Best Treatment for Eczema

Eczema, also called as dermatitis, refers to group of medical conditions that cause inflammation and irritation you’re your skin. Although eczema is not a dangerous, it may be bothersome for every individual. So it is necessary to treat every individual in order to relieve the itching and to prevent it from recurring.

There is no any best treatment for eczema that works on everyone, treatment may vary from person to person. The goal of treatment for eczema is to relieve and prevent itching. Itching can be reduced by applying moisturizer, calamine soothing lotion or a topical steroid cream and taking oral antihistamines. This will reduce the scratching thus healing the lesion.

Avoidance of the triggering factors like, foods such as eggs, irritants such as wool and lanolin, strong soaps and detergents and other chemical based solvents and other factors that triggers allergy symptoms. Limitation of water exposure to the area, and regular use of moisturizer may prevent recurrent episodes of eczema.

Medications:
Anti-inflammatory agents
Mild to moderate corticosteroids are highly effective in controlling or suppressing symptoms in most cases [1]. Several classes of corticosteroids can be used according to lesion characteristics and location of the eczema.
Hydrocortisone ointment 1%: Mild topical corticosteroid mixed in petrolatum is generally well tolerated. It has mineralocorticoid and glucocorticoid effects and anti-inflammatory activity. Generally given as 1% ointment 2-3 times daily.

Betamethasone topical: Medium-strength topical corticosteroid is generally used for body areas. It decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing capillary permeability. Affects production of lymphokines and has inhibitory effect on Langerhans cells. Usually given as 0.05-0.1% ointment in adults and 0.05% ointment in pediatrics patients. Prolonged use of topical corticosteroids is thought to increase the risk of side effects, the most common of which is the skin becoming thin and fragile [2].

Antihistamines
Antihistamines may reduce the itch during a flare up of eczema, and the reduced scratching in turn reduces damage and irritation to the skin. However, in most of the cases, significant benefit may be due to the sedative side effects of these drugs, rather than their specific antihistamine effect. Thus sedating antihistamines such as promethazine, or diphenhydramine may be more effective at preventing night time scratching than the newer, nonsedating antihistamines [3]. So, combination of therapy with sedating antihistamines during night and non-sedating antihistamines during day may be beneficial.

Immunomodulators

Immunomodulators are used for those eczema cases in whom conventionaltherapy approach have been failed. Topical immunosuppressants like and tacrolimus are newer agents which effectively suppress the immune system in the affected area, and appear to yield better results in some populations. Other immunomodulators like Methotrexate and Cyclosporine are also being used in the treatment of severe eczema with satisfactory response seen 3-6 wk following administration. If there is no response treatment should be stopped.

Light therapy
Eczema may be controlled using light therapy with ultraviolet light [4]. Most commonly used light therapy is UVA, but UVB and Narrow Band UVB are also being used. However over exposure to UV light may have risk of developing skin cancer [5].

Diet
In a study at the University of California, San Diego School of Medicine, the authors suggests that use of oral vitamin D3 supplements bolsters production of a protective chemical usually found in the skin, that might prevent skin infections which are a common result of atopic dermatitis, the most common form of eczema [6]. It can be noted that the production of vitamin D3 is catalyzed by UV radiation and may influence histocompatibility expression, correlating with both the seasonality of eczema and its relation to the immune system. Also, hemp seed oil has been shown to relieve the symptoms of atopic eczema [7].

 References:

[1] Hoare C, Li Wan Po A, Williams H (2000). “Systematic review of treatments for atopic eczema”. Health Technology Assessment 4 (37): 1–191.
[2] Atherton DJ (October 2003). “Topical corticosteroids in atopic dermatitis”. BMJ 327 (7421): 942–3.
[3] NHS evidence “Evidence on the effectiveness of antihistamines.”
[4] Polderman MC, Wintzen M, le Cessie S, Pavel S. UVA-1 cold light therapy in the treatment of atopic dermatitis: 61 patients treated in the Leiden University Medical Center.Photodermatol Photoimmunol Photomed. 2005 Apr;21(2):93-6.
[5] Stöppler MC. Psoriasis PUVA Treatment Can Increase Melanoma Risk. MedicineNet
[6] “Oral Vitamin D May Help Prevent Some Skin Infections”. University of California, San Diego. October 6, 2008.
[7] Callaway, JC, Schwab U, Harvimaa I, Halonen P. et al. Efficacy of dietary hempseed oil in patients with atopic dermatitis. Journal of Dermatological Treatment 16: 87-94.