Treatment Help Beyond Moisturizers
After dealing with eczema as an adult, I thought I had a good idea of how to treat my skin. Then motherhood came and each of my kids started out with soft, smooth skin. As the weeks and months went by, they started to develop dry, red skin patches. My first response was to smother these patches with moisturizers. Sometimes it worked, but most of the time I needed something more potent. Treating eczema on babies and kids were new to me. The kids’ pediatrician would typically prescribe a corticosteroid cream. This made me wonder what my kids’ other treatment options may be. While at a recent visit with their doctor, I picked up an educational handout published in 2015 by the National Eczema Association. First, let’s summarize the two most common treatment options – moisturizers and corticosteroids.
Moisturizers and corticosteroids
- Moisturizers: Lotions do not have a rich and thick consistency to offer any considerable benefit. In fact, lotions have a net drying effect on the skin. Instead, ointments such as petroleum jelly are best. However, I find it to be too thick and shiny, and the kids sometimes find it to be uncomfortable. As an alternative, creams may be used for moderately dry skin or in hot, humid weather. Moisturizers are most effective when applied to wet skin, immediately after bathing.
- Corticosteroids: These may also be called topical steroids. They are cortisone-like mediations that are in the form of creams or ointments. Some of the typical corticosteroids prescribed by doctors for eczema may be hydrocortisone, mometasone, desonide, and triamcinoline. Often these are the go-to treatment for inflamed skin. As with most prescription medication, its use must be carefully supervised. Topical steroids come in a range of strengths. Hydrocortisone is generally a safe and very mild steroid. The more potent topical steroids may cause thinned skin, stretch marks, and even growth retardation.
What are some other common treatment options?
- Topical immunomodulators (TIMs): TIMs have been available for more than 10 years. This family of topical medication works to inhibit the skin’s inflammatory response. Inflammation is the cause of redness and contributes to itching of the skin. These are not steroids and do not cause thinning of the skin. However, since they can suppress the immune system in the skin, it is important to use sun protection for children using this therapy.
- Tar preparations: Tar creams or bath emulsions may be useful for children with mild inflammation.
- Antibiotics: Depending on the source of the flare-ups, an oral or topical antibiotic may reduce the surface bacterial infections that accompany inflammation.
- Antihistamines:Antihistamines are prescribed to reduce itching, but may cause drowsiness.
With each treatment application, I have wondered when and if my child will outgrow atopic dermatitis. According to the National Eczema Association, the majority of babies with eczema will overcome the disease by adolescence, even before grade school. However, severe atopic dermatitis will continue to affect a small number of children well into adulthood. Some people may find that their eczema goes away, but returns years later. Even during remission they may still have dry skin.
Since I’m experiencing eczema into adulthood, my guess is that my children will also experience eczema to varying degrees as an adult. That means we may be using several different treatment options to address their changing needs as they grow older.
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