Eczema, how to treat

The following is a summary of how to treat eczema.  It is better to over treat at the start of a flare up as this will quickly settle inflammation and lessen the amount of medications needed.

 

When skin looks good !

  • Two – three times per day apply QV or dermeze cream to face and neck and dermeze or QV intensive to limbs and body.
  • Bath 10 – 15 mins with added bath oil only and apply moisturiser within 10mins to lock in the water- keep temperature of bath mild and pat dry.
  • Keep cool and moist on hot days – eg wet T shirt or wet bandanna.
  • Cool compresses – mix 10mls of bath oil in a bowl of cool water and soak clothing or cloth such as chux and apply to any hot red area for 10min several times per day.shutterstock_144900970

When skin starts to look Red or Inflamed

  • Face – Apply moisturiser as above and start topical steroid creams. 1% hydrocortisone (dermaid Sigmacort etc) or elidel. This should be applied twice per day.
  • Limbs – Apply above cool compresses, moisturiser and use elocon or advantan before moisturiser at night for severe inflammation, or celestone M twice per day for mild moderate flare.

NB if a cream/ointment stings, this needs to be changed. Some have adjuvants that can irritate.

If No Improvement

  • Increase treatment and wet dressings. This prevents scratching and helps moisturise.
  • Commence bleach baths.

For Staphylococcus Infection

  • Sometimes oral antibiotics are needed – these include Keflex and flopen. Amoxil has no effect against staph.
  • Bactroban is a topical antibiotic cream/ointment should be applied to the nose and fingernails in children with recurrent staphylococcus infection.  In some families staphylococcus resides in the nostril hairs and can be transferred to the skin by busy fingers.

Bleach Baths for Eczema

Household bleach has been safely used for many years to help treat skin infections. A small amount of bleach added to the bath is recommended for conditions such as eczema to help reduce bacteria on the skin and improve the severity of disease.

What you need:

  • White King household beach 4.2% – 12mls for each 10litres (bucket)
  • Measuring cup and standard 10litre bucket.
  • 1-2 capfuls of bath oil per bath
  • 100 grams pool salt (1⁄3 of a cup) for each bucket (10 litres of water)

Procedure for making the bath:

  1. Fill the bath to desired level by using a household bucket to accurately estimate amount of water. Ensure no hotter than 30degrees.
  2. Add bath oil, pool salt and bleach in concentrations above.
  3. Soak in the bath for 10minutes
  4. Wash head and face but do not immerse head or face in the bath
  5. Do not rinse your child after bathing, and wet the face and head every bath.
  6. Use old or white towels to prevent bleaching of coloured towels

How often ?

Every day for one month then three times a week for a month and once a week for a month.

Possible side effects:

Household bleach can sometimes cause stinging or a burning sensation on the skin. By diluting the bleach in the bath there is less risk of this happening. The final bleach concentration is lower than a swimming pool, which most people can safely swim in without damage to their skin. Sometimes children with bad eczema say that plain water can sting their skin anyway because their skin is more sensitive. Discontinue addition of bleach to the bath if definite stinging or irritation occurs.


Wet Dressings for Eczema

Excellent when the child is hot especially at night. They help to reduce the itch and prevent infection. The skin is rehydrated and there is an element of protection. You will need: moisturiser, cortisone, water, chux wipes, bandages.

Method – dampen chux towels in water in a bowl. Apply cortisone then moisturiser. Wrap chux around affected area and then apply bandages firmly but not tightly. Avoid bandage being in direct contact with the skin. Wet dressings can be applied as often as required. Wet towels can be applied to the face. A wet tshirt is a good alternative for the trunk and a wet bandanna to the scalp. The dressings can be left overnight or changed every 4 -6 hours during the day.


 

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