ones.
Eczema Treatment Tips for Adults
The truth is modern medicine still can’t pinpoint exactly what will work for the appearance of eczema rashes on your skin. Some treatments work wonders for some, while other treatments work wonders for others. What we do know is that the following steps are a great start in treating your eczema.
1. Preemptive Skin Care Works Best for Mild Eczema
There are several steps you can take, in order to make sure your eczema stays manageable. Here’s what good skin care looks like:
- Moisturize your skin on a daily basis—and always remember to do so within 3 minutes of bathing. This helps ‘lock in’ skin moisture.
- Wear soft cotton—avoid wool, or other rough and scratchy fabrics, as well as tight clothing.
- Bathe and shower in warm, not hot water, with alcohol-free soap and/or shower gel.
- Don’t rub your skin dry with the towel—pat it dry.
- Learn what your eczema triggers are and avoid them. If you react to pet hair, consider dispensing with your carpeting and applying anti-dander treatment to your pets.
- Avoid rapid temperature changes, if you can, and also try to steer clear of profuse sweating.
- Trim your nails to make sure scratching that eczema itch won’t break your skin and cause further complications.
2. Some High Strength Emollients CAN Work Wonders for Eczema
When the skin is functioning properly, its main feature is to create a barrier between your body and the outside world. For people with eczema, this barrier often breaks down. That’s where strong moisturizers step in – we’re talking moisturizers that can only be obtained at a doctor’s office. Brand names include Mimyx, Epicuren, and Hylatopic Plus.
Bear in mind that these are not cosmetic-grade moisturizers, since they don’t contain alcohol or anti-aging ingredients. Proper use involves applying them liberally and frequently, up to 3 times a day, directly to the eczema patches. You will need to try several products to find which one works best for your skin, as some will tend to leave it oilier than others. Finally, proper use of creams or ointments can reduce or eliminate your need for topical corticosteroid treatment.
3. Topical Corticosteroids for Eczema Should be used Sparily
If you suffer from severe eczema, your doctor may prescribe such coticosteroids to help control particularly harsh flare-ups, when your skin becomes very red and irritated. It’s important to use steroids in conjunction with ointments and only use it for short bursts. Using steroids to keep your eczema in check on the long-term can come to cause further complications.
- Thinner skin
- More prominent blood vessels
- Emergence of fine hairs on the affected area
- Stretch marks
- Peri-oral dermatitis (spots around the mouth)
Steroids are natural hormones produced by the human body. In some situations, such as a severe bout of eczema rash, medical, synthetically-obtained steroids may be needed to help alleviate the symptoms. They will minimize the inflammation and help cracked skin heal. They need to be applied once or twice per day, during treatment, to the active eczema rash areas.
Some people, who experience nearly continuous bouts of eczema flare-ups, will be prescribed ‘weekend therapy’. This means they will have to apply topical steroids to the affected area 2 days each week.
The measuring unit used to determine the quantity of steroids that you need is FTU (= Finger Tip Unit). You may use them before or after applying an emollient—just make sure to leave 30 minutes in between the two applications.
The safety of topical steroids depends on their strength, condition, and the age of the patient. Some such eczema treatments can cause side effects. Hydrocortisone 0.05%, 0.1%, 0.5% and 1% is not likely to cause adverse reactions. However, be careful with taking oral corticosteroids—they are usually prescribed by doctors when all else fails and are far more potent than topical steroids.
4. Do Other Eczema Treatments Actually Work?
An alternative to prescription-strength emollients for people with severe eczema is ultraviolet light therapy. Its benefits have yet to be proven resolutely, but it has been known to work in some cases.
Finally, when all else fails, your doctor may prescribe an eczema treatment that directly targets your immune system. There are two such categories of drugs that have been known to work:
- Immunosuppressants: these include Azathioprine, Methotrexate, Mycophenolate and Cyclosporine. These substances effectively suppress your immune system.
- Immunomodulators: the list contains names such as Elidel and Protopic. These drugs control the reaction of your immune system and thus help reduce inflammation.
Bear in mind that immunity-affecting medication should only be taken under medical supervision, as it can produce harmful side effects. In fact, the FDA has labeled Elidel and Protopic as ‘black box’ – its strongest warning; these drugs can only be prescribed to kids over the age of 2 and adults, after all other types of eczema treatments have failed.
Eczema Treatment Tips for Babies
It can be a bit scary to see that your beautiful, otherwise perfect little bundle of joy developing red, irritated, and flaky skin patches known as “baby eczema”. When they crack and baby is suddenly covered in crusts and scars, things only get scarier.
However, there’s no reason to panic: 10-15% of babies develop baby eczema. The good news is that it’s entirely treatable. Here are the steps you need to take, in order to deal with it:
1. Make Sure that it IS Baby Eczema
There are plenty of other conditions that may look like eczema, but are not it. These include cradle cap (less red and scaly), which is less severe and usually clears up by the age of 8 months.
Unlike eczema, it shows up on the sides of the nose, eyelids, eyebrows, behind the ears, and on the scalp. Make sure your child gets properly diagnosed, before attempting any type of treatment.
2. Proper Skin Care can Alleviate Eczema Rashes
As explained above, proper skin care is essential to alleviating the difficulties of eczema rashes. Give your kid lukewarm baths and apply ceramide-containing moisturizers. Eczema develops when the skin does not contain enough of these fatty cells, which literally create the skin barrier.
You can buy such creams over the counter, and you can also opt for any perfume-free cream, petroleum jelly, or ointment. Apply them a couple of times each day, especially after bath time.
3. Consider More Serious Eczema Treatments
If moisturizers alone aren’t doing the job to clear up the baby eczema, talk to your pediatrician. They will typically recommend one or several of the following:
- Antibiotics, to prevent viral and bacterial infections
- Antihistamines, to help deal with itchy skin
- Dry bandages and medicated dressings
- Emollients, to provide a protective film over the skin that keeps irritants out and moisture in
- Topical steroids, as highlighted above. Make sure you don’t over-use them, as they can lead to skin issues, such as thin skin
- Topical calcineurin inhibitors, to help with inflammation
- Ultraviolet light therapy, AKA Phototherapy
What is interesting about ultraviolet light therapy is that no one know exactly why it helps, but they know it does sometimes. It is believed to involve immunosuppression but the mechanism of action is not completely understood.
4. Start Eczema Prevention at Home
In terms of preventing baby eczema, all the advice for adults also applies to babies, infants, and toddlers:
- Try to prevent scratching. Keep your baby’s nails trimmed – file them, if possible. Consider the use of scratch mittens, or long socks, tucked under their long-sleeved shirt.
- Only use alcohol-free products. This includes soap, shampoo, detergents, deodorants, etc.
- Try oatmeal soaking. Feel free to ask your doctor about this: oatmeal products added to the bath water have been known to reduce irritation.
- Create a healthy post-bath routine. Pat the baby’s skin dry and immediately apply moisturizer.
- Avoid fabric irritation. To do this, always dress the little one in loose cotton clothing. Avoid wrapping them in too many blankets or putting too many clothes on their backs, in order to also avoid overheating and sweatiness.
5. Talk to Your Doctor About Baby Eczema
If a week of OTC hydrocortisone treatment has gone by and your baby is not responding (i.e., you’re not seeing the eczema receding), talk to your doctor for a prescription baby eczema treatment.
Be particularly wary of pus-filled blisters emerging over the affected skin patches, as these may signal a bacterial infection. Also, try to keep the baby out of contact with anyone suffering from cold sores or genital herpes, as they may be particularly sensitive to them, when affected by eczema.