Management options for eczema
OPTIMISING MOISTURISER USE IN CHILDHOOD ECZEMA
Management options for eczema
The goals of eczema management are to alleviate symptoms and ensure long-term control.1,11 A stepped approach should be used for managing eczema in children and treatment options should be stepped up or down depending on severity of symptoms. NICE guidelines tailor treatment options to the severity of atopic eczema.
Parents and carers should start treatment of flares as soon as signs and symptoms emerge. Treatment other than moisturisers should continue for about 48 hours after symptoms resolve to minimise inflammation that can remain once acute symptoms resolve.14,15
Emollients and moisturisers explained
Whilst the terms 'emollient' and 'moisturiser' are used interchangeably, by definiton, an emollient is an ingredient contained in a moisturiser. 17 Moisturisers are the first-line therapy during acute flares and as maintenance therapy during remission and can also be used with, when necessary, other treatments.16,17
Evidence has highlighted that moisturisers reduce the number of eczema flares by 60% and increase the average time to flare from 30 to 180 days.17
Moisturisers contain varying amounts of emollient which form an occlusive layer and soften the skin by offering a source of lipids.21
| Eczema severity | Stepwise Treatment |
|---|---|
| Mild | Emollients |
| Mild potency topical corticosteroids | |
| Moderate | Emollients |
| Moderate potency topical corticosteroids | |
| Topical calcineurin inhibitors - e.g. Tacrolimus and Pimecrolimus | |
| Bandages | |
| Severe | Emollients |
| Potent topical corticosteroids | |
| Topical calcineurin inhibitors - e.g. Tacrolimus and Pimecrolimus | |
| Bandages | |
| Phototherapy | |
| Systemic therapy |
NICE recommendations for eczema in children younger than 12 years14