Eczema

• Refer if signs of infection or flareups arent being controlled
• First line treatment is emollients to hydrate and soothe the skin
• Some creams contain active ingredients which may cause irritation
• Formulations are ointments,creams, gels, lotions or bath/shower additives
• Poor complicance with ointments due to oiliness
• Topical corticosteroids are second line, lowest strengths should be used
• Corticosteroid strength depends on severity of eczema
• One fingertip unit= area about the size of a hand
• Hydrocortisone 1% for over 10 yrs only
• Clobetasone 0.05% 12yrs and up
• Topical corticosteroids only use for 7 days
• Corticosteroids cannot be used in pregnancy
• Corticosteroids cannot be used on broken skin or severe flareups
• Intense itchy red patches normally in creased areas and face
• Skin is dry, flaky and red
• Can cause hyperpigmentation
• Severe flareups may develop blisters and affect sleep
• Severe eczema will need to be referred for more potent treatment or if infected
• Refer if treatment doesnt contain flareups
• Avoid itching and excessive handwashing
• Avoid trigger factors e.g materials or food allergies
• Firstline is emollients to hydrate the skin, apply liberally and as needed, even when no flareup
• Wait 15-30 mins after emmolient to applu corticosteroids e.g hydrocortisone
• Start at lowest does of hydrocortisone (10+) or clobetasone (12+), only use for 7 days
• Refer if under 10, pregnant or if applying to face, broken skin and severe flareup