Eczema Pathway - Treatment Review
- Be aware that your prescribing may be causing part of the problem.
- Use the mildest steroid that works being aware of the relative strengths of potency.
- Apply daily under or over emollients without rubbing the skin.
- Aqueous cream contains Sodium Lauryl Sulphate used to emulsify the oils. It has been shown to cause skin sensitisation, thinning of the skin layers and increased water loss from the skin. White soft paraffin or Cetomacrogol could be an appropriate substitute.
- Facial eczema may indicate allergy to either the environment or the treatments being applied and causation sought.
- Oral anti histamines may be useful at night to reduce itch while waiting for the topical treatments to work.
- Non sedating antihistamines can be offered for 1 month trial and extended if helpful.
- Sedating antihistamines may be offered to the over 6 month infants for short courses (7 -14 days) if their eczema is causing sleep disruption. They should not be used long term.
- Crusting or weeping skin probably indicates staph or strep skin sepsis and should be treated with extended courses of oral antibiotics if extensive. Localised areas can be treated with topical antimicrobials (Bactroban).
- Recurrent skin sepsis indicates the need for effective hand face buttock antisepsis with short courses of Chlorhexidine and the use of Janola in the bathing waters.
- Allergens are rarely the cause of eczema unless other food related symptoms occur or poorly responsive condition to optimal treatments.
Last updated : Thursday, May 18, 2017
Next review date : Friday, May 18,2018
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