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Eczema: Always Moisturize


By Joshua Ng (Pharmacist, Caring Pharmacy) | Malaysia | Fri May 11, 2018 10:46am

 ECZEMA: ALWAYS MOISTURIZE

The symptoms of eczema i.e. dryness can be treated with moisturizers or gentle soaps. Good skin care is the first line of defense for eczema regardless of severity. If good skin care alone is ineffective, pharmacological treatment can be considered. The treatment of eczema with medication is based on your diagnosis, therefore please consult a doctor first.

First, caring for your skin:

  • Moisturizers provides a physical barrier against water evaporation, thereby reduces skin dryness. Moisturizing may effectively break the vicious cycle of itching. It should be applied all over at least twice daily regardless of the presence of active eczema. It should be applied preferably within 5 minutes after a shower. The use of moisturizers can reduce the dependence on topical corticosteroids.
  • Gentle soaps that are fragrance-free, hypoallergenic, and a neutral to low pH are preferred. Soaps with essential oils such as linoleic acid is a good choice as this allows a layer of essential oils to be left behind on the skin after bath, to serve as a moisturizer and protective barrier on skin.

Medications commonly prescribed for eczema are:

Topical corticosteroids (i.e. Hydrocortisone 1% cream)
  • Usually prescribed as first line treatment
  • Anti-inflammatory and anti-itch properties
  • Side effects: may thin skin, therefore to apply sparingly
  • Topical corticosteroids are available in mild to potent strengths with higher strengths more effective yet carrying higher risk of side effects
Antihistamines (i.e. Chlorphenaramine 4mg tablet)
  • Usually prescribed to be taken to reduce itch symptoms only
  • Drowsiness is a common side effect
  • Long term usage may result in dry mouth and constipation especially in elderly
Oral corticosteroids (i.e. Prednisolone 5mg tablet)
  • Usually prescribed for eczema flare ups (second line treatment after topical corticosteroids)
  • Anti-inflammatory and anti-itch properties, also able to suppress the immune system
  • Not for long term due to its side effects such as infections, diabetes, osteoporosis, hypertension, etc.
  • Dosage is usually gradually tapered down to prevent withdrawal symptoms
Topical Immuno-suppressants (i.e. Tacrolimus 0.1% ointment)
  • Usually prescribed when patient does not respond to corticosteroid treatment
  • Similar properties to topical corticosteroids
  • Well tolerated, less side effects compared to topical corticosteroids
Oral Immuno-suppressants (i.e. Cyclosporine 25mg tablet)
  • Usually prescribed in severe eczema
  • Long term use requires regular monitoring of liver and kidney function, full blood counts, etc.

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