More treatment options for eczema
Published: 20 Apr 2018
Eczema is a common chronic condition that causes the skin to be red, scaly and itchy. In severe cases, the skin may even weep, blister or bleed. More treatment options have surfaced in recent years for eczema patients, such as topical steroids, wet wrap therapy, calcineurin inhibitors and Dupilumab.
Also known as corticosteroids, topical steroids ease redness and reduce inflammation and itching, so that the skin of eczema patients can heal. They come in varying strengths from mild to very potent, and work directly with the immune system to reduce inflammation. Doctors generally prescribe these steroids depending on the parts of the body, severity of the eczema and age of the patient.
Wet wrap therapy is an intensive moisturising therapy that complements the usual skincare practices for eczema treatment. This usually includes the use of gentle soaps or washes and avoiding environmental triggers that can aggravate the condition, according to Dr Yew Yik Weng, an alumnus of NUS Medicine. Dr Yew is also a consultant at the National Skin Centre (NSC). It is performed by applying steroids and moisturisers before a dampened piece of clothing or gauze is wrapped around the affected area. A dry layer is wrapped over the wet one and left to rest for several hours or overnight. As a lot of time and effort is required, a good compromise is to do wet wrap therapy over the weekends or for shorter periods of time, Dr Yew added.
Calcineurin inhibitors block a chemical called calcineurin which activates skin inflammation and causes redness and itch. However, these topical medications are usually more expensive than steroids and may take longer to work.
Another potential eczema treatment is Dupilumab, which is used to treat adults with moderate to severe atopic dermatitis. The non-steroid injection works by blocking two proteins, interleukin-4 and interleukin-13, which are believed to cause eczema and inflammation. It is not available in Singapore, but two trials of the treatment have already been completed at the National Skin Centre.
While doctors agree that a variety of treatment options are available for patients today, topical steroids are still the mainstays of eczema treatment. However, parents of young eczema patients can be reluctant to use them, despite being one of the most effective and widely used drugs for treatment of eczema and atopic dermatitis.
“Some parents have serious steroid phobia and do not want to touch it but this really deprives the child of a better quality of life,” NUS Medicine alumnus, Dr Chong Jin Ho, who works as a specialist in paediatric medicine and consultant at Raffles Children Centre, said.
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