Treatment options
Treatment options
Emollients (moisturisers) are the mainstay of eczema management. They form a protective layer over the skin, trapping water. A huge array of products are available over-the-counter and on prescription. But how do they differ?
- Many emollients are based on hard, soft or liquid paraffin – occlusive agents that form a protective barrier when they are applied to the skin
- Colloidal oatmeal is often included for its anti-itch, moisturising, cleansing and protective properties
- Humectants, such as urea and glycerol, are hygroscopic ingredients, which means they draw water into the skin
- Antiseptics (e.g. benzalkonium chloride) are only really recommended if an infection is present or is a frequent problem
- Lanolin penetrates deep into the skin, making it helpful for dry, cracked skin. As it can cause allergies, it is not suitable for everyone, although hypo-allergenic derivatives are available
- Lauromacrogols have a local anaesthetic effect and can help to soothe the skin by reducing itching
- Ceramides may help to replenish barrier lipids, support the skin barrier and reduce water loss, alleviating dryness.
Personal preference is key with treatment because the correct emollient for someone is the one they will use. This means that branded products are usually prescribed, rather than generic, and a person may need to try several products before settling on those that work best for them.
Important notes:
- Aqueous cream is no longer recommended as a leave-on emollient as it may increase the risk of skin reactions
- Some products may contain nut or soya oil, so remember to check whether the patient has any allergies.
Topical corticosteroids
Creams containing topical corticosteroids such as hydrocortisone (e.g. Eurax HC Cream, Hc45 Hydrocortisone Cream) or clobetasone (e.g. Eumovate Eczema & Dermatitis 0.05% Cream) can be used on a short-term basis for flare-ups. They work by suppressing the inflammatory reaction.
All topical steroids should be applied sparingly to the affected area, following an emollient and after the emollient has been fully absorbed. Make sure you understand the age and usage restrictions on these products so that you can explain these to your customer. Also remind customers how often they should apply a topical steroid and how long they can use it for.
Stronger topical steroids, such as betamethasone valerate 0.1% or mometasone furoate can be prescribed if necessary.
Did you know?
Skin is the body’s largest organ, accounting for around 10 to 15 per cent of our body weight. It contains water, proteins, lipids, hair follicles, sebaceous (oil) and sweat glands, nerve endings and blood vessels.