Treating Eczema with Non-steroid Creams
While there’s not yet a known cure for eczema, there are several treatment options that your child’s doctor may advise. Most treatments will be used in conjunction with regularly moisturising the skin.
Moisturisers (emollients) should be applied regularly every day to stop the skin becoming dry. Many emollients are available and it is important that you experiment until you find one that works effectively and that your child is comfortable with. You can get very basic, fragrance-free moisturisers at reasonable cost from your local pharmacist.
It’s important that you reapply moisturiser frequently; every few hours if need be. Moisturising will help to prevent the skin drying out and will help protect the skin’s barrier function.
If your child’s eczema becomes wet and weepy, it may mean that it’s infected and that antibiotics are needed.
If steroid creams haven’t helped, or if eczema is a particular problem on the face and neck, some people benefit from the recently introduced non-steroid creams, Tacrolimus ointment and Pimecrolimus cream, which can reduce inflammation in the skin if other treatments haven’t worked. They can be effective against atopic eczema in adults and children aged over two.
These preparations do not thin the skin or cause the side effects associated with topical steroids. However, they may sting on application and might increase the risk of skin infections. They should not be applied to sun-exposed areas of the body or used at the same time as ultraviolet light treatment. Although, theoretically, they might increase the risk of skin cancer, they have been safe in use for up to four years.
Bandaging can sometimes help, particularly for the arms and legs. ‘Wet wraps’ are cooling bandages which are soothing for short periods. They may be particularly helpful at night.
Children with severe or widespread eczema sometimes need stronger treatments, usually given in a hospital skin department. Oral steroids (usually prednisolone) are sometimes used for a very short time if the eczema has flared badly. They work well but cannot be used in the long term as they may cause side effects. More severe forms of eczema may need longer courses of other tablets that calm down the immune system, such as azathioprine or ciclosporin. They too have side effects that need to be monitored with regular blood tests and visits to the hospital.
Treatments that require caution
The so-called ‘non-sedating’ types of antihistamines, particularly those used to treat hay fever, are of no benefit to people with eczema. The only antihistamines that may help control atopic eczema are the ones that make people feel drowsy. These are less effective in the long term but may be helpful for short periods, especially at night, to help your child sleep.
Chinese herbs are an alternative therapy which some people favour. Most doctors would not recommend their use, as their ingredients are not regulated. Liver problems have been known to occur with Chinese herbs and patients taking them should be monitored for side effects.
All treatment options should be discussed with your GP or dermatologist.