First, relax….
No, eczema can’t be cured. Yes, there is a chance you can have eczema for life. Yes, you might have to apply creams for perhaps the rest of your life! And yes, you do have one of the most frustrating conditions there is.
Please, have your moments of despair, but never, never, never stop using your moisturizers! They are the single most important tool in your eczema treatment toolbox! They are without side effects in most people and can make a major difference to the control of dermatitis by simply keeping skin well hydrated.
Moisturizers are the most important tool in your treatment toolbox
By hydrating your skin the best you can, you will also use less immunosuppressant creams and ointments like corticosteroids, Tacrolimus and Pimecrolimus. Less immunosuppressant medication means there is less chance of getting the side effects of these medications like skin thinning (corticosteroids), infections and even the small unproven possibility of skin cancers (Tacrolimus and Pimecrolimus).
If you do not apply your moisturizers religiously, the whole emphasis of your treatment will start shifting toward immunosuppression. If you were someone who controlled your eczema with emollients and intermittent corticosteroids you will find that you need more corticosteroids. Some people will need treatment with light therapy and a few people might need immunosuppressive tablets. Light therapy raises the chances of skin cancer and most immunosuppressive tablets raises the chances of skin and other cancers.
There are many different emollients on the market. Experiment! Find one you like and stick with it! Use it head-to-toe at least twice a day. Use it even if your skin looks perfect to you. Remember, the goal of using emollients is not only to sooth active eczema, but also to prevent flare-ups from occurring!
Get fed up, feel despair, feel frustrated and then just start applying the emollients again and again…….!
Hi Dr. Louw,
I suffer from diagnosed atopic eczema – although it is not very visually apparent it is lightly present on almost my whole body – leading to general itching, most intense on my back and shoulders, and at night.
I am doing all the above (including the despair, frustration etc.) but am struggling to wean myself off cortiosteroid creams – when I stop applying them the eczema flares up again, right on cue. I don’t want to have to keep using the cream (for health and financial reasons) but feel that my skin is dependent on it.
I am also using EpiMax cream as my moisturizer – it definitely works because when I don’t use it my eczema gets worse. I apply it once a day.
Any suggestions on another moisturizer and/or a different treatment regime?
P.S. my dermatologist put me on a course of oral cortizone a few months back – during the course and for a week or so after, my skin was great. But then the dryness and eczema slowly came back.
Any suggestions would be great!
Thanks,
Nicholas
Dear Nicholas. Thank you for your email. As you most likely know, Atopic Dermatitis is a genetic condition and therefore not curable. It is only controllable. AD is like the skin equivalent of Asthma. It is certainly worth experimenting with different moisturizers. Have you tried Nutraderm or Nutraplus? What do you wash with? Remember all soaps are drying. Try something like Epizone E as a soap. However, if EpiMax works well for you, then you will struggle to get a better option……. It is sometimes not possible to completely wean oneself of topical corticosteroids. The idea is then to just minimize the use… Good luck. Let my know if I can help in any other way.
Thanks Dr. Louw – much appreciated!
Morning
I have a son with severe eczema. He scratches himself until he is bleeding. What meds can I use that will help to stop the scratching. I am using ointments for his skin.
Dear Hanlie. You will have to come and show me. The medication that he requires will depend on the characteristics of his eczema.