Stepped care and sub-clinical eczema
Mild irritant contact dermatitis and mild dry skin are regarded as self-limiting or minor conditions that are amenable to self-care with OTC treatments recommended by a pharmacist.3
Atopic eczema is a chronic condition and so prescribed emollient treatment is permissible. Although patients can have periods without any overt skin disease, experts describe this as sub-clinical eczema because the basic skin defects remain and the eczema could flare up at any time.
Table 2: Stepped care treatment options1
Mild atopic eczema:
- Emollients
- Mild potency topical corticosteroids
Moderate atopic eczema:
- Emollients
- Moderate potency topical corticosteroids
- Topical calcineurin inhibitors
- Bandages
Severe atopic eczema:
- Emollients
- Potent topical corticosteroids
- Topical calcineurin inhibitors
- Bandages
- Phototherapy
- Systemic therapy.