Treating Eczema Appropriately
As the seasons change, we begin to see an influx of xerosis, dermatitis and eczema cases. Far too often these patients receive topical cortisone creams and kenalog shots visit after visit.
Prolonged, excessive usage of steroids in the treatment of eczema can create a chronic dermatitis by producing vasodilation.
These photos show a 26-year-old patient with history of eczema since childhood. She was treated with topical steroid creams and kenalog injections continuously starting in the third grade. Now, this patient suffers from steroid dermatitis and is nonresponsive to topical and oral cortisone, as well as conventional eczema treatments.
Steroid rebound flares are controlled for this patient with cyclosporine 400 mg daily. After 4 years of nonsteroidal treament, this patient is finally feeling and looking better.
In my practice, I lean toward hydroxyzine (Atarax), an antihistamine, as my primary treament for eczema, instead of prednisone. What about you?