How to treat severe eczema

Written by sarah metzker erdemir
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How to treat severe eczema
Very severe eczema on the hand (Photo courtesty of Dbnull:

Eczema is a skin disease that causes thick, scaly red patches on the skin and unbearable itching. Eczema can affect anyone, from babies to adults. Some eczema sufferers are lucky enough that their eczema abates or disappears altogether when they reach adulthood, while others have it their whole lives. Many cases of eczema can be treated with lifestyle changes and topical creams, but others are quite severe and require a doctor's intervention.

Skill level:
Moderately Challenging

Things you need

  • Unscented moisturising soap
  • Unscented moisturising lotion
  • Corticosteroid cream
  • Pimecrolimus cream
  • Tacrolimus cream
  • Antihistamines
  • Oral steroids
  • Immunosuppressant drugs

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  1. 1

    Keep your skin moisturised, even if you're not having a flare-up. Use gentle, unscented moisturising soap and unscented lotion every time you bathe. This will help protect your skin from outside irritants and reduce itching. While moisturising alone won't make the eczema go away, it will help to reduce your discomfort.

  2. 2

    Learn your triggers. Some eczema is worsened by certain foods, like nuts, fish or cow's milk. Most eczema is inflamed by strong soaps that strip the skin's moisture as well as the perfumes in cosmetics, soaps and detergents. Other cases might be sensitive to pet dander or dust mites. Identify your triggers by keeping track of anything different you ate or came into contact with a couple of hours before a flare-up started. Do your best to avoid the suspected trigger to see if your symptoms improve.

  3. 3

    Use prescription medicated creams if over-the-counter creams are ineffective. Most prescription creams for eczema contain corticosteroids (a larger amount than is available without a prescription). Some newer creams contain pimecrolimus or tacrolimus, which are given when steroids don't work or cause bad side effects.

  4. 4

    Take sedating antihistamines if the itching makes it hard for you to sleep. Doctors often prescribe these for use during severe eczema flare-ups, both to help patients sleep better and to keep them from inflaming or infecting an eczema patch with uncontrollable scratching.

  5. 5

    Use oral steroids under a doctor's supervision if the eczema is very severe. In many cases, oral steroids can help suppress a serious inflammation.

  6. 6

    Try phototherapy (light therapy) if you feel like exposure to sunlight helps your eczema. Phototherapy treatments involve short (usually 2-hour) exposures to intense UVA or UVB light, sometimes coupled with a drug that makes the skin photosensitive. Light therapy can cause sunburn or premature ageing, but it is an effective way to treat an acute flare-up of eczema.

  7. 7

    Take immunosuppressant drugs if your eczema does not respond to steroids or lifestyle changes. In very severe cases, the benefits of these types of drugs outweigh the risks. Make sure you help your doctor carefully monitor you while using these drugs, as you will be more susceptible to colds, infections and some types of cancer.

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