Eczema treatment and prevention tips

In addition to topical steroid creams and moisturisers, the following strategies may be required:

  • Oral steroids: These are often used for severe allergic contact dermatitis and severe flares.

  • Phototherapy and immune-suppressing medications such as azathioprine and cyclosporine: These are suitable for chronic, persistent and extensive eczema.

  • Antibiotics and antiviral medic​ations: These are suitable if the eczema is complicated by secondary bacterial and viral infections.

  • Oral antihistamines have anti-pruritic effect (soothe itching).

Reducing the recurrence of eczema

Your doctor may prescribe non-steroidal creams called topical calcineurin inhibitors (eg topical tacrolimus / pimecrolimus) to substitute topical steroid creams when the eczema is under control to prevent recurrence of eczema.

“Non-steroidal creams are not more effective than steroid creams but can be useful for the treatment of eczema over areas of thin skin such as around the eyes, where long term topical steroid use is not recommended because of the risk of side effects,” says Dr Pang Shiu Ming​, Senior Consultant at the Department of Dermatology at Singapore General Hospital (SGH), a member of the SingHealth​ group.

Dr Pang advises sponging gently under the arms, in the groin and other areas where cleansing is imperative when you have eczema. “Try not to rub or scratch the rash. When it gets severely itchy, try to relieve it by tapping or pinching the skin,” he says.

As for perfume, he says to avoid spraying it directly on your skin if you have bad eczema.

Recurrence is common if you have eczema. To reduce recurrence of rash, you can eliminate the following aggravating factors:

  • Dry skin: Keeping your skin well moisturised is an effective way to avoid an itchy flare-up.
  • Frequent use of soap, hot water and cleansers: These can remove natural oils from the skin. Use mild unscented soaps/cleansers and shower with lukewarm water instead of hot water.
  • Hot temperatures and sudden changes of temperatures: Stay in a cool environment as far as possible and avoid coming into an air-conditioned room from the hot outdoors.
  • Strenuous exercise: It’s best to avoid heavy sweating. Swimming is good exercise if you have eczema.
  • Rough, tight and woollen clothing: Wear light, smooth, soft, non-binding clothing instead.

Dr Pang also advises wearing gloves and protective clothing when doing housework to avoid coming into contact with allergens and household skin irritants, such harsh detergents and household cleaning agents.

Special tips for children with eczema

Here are some tips on what to do if your child has rash due to eczema:

  • Avoid bubble baths.
  • Gently pat your child dry with a towel after a bath. Do not rub the skin vigorously.
  • Avoid fluffy toys and carpets/rugs in your child’s room and ensure there is no dust in the house.
  • Avoid giving your child allergy-causing foods such as eggs and peanuts.
  • Giving an antihistamine to your child may help to reduce the itching.

Ref: S13