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General
Several treatment options for eczema are available. But primarily, it is most important to diagnose correctly and to identify the underlying aetiological factors (e.g. allergens in case of allergic contact dermatitis). Avoidance of the aetiological factors is one important therapeutical approach. Symptomatic treatment includes topical and systemic treatment regimens. The treatment depends on the underlying type of eczema and on its localisation.
The following general guidelines have proved helpful in eczema patients:
- Avoid factors that aggravate dry skin such as excessive exposure to water, long bathing in hot water, alkali, soaps, detergents, irritant topicals containing alcohol
- Use mild, non-alkali soaps
- Have short-lasting showers or bath in temperately warm water not longer than 10 – 15 minutes at a time adding bath oil, tar, colloid or permanganate
- Don’t rub your body dry after washing, rather dab at it with a soft towel
- After showering or bathing, immediately apply a moisturiser to the skin
- Regularly moisturise your skin on a daily basis with a non-specific emollient
- If eczema lesions also affect the scalp, use bland shampoos or tar shampoos
- Wear appropriate clothing such as cotton clothing (no wool or synthetic fabric)
- Avoid factors that increase the itching by increasing the blood circulation such as heat, hot food and hot liquids
- Avoid stress and anxiety as far as possible
Emollients should be selected depending on the individual skin condition and in consideration of the patient’s compliance. Rich emollients may be used at night time, whereas creams are more appropriate for daytime use because they enable the patient to wear clothing without any restriction. An effective use of emollients can replace the natural oils to a certain extent, cover tiny fissures, and restore a protective film over the skin. In case of severe pruritus, adequate methods of how to interrupt the itch-scratch cycle should be performed (e.g. application of a cold wash cloth, gentle pressure). In case of atopic dermatitis (AD), contact allergens such as house dust and dust mites should be avoided.
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