Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to firstname.lastname@example.org
Last week I discussed how the initial approach to eczema involves avoidance of exacerbating factors and hydrating the skin. This week and next week I discuss prescription options which may be required for resistant cases. Apart from Hydrodrocortisone 1% Cream (available over the counter from pharmacies after consultation with your pharmacist), all the treatments mentioned in this article can only be prescribed by a medical professional and must be used under strict supervision from your healthcare professional.
The face and skin folds are areas that are at risk of thinning/marking with corticosteroids. Initial treatment in these areas should start with a low potency steroid such as hydrocortisone 1% cream. A moderate or potent corticosteroid such as clobetasone-Eumovate® (moderate) or betamethasone-Betnovate® (potent) may be needed for more severe cases. Higher potency topical corticosteroids (clobetasol-Dermovate®) can be used for up to 10 days in some patients with severe flares, and then replaced with lower potency preparations until symptoms resolve. Potent steroids are generally avoided on the face and skin folds. Generally, ointments are more effective than creams, as the emollient action and occlusive effect results in better penetration. Ointments also require fewer preservatives so the potential for irritant and allergic reactions is lower.
Topical calcineurin inhibitors
Those requiring treatment to the face or skin folds for more than three weeks should be treated with a topical calcineurin inhibitor (ie, tacrolimus) rather than a topical corticosteroid. Unlike corticosteroids, topical calcineurin inhibitors do not cause skin thinning or marking. Tacrolimus is applied twice a day. Tacrolimus (Protopic®) comes in two strengths; the 0.1 percent formulation is appropriate initial therapy for adults, and the 03 percent formulation is appropriate for children and for adults who do not tolerate the higher dose. Topical calcineurin inhibitors are considered as being equal in strength to low potency topical steroids and should only be considered a second line option. Treatment should only be initiated by a dermatologist and continuous long term treatment should be avoided.
Free Eczema skincare consultation at our Eczema Clinic
Whelehans Pharmacy offer free Eczema skincare consultations at our Eczema Clinic on Saturday May 27th with skincare expert Trish Wallace. Learn how to reduce redness and irritation and how to reduce frequency of flare-ups. Whelehans offer a range of effective products that give clearer skin in a safe and effective way without the need for stronger and potentially damaging prescription medicines like steroid creams. Book your free appointment; call Whelehans at 04493 34591 or e-mail email@example.com.
To be continued....next week I will discuss more prescription medicines treatment options
This article is shortened to fit within Newspaper space limits. More detailed information and leaflets is available in Whelehans