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Suggest Treatment For Ezcema

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Posted on Wed, 28 May 2014
Question: Okay. What's the best way to deal with ezcema?
doctor
Answered by Dr. Shafi Ullah Khan (2 hours later)
Brief Answer:
Eczema needs examination and then management

Detailed Answer:
Thank you for asking!
Eczema is a reaction pattern caused by inflammation of the epidermis that typically manifests as scaling or crusting of the skin. It may be acute, subacute, or chronic depending on the historical and physical characteristics. The list of potential etiologies is extensive and includes allergic, autoimmune, idiopathic, and inflammatory mechanisms. Although eczema is often used interchangeably with atopic dermatitis (shown), there are many different causes of eczematous dermatitis, including allergic contact dermatitis, seborrheic dermatitis, irritant contact dermatitis, nummular eczema, dyshidrotic eczema, asteatotic eczema, venous stasis dermatitis, and lichen simplex chronicus (neurodermatitis).
In nutshell there are six major causes of eczema and unless examined by a professional dermatologist and assessed, it would be hard to sort out which one it is.
Atopic Dermatitis
Dyshidrotic Eczema
Asteatotic Eczema
Seborrheic Dermatitis
Allergic Contact Dermatitis
Lichen Simplex Chronicus

Most of the eczemas are atopic ones.
Here are some things one can do to help the ezcema.
1)lukewarm baths followed by the application of a moisturizer such as white petrolatum. Frequent baths with the addition of emulsifying oils (1 capful added to lukewarm bath water) for 5-10 minutes hydrate the skin. The oil keeps the water on the skin and prevents evaporation to the outside environment. In infants, 3 times a day is not a great burden; in adults, once or twice a day is usually all that can be achieved. Leave the body wet after bathing.

2)apply an emollient such as petrolatum or Aquaphor all over the body while wet, to seal in moisture and allow water to be absorbed through the stratum corneum. The ointment spreads well on wet skin. The active ingredient should be applied before the emollient. Newer emollients such as Atopiclair and Mimyx have been advocated as having superior results, but they are expensive

3)Topical steroids
Topical steroids are currently the mainstay of treatment. In association with moisturization, responses have been excellent.
Ointment bases are preferred, particularly in dry environments.
Initial therapy consists of hydrocortisone 1% powder in an ointment base applied 2 times daily to lesions on the face and in the folds.
A midstrength steroid ointment (triamcinolone or betamethasone valerate) is applied 2 times daily to lesions on the trunk until the eczematous lesions clear.
Steroids are discontinued when lesions disappear and are resumed when new patches arise.
Flares may be associated with seasonal changes, stress, activity, staphylococcal infection, or contact allergy.
Contact allergy is rare but accounts for increasing numbers of flares. These are seen mostly with hydrocortisone.

4)Immunomodulators
-Tacrolimus (topical FK506)
-Pimecrolimus 1%
- Omalizumab
5)Probiotics have been explored as a therapeutic option
6)acyclovir is effective in prophylaxis.
7)hydroxyzine and diphenhydramine hydrochloride provide a certain degree of relief from itching
8)Ketotifen (a calcium channel blocker)
9)Oil of evening primrose

Following precautions will help.
Clothing should be soft next to the skin. Cotton is comfortable and can be layered in the winter. Wool products should be avoided.
Cool temperatures, particularly at night, are helpful because sweating causes irritation and itch.
A humidifier (cool mist) prevents excess drying and should be used in both winter, when the heating dries the atmosphere, and in the summer, when air conditioning absorbs the moisture from the air.
Clothes should be washed in a mild detergent with no bleach or fabric softener.
Food avoidance is discussed in Diet, below, and in Causes

Get to a dermatologist and discuss the above mentioned treatment modalities and let them choose what is best for you. Keep the precautionary measures and let them take care of it.
I hope it helps. Don't forget to close the discussion please.
Take care
S Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (36 minutes later)
Thank you so much. I'll try some of your suggestions!!

From a few dermatologists I've heard the terms 1. Lichen Simplex for a spot on my upper thigh. And 2. Atopic Dermatitis.

Allergic contact might mean certain beauty products for skin repair & hydration, certain hair sprays, & other hair products?

I've applied petroleum jelly on my skin while my skin is still wet. That is always soothing. Aloe helps with sunburned skin.
doctor
Answered by Dr. Shafi Ullah Khan (9 hours later)
Brief Answer:
well said

Detailed Answer:
Thank you for getting back and appreciating!
You are quite right. Allergic contact is mostly due to the skin products you mentioned like soaps etc. Keep applying petroleum jelly it will be an asset. DO as directed above and stay in touch with your dermatologist. You will be fine and will have nothing to worry about. All will turn around well.
I hope it helps. Please close the discussion and take very good care of yourself.
My regards XXXXXXX
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
doctor
Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest Treatment For Ezcema

Brief Answer: Eczema needs examination and then management Detailed Answer: Thank you for asking! Eczema is a reaction pattern caused by inflammation of the epidermis that typically manifests as scaling or crusting of the skin. It may be acute, subacute, or chronic depending on the historical and physical characteristics. The list of potential etiologies is extensive and includes allergic, autoimmune, idiopathic, and inflammatory mechanisms. Although eczema is often used interchangeably with atopic dermatitis (shown), there are many different causes of eczematous dermatitis, including allergic contact dermatitis, seborrheic dermatitis, irritant contact dermatitis, nummular eczema, dyshidrotic eczema, asteatotic eczema, venous stasis dermatitis, and lichen simplex chronicus (neurodermatitis). In nutshell there are six major causes of eczema and unless examined by a professional dermatologist and assessed, it would be hard to sort out which one it is. Atopic Dermatitis Dyshidrotic Eczema Asteatotic Eczema Seborrheic Dermatitis Allergic Contact Dermatitis Lichen Simplex Chronicus Most of the eczemas are atopic ones. Here are some things one can do to help the ezcema. 1)lukewarm baths followed by the application of a moisturizer such as white petrolatum. Frequent baths with the addition of emulsifying oils (1 capful added to lukewarm bath water) for 5-10 minutes hydrate the skin. The oil keeps the water on the skin and prevents evaporation to the outside environment. In infants, 3 times a day is not a great burden; in adults, once or twice a day is usually all that can be achieved. Leave the body wet after bathing. 2)apply an emollient such as petrolatum or Aquaphor all over the body while wet, to seal in moisture and allow water to be absorbed through the stratum corneum. The ointment spreads well on wet skin. The active ingredient should be applied before the emollient. Newer emollients such as Atopiclair and Mimyx have been advocated as having superior results, but they are expensive 3)Topical steroids Topical steroids are currently the mainstay of treatment. In association with moisturization, responses have been excellent. Ointment bases are preferred, particularly in dry environments. Initial therapy consists of hydrocortisone 1% powder in an ointment base applied 2 times daily to lesions on the face and in the folds. A midstrength steroid ointment (triamcinolone or betamethasone valerate) is applied 2 times daily to lesions on the trunk until the eczematous lesions clear. Steroids are discontinued when lesions disappear and are resumed when new patches arise. Flares may be associated with seasonal changes, stress, activity, staphylococcal infection, or contact allergy. Contact allergy is rare but accounts for increasing numbers of flares. These are seen mostly with hydrocortisone. 4)Immunomodulators -Tacrolimus (topical FK506) -Pimecrolimus 1% - Omalizumab 5)Probiotics have been explored as a therapeutic option 6)acyclovir is effective in prophylaxis. 7)hydroxyzine and diphenhydramine hydrochloride provide a certain degree of relief from itching 8)Ketotifen (a calcium channel blocker) 9)Oil of evening primrose Following precautions will help. Clothing should be soft next to the skin. Cotton is comfortable and can be layered in the winter. Wool products should be avoided. Cool temperatures, particularly at night, are helpful because sweating causes irritation and itch. A humidifier (cool mist) prevents excess drying and should be used in both winter, when the heating dries the atmosphere, and in the summer, when air conditioning absorbs the moisture from the air. Clothes should be washed in a mild detergent with no bleach or fabric softener. Food avoidance is discussed in Diet, below, and in Causes Get to a dermatologist and discuss the above mentioned treatment modalities and let them choose what is best for you. Keep the precautionary measures and let them take care of it. I hope it helps. Don't forget to close the discussion please. Take care S Khan