Eczema belongs to the common diseases of dermatology, is caused by a variety of internal and external factors erythema, papules, blistering skin disease, often intensely itchy, easy to recur, patients often have these misconceptions about the treatment of eczema.
Myth 1: Eczema needs to be kept dry
Quite the opposite, eczema needs to be moisturized. Children with eczema have skin barrier dysfunction and it is critical to moisturize to promote skin barrier recovery. Patients should apply moisturizers regularly, not just after bathing, but should insist on daily use, multiple times a day if needed. Consider using a humidifier in the room during the dry winter season to keep the room temperature at about 50%.
Myth 2: Eczema patients try to shower less
Excessive cleaning and long periods without bathing are not correct. Excessive bathing, especially the use of hot water bathing or scrubbing the affected area, eczema itching will be temporarily relieved, but after that will be due to adverse stimuli and excessive cleaning caused by the destruction of the skin barrier and the use of lesions aggravated, more and more itchy. Not bathing for a long time is also not advisable.
Children with atopic eczema should be bathed once a day. Do not overheat the water temperature when bathing (27 to 30°C), and it is usually best to take a bath for no more than 10 minutes each time, and try to choose non-irritating bath products. Use a moisturizer within 3 minutes after bathing to lock in moisture. In acute attacks, you can soak in a warm bath for 10 to 20 minutes, followed immediately by topical glucocorticoids, which can flatten crusted lesions and rapidly improve the condition.
Myth 3: Hormones have a lot of side effects, so don’t use hormones for eczema
In fact, topical glucocorticosteroids are still the drug of choice for eczema. Glucocorticoid ointments can cause skin atrophy, capillary dilation, hypopigmentation or hyperpigmentation, and can also induce acne, folliculitis, fungal infections, and hormone-dependent dermatitis, but most of the adverse reactions are caused by the long-term unreasonable use of large doses. As long as the hormone ointment of different strengths is chosen for the condition, lesion site, and different ages, the powerful anti-inflammatory and anti-allergic effects of hormones can be brought into play, while avoiding their adverse effects.
Generally, children with eczema can choose hydrocortisone ointment, dinaide ointment, hydrocortisone butyrate ointment, etc. They can first use medium to strong glucocorticoids to control the condition quickly, and then use low strength glucocorticoids to maintain the condition, as long as they are used reasonably, even long-term use is safe.
Myth 4: Eczema is more likely to recur after using hormone ointment
Most of the relapses are due to the lack of standard treatment and other triggering factors. Some patients immediately stop the medication once their condition is controlled, resulting in a quick relapse, and eczema itself has the characteristic of easy recurrence, so it is best to follow medical advice to gradually reduce the amount of medication according to the condition, and if necessary, maintain a small amount for a long time. Oral or injectable glucocorticoids are generally not recommended.
For some chronic eczema that needs to be controlled with topical medication for a long time, in order to avoid adverse reactions caused by long-term use of hormones, non-hormonal creams such as tacrolimus ointment or pimecrolimus ointment can also be used alternatively for mild eczema, and current research shows that they are safe for use in children.
Myth 5: “Pure” plant-based creams are safer and more effective
These medicines have limited effectiveness and are not always safe. Some pure plant-based medicines may be effective, but it is not wise to go for hormone-free “pure plant” creams. An analysis of so-called “pure plant” creams for eczema in the UK found that 80% of these creams contained hormones, more than half of which were propanolol clobetasol (a super-potent glucocorticoid), and some so-called “pure herbal” ointments have been found in China. The ointment contains hormones, which are more harmful when used in large quantities for a long time without knowledge.
Myth 6: Eczema should be combined with the use of antibiotics
The actual fact is that you will not need to use antibiotics for severe eczema or secondary infections. Although some studies have confirmed the involvement of Staphylococcus aureus in the development of eczema, the use of antibiotics is controversial, and some studies have found that the use of antibiotics in infants and children will also increase the prevalence of eczema, so in mild eczema is not recommended, for severe atopic eczema, the general treatment is not effective, you can cooperate with the use, preferably no more than 2 weeks.
Myth 7: Eczema patients cannot swim
It is possible to swim in a pool. Patients with eczema can swim in pools disinfected by chlorine, which also has a certain antibacterial effect on the skin surface, but in order to avoid irritating the skin with long-term residual chlorine on the skin, they should take a shower and use moisturizers immediately after swimming.
Myth 8: Breast milk can cure eczema
Topical breast milk is not effective for eczema. Although some studies have concluded that breastfed children have a lower incidence of relative eczema, and that breast milk is the best food for babies and should not be easily weaned because of eczema, topical breast milk is ineffective in treating eczema, not only delaying treatment, but in some cases stimulating aggravation of eczema.
Myth 9: Oral antihistamines can be dependent
Antihistamines are not dependent and do not become addictive. Children can choose cetirizine drops, paracetamol, etc. Adults can choose a generation of antihistamines. When using antihistamines with drowsy effects, it is best to take them half an hour to one hour before bedtime at night.
Myth 10: A positive allergen test must be the cause of eczema
Allergen test results need to be judged in the context of the actual situation. Patients with atopic eczema do skin allergen prick test and blood check allergen-specific IgE will show a variety of positive reactions, these results are for reference only, need to be judged in conjunction with the actual consumption of whether the disease is really aggravated and other medical history, and should be based on the actual situation, it is currently believed that checking the blood for food IgG antibodies to eczema is not significant. The “certain health”, “certain pull” through the biological wave to check hundreds of allergens is not based. Adult eczema can be combined with a medical history to do patch tests to identify allergens if necessary, and then targeted to avoid.
Myth 11: Eczema requires avoidance of “hairy foods”
Most eczema has nothing to do with food and does not require excessive avoidance. Many eczema patients believe that eczema is caused by food, and “allergen check” found a lot of allergic food, which increases the concern in this regard, and excessive abstinence. But in fact, even if you stop these foods, you can not effectively prevent and relieve the symptoms of eczema, but rather cause nutritional imbalance, and may further aggravate the eczema. Although some eczema, especially atopic eczema, may be related to food, most eczema is not related to food or even to so-called “suspected allergens” in the environment. Unless there is a very clear-cut food allergy, there should be no deliberate restriction of diet. For infants, milk restriction should be done with caution. Spicy and irritating foods and alcohol should be avoided as much as possible.
Myth 12: Treatment can completely cure eczema
There is no treatment that can absolutely cure eczema. This is because the causes of eczema are very complex and are triggered by the interaction of environmental and genetic factors, but genetic constitution is not set in stone, and some of them heal themselves as their constitution changes and they are no longer allergic to the stimuli that triggered eczema in the past. Nevertheless, treatment is very important and proper care and rational use of medication can control the condition of eczema and avoid recurrence, which can reduce the impact of eczema on the quality of life.
Myth 13: You should not be exposed to vaccines during eczema
The pros and cons need to be weighed and important vaccines should be administered in a timely manner. This issue is a major concern for parents of infants with eczema. Although vaccination may aggravate eczema, the incidence is not high and not serious, while some important vaccines may have serious consequences once infected if not vaccinated in a timely manner, which requires weighing the pros and cons, so vaccines that must be contacted should still be vaccinated on time (pediatricians should be consulted), but the condition should be closely observed after vaccination The vaccine should be closely monitored for changes, and the patient should be seen promptly if the condition worsens.
Eczema is one of the most consulted skin diseases online, so we have summarized our concerns in a special article, hoping to help patients and parents suffering from eczema.