Understanding Eczema - Diagnosis & Treatment

Understanding Eczema - Diagnosis & Treatment

How Is Eczema Diagnosed?
To diagnose eczema, your doctor will first talk to you about your symptoms and medical history. He or she will also ask about your family's history of rashes and other allergy-related medical conditions, such as asthma and hay fever. While there is no single test to effectively diagnose eczema, a good medical history combined with an exam of your skin is usually adequate.

What Are the Treatments for Eczema?
Good skin care is a key component in controlling eczema. Proper care of the skin can often be enough in many milder cases of eczema.

In treating eczema, most doctors will start patients on basic therapies. A good moisturizer (in cream, lotion, or ointment form) helps conserve the skin's natural moisture and should be applied immediately after showering or bathing and one other time each day.

Corticosteroid creams and ointments have been used for many years to treat eczema. Your doctor may recommend application of over-the-counter hydrocortisone cream in mild cases but often will prescribe a stronger steroid cream when the eczema is more severe. When other measures have failed, the doctor may prescribe oral corticosteroid medication; steroids should always be taken with caution and never without medical supervision.

Newer drugs called topical immunomodulators are available to help treat eczema. These medicines help control inflammation and reduce immune system reactions when applied to the skin. Examples include Elidel and Protopic. These drugs are thought to be as effective as corticosteroids.

WARNING: The FDA has issued its strongest "black box" warning on the packaging of Elidel and Protopic. The warning advises doctors to prescribe short-term use of Elidel and Protopic only after other available eczema treatments have failed in adults and children over the age of 2. Younger children should not take these medications.

Research in animals has linked Elidel and Protopic with an increased risk of non-Hodgkin's lymphoma. In those studies, the risk of cancer increased as the dose of the drugs increased. The FDA has also received reports of serious adverse events in children under the age of 2 who were prescribed the drugs, although they have not been approved for use in children in this age group.

Taking oral antihistamines may also help relieve symptoms. Some of these may cause drowsiness, which may be of benefit if nighttime itching is a problem.
For extreme cases of eczema, therapy using ultraviolet light may be prescribed. In adults, drugs that suppress the immune system may also be an option in the more severe cases. These medicines, such as cyclosporine or methotrexate, may be used in cases when other treatments have failed.

To relieve stress and improve circulation, it also helps to take a brisk walk or exercise on a regular basis. Set aside time for other relaxing activities.

Home Remedies for Eczema
Home remedies for eczema may be as simple as changing your laundry detergent or as difficult as moving to a new climate or changing jobs. Removing whatever is causing the allergic reaction is the easiest and most effective treatment.

Prevent dry skin by taking warm (not hot) showers rather than baths. Use a mild soap or body cleanser. Dry yourself very carefully and apply moisturizing skin lotions all over your body.
Avoid lotions with fragrances or other irritating substances.

Avoid wearing tight-fitting, rough, or scratchy clothing.

Avoid scratching the rash. If you can't stop yourself from scratching, cover the area with a dressing. Wear gloves at night to minimize skin damage from scratching.

Anything that causes sweating can irritate the rash. Avoid strenuous exercise during a flare.

If the allergy-causing agent cannot be removed or identified, the next step is to lessen the allergic inflammatory response.

* Apply a nonprescription steroid cream (hydrocortisone) along with anti-itching lotion (menthol/camphor, such as calamine). The cream must be applied as often as possible without skipping days until the rash is gone.

* Diphenhydramine (Benadryl) in pill form may be taken for the itching. Caution - you should not take this medication if you need to drive a car or operate machinery as it will make you sleepy.

* Clean the area with a hypoallergenic soap every day. Apply lubricating cream or lotion after washing.

Avoid physical and mental stress. Eating right, light activity, and adequate sleep will help you stay healthy, which can help prevent flares.

Do not expect a quick response. Eczema is easier to control than cure.