Medical treatments for eczema
Clinical diagnosis of eczema is most commonly based on the appearance of a patient’s skin and on their family and personal history. However, because there are many similar conditions to eczema (e.g. psoriasis), your medical practitioner will have to examine your skin lesions in order to rule out alternatives problems. They may even need to carry out a skin lesion biopsy to establish exactly what you are suffering from, although in most cases this is unlikely to be necessary. Once your medical practitioner has established that you are indeed suffering from eczema, it is likely that they will recommend various courses of action depending upon the severity of your eczema problem.
Nevertheless, irrespective of what kind of treatment they prescribe for you, the ultimate objectives of the treatment will always be the same:
• To control and reduce itching;
• To reduce skin inflammation;
• To loosen and then remove scaly skin lesions;
• To reduce the outbreak of new lesions; and
• To clear any infection that has already set in.
There are many strategies that your medical practitioner may recommend you should adopt as a way of reducing the severity of your problem, ranging from moisturizing your skin (more of which later), applying topical pharmaceuticals, or in more serious cases, they may even recommend oral medications. Most commonly, the medications that will be prescribed for treating your eczema are likely to be based on corticosteroids, a type of steroid hormone that is naturally produced in the adrenal cortex.
As a first option, most medical practitioners will recommend a topical cream or ointment that is based on corticosteroids as a first-line treatment for eczema. Many such corticosteroid creams can be bought across the counter without a prescription in Western countries, which suggests (quite correctly) that the creams that you buy are not especially strong.
They are unlikely to have any particularly adverse side-effects either, but their effectiveness may be fairly limited.
If your condition continues to deteriorate or does not improve, your doctor may prescribe you a corticosteroid cream or lotion, meaning that this particular topical treatment is likely to be considerably stronger than those that you buy across the counter.
It is widely accepted within the medical community that long-term usage of corticosteroids can have adverse side-effects, such as irreversible skin thinning. Consequently, if your doctor prescribes topical corticosteroid based lotions or creams, it is likely that they will recommend that you only use them for a short period of time.
The third corticosteroid-based option is for your medical practitioner to recommend oral corticosteroid drugs such as prednisone or prednisolone. While the potential adverse side effects of taking these drugs will depend upon the strength of the drug you are taking and the period of time you have to take it for, there are widely recognized adverse side-effects of long-term use of drugs like these.
For example, scroll down the prednisolone page highlighted above and you will see that listed amongst the potential side-effects are weight gain, high blood pressure, worsening of diabetes, glaucoma, diabetes, growth retardation in children and psychic disturbances.
While it is fair to say that it would only be in the most serious of circumstances that a medical practitioner would prescribe a long-term use of corticosteroid drugs like these, it is not impossible that some doctors might do so. Hence, you need to be aware of the dangers of corticosteroid drugs, and if at all possible, avoid using them.
Other pharmaceuticals that might be prescribed by your doctor would be antibiotics in a situation where by scratching the eczema affected areas of your skin you have caused an infection.
When you suffer severe itching as a result of your eczema, you might want to use antihistamines to reduce the severity, with antihistamine-based products being available both across the counter and by prescription.
However, if you are going to use antihistamines, be aware that one of the effects of taking this particular class of drug is that they cause drowsiness. Hence, it is best to take them at night before retiring to ensure that you get a good night’s sleep. Never be tempted to take them if you are driving, or operating machinery as part of your job.
Finally, a few years ago, the FDA approved two new drugs that belong to the class known as calcineurin inhibitors, drugs that suppress the activity of your immune system as a way of reducing the worst effects of conditions like eczema.
The two best known ‘types’ of drugs of this nature are Pimecrolimus (Elidel) and Tacrolimus (Protopic), but because these drugs are still new, there is not as yet a great deal of scientific evidence about any adverse side-effects.
It has been suggested that avoidance of using them helps the kidneys of renal transplant patients to function far more efficiently, which would point to the likelihood that there are possible side-effects.
Claims that applying these drugs to the skin can also cause burning and discomfort for several days, with less common side-effects being listed as acne, headaches and possible flu-like symptoms, are a little worrying.
In fact, the same article goes on to suggest that the FDA has now issued a warning about possible links between topically applied calcineurin inhibitors and cancer. There seems little doubt that like so many that have gone before, the possible long-term adverse effects of these particular pharmaceuticals mean that they are not the much heralded ‘wonder drug’ that they might have appeared to be at first.
From this chapter, one thing should have become abundantly clear. While your medical practitioner might be able to recommend many chemical-based pharmaceutical treatments for eczema, you would not necessarily want to use any of these particular methods of treatment given the potential adverse side-effects that are inherent in using chemical-based pharmaceuticals.
Because the majority of eczema sufferers have an intermittent problem that is not especially serious apart from the highly irritating itching, even medical practitioners are often happy to recommend natural solutions that you can try to get rid of the problem before turning to pharmaceuticals. Let us consider some of these natural options next.