“How do you manage eczema?”
My 11 year old daughter has eczema and dry patches. How do you manage eczema?
2 Answers
There are many ways to manage eczema depending on severity. My son has eczema and I treat patients with eczema regularly in the clinic. First, use less soap or use moisturizing soap (our family typically goes with the less soap option - my son literally says, "I am so itchy after I use soap" - even the 6 year-old understands). Most patients look at me like I am nuts when I ask them to only use soap in the armpits, groin, face, hands and feet (and I get it). For years, everyone's parents have taught them to clean up squeaky clean. This is fine for most, but for those with eczema (essentially a genetic skin barrier issue), using harsh chemicals or soaps that strip the oils from our skin can wreak havoc. Simply put, less soap and hot water, more lotion.
Next, eczema skin (and even areas of the skin that don't have rash in patients with eczema) have overactive immune cells present. So, topical steroids, and non-steroid anti-inflammatories are a mainstay if you have itch and rash. If your dermatologist is up to date, then they will also be asking you to put the anti-inflammatory cream on "hot spots" a couple times a week to prevent flares. The importance of this cannot be understated. If you are always acting in a "reactive" way instead of "proactive," then your eczema will always be flaring and then getting better and then flaring again...sad, but all too often I see this every day in my practice. Simply put, put on the physician prescribed creams and use preventative strategies.
Finally, for very severe patients, we use systemic (tablets or injectables) medications. One such medication is Dupixent, which is approved down to age 6. Thus far, it has been shown to be very safe (much safer than other systemic we used to use - and still do - i.e., methotrexate, azathioprine, cyclosporine, etc.). Typically, topicals will still need to be used, but I have seen it work wonders for patients. Big Pharma isn't always bad - they make medications like this and really help physicians change peoples lives. Simply put, if topicals don't cut it, a dermatologist can discuss going to a stronger option.
Anyways, hope this helps and your daughter gets better and/or sees a dermatologist and they help you get her better. Eczema can be debilitating, it leads to poor sleep (itch), poor learning in school (distraction from itch), and many other issues that are not just skin deep. A board-certified dermatologist can help her return to normal skin and a healthier outlook.
Warm Regards,
Dr. Contestable
Next, eczema skin (and even areas of the skin that don't have rash in patients with eczema) have overactive immune cells present. So, topical steroids, and non-steroid anti-inflammatories are a mainstay if you have itch and rash. If your dermatologist is up to date, then they will also be asking you to put the anti-inflammatory cream on "hot spots" a couple times a week to prevent flares. The importance of this cannot be understated. If you are always acting in a "reactive" way instead of "proactive," then your eczema will always be flaring and then getting better and then flaring again...sad, but all too often I see this every day in my practice. Simply put, put on the physician prescribed creams and use preventative strategies.
Finally, for very severe patients, we use systemic (tablets or injectables) medications. One such medication is Dupixent, which is approved down to age 6. Thus far, it has been shown to be very safe (much safer than other systemic we used to use - and still do - i.e., methotrexate, azathioprine, cyclosporine, etc.). Typically, topicals will still need to be used, but I have seen it work wonders for patients. Big Pharma isn't always bad - they make medications like this and really help physicians change peoples lives. Simply put, if topicals don't cut it, a dermatologist can discuss going to a stronger option.
Anyways, hope this helps and your daughter gets better and/or sees a dermatologist and they help you get her better. Eczema can be debilitating, it leads to poor sleep (itch), poor learning in school (distraction from itch), and many other issues that are not just skin deep. A board-certified dermatologist can help her return to normal skin and a healthier outlook.
Warm Regards,
Dr. Contestable
The simple answer (not knowing anything more than age) is to aggressively moisture the skin. Eczema is really not a specific disease but a type of skin inflammation that is characterized by breakdown of the outermost layer of skin. This breakdown of that outer layer causes a plethora of other processes (that are best assessed with the direct help of a health provider). Still, the easiest and most helpful action that a parent can take is to repair the skin barrier of the child’s eczematous skin. Repair means moisturizing. Bland moisturizers as petrolatum (Vaseline) based products are the best. Barrier repair is a fundamental part of eczema management.
