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Having Atopic Eczema. No Family History Of Atopic Eczema. Treatment Without Steroids?
Question: Treatment of atopic eczema without use of steroids? For a child of six years age without any family history of atopy
Hi,
Thanks for writing to us.
To treat atopic eczema , we have to keep two things in mind
Severity of disease
Breaking the itch scratch cycle.
If the disease is severe or there is an acute flare up, then a course of steroids to control the disease might be required. Once the acute phase is over or if the disease is not very severe, these steps would help preventing flare up-
The key word is moisturise and keep the skin hydrated
1. Use a mild soap for bathing like cetaphil cleanser or venusia bar or hidrate soap etc.
2) adding a bath oil to water XXXXXXX gives good results, for the same you may use oilatum lotion
3) moisturise the skin immediately after bath and two to three times in a day after doing s wet sponging of body. Personally I prefer cetaphil restoraderm moisturiser, it gives wonderful results.
4) wear cotton clothes as wool synthetic clothes irritate atopic skin.
5) diet has some role. Dairy products, eggs may flare up the disease. If your child never had any flare up with particular diet then do not restrict any particular food. Probiotics have a role in atopic eczema, hence its intake may be encouraged.
6) sometimes steroid creams are required to treat the existing rashes. If you don't want to use steroids at all then you may replace it with tacrolimus cream.
7) use a good antihistamine round the clock to prevent itch as itching exacerbates disease.
8) if you strictly do not want steroid then you may try narrow band UVBtherapy . Its a photo therapy given three times in a week and offers very good results in atopic eczema without steroid use.
Hope that answered your query. Should there be a further query, please write back.
Thanks for writing to us.
To treat atopic eczema , we have to keep two things in mind
Severity of disease
Breaking the itch scratch cycle.
If the disease is severe or there is an acute flare up, then a course of steroids to control the disease might be required. Once the acute phase is over or if the disease is not very severe, these steps would help preventing flare up-
The key word is moisturise and keep the skin hydrated
1. Use a mild soap for bathing like cetaphil cleanser or venusia bar or hidrate soap etc.
2) adding a bath oil to water XXXXXXX gives good results, for the same you may use oilatum lotion
3) moisturise the skin immediately after bath and two to three times in a day after doing s wet sponging of body. Personally I prefer cetaphil restoraderm moisturiser, it gives wonderful results.
4) wear cotton clothes as wool synthetic clothes irritate atopic skin.
5) diet has some role. Dairy products, eggs may flare up the disease. If your child never had any flare up with particular diet then do not restrict any particular food. Probiotics have a role in atopic eczema, hence its intake may be encouraged.
6) sometimes steroid creams are required to treat the existing rashes. If you don't want to use steroids at all then you may replace it with tacrolimus cream.
7) use a good antihistamine round the clock to prevent itch as itching exacerbates disease.
8) if you strictly do not want steroid then you may try narrow band UVBtherapy . Its a photo therapy given three times in a week and offers very good results in atopic eczema without steroid use.
Hope that answered your query. Should there be a further query, please write back.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your prompt response. I was using Cetaphil Lotion but it causes lot of burning sensation so I am using Aquasoft Lotion and with that I am using Pimercrolimus Cream 1% twice a day. And I also Elocon Cream once a day when there is flare up. Along with Cypl-L Syp. 3 times (Poor response with Benadry -A hence changed.) All these are prescribed by dermatologist however I am not happy with the response. Kindly advice.
Hi XXXXXXX
Thanks for writing back and accept my apologies for delayed response.
I can see that you are using everything that is required to control atopic eczema.
If you think these medicines are not helping you much, then I would advise that you may discuss the option of giving the child a short course of oral steroid or may start with phototherapy for better results. Steroids when used properly and for short while are not harmful.
I would also like to mention few points
Cetaphil restoraderm is a much better version of cetaphil moisturiser. Its worth giving a try. Use a moisturiser multiple times in a day
Pimecrolimus sometimes causes slight burning sensation, if it does try tacrolimus 0.03 percent
Use elocon twice in a day for few days for better results. Once results are obtained, use once in a day for week then once in a day every alternate days for a week and then finally maintain the child on once a week application. There are many studies that promote steroid use in above mentioned way for good response and least side effects. Before you put your child on oral steroid, I would advise that you try to maintain the skin by topical steroid first.
Use a mild soap and bath oil.
Do follow these steps for a week and let me know, if the child is responding well. I shall be available for follow up.
Regards
Thanks for writing back and accept my apologies for delayed response.
I can see that you are using everything that is required to control atopic eczema.
If you think these medicines are not helping you much, then I would advise that you may discuss the option of giving the child a short course of oral steroid or may start with phototherapy for better results. Steroids when used properly and for short while are not harmful.
I would also like to mention few points
Cetaphil restoraderm is a much better version of cetaphil moisturiser. Its worth giving a try. Use a moisturiser multiple times in a day
Pimecrolimus sometimes causes slight burning sensation, if it does try tacrolimus 0.03 percent
Use elocon twice in a day for few days for better results. Once results are obtained, use once in a day for week then once in a day every alternate days for a week and then finally maintain the child on once a week application. There are many studies that promote steroid use in above mentioned way for good response and least side effects. Before you put your child on oral steroid, I would advise that you try to maintain the skin by topical steroid first.
Use a mild soap and bath oil.
Do follow these steps for a week and let me know, if the child is responding well. I shall be available for follow up.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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