Will the steroid cause thinning of the skin?
No, because it is significantly diluted in the moisturising element of the cream. When the eczema is controlled, the frequency (dosage) of applications may be reduced so that control can be maintained with dosage as low as one or two applications daily, or even fewer.
How long must I continue with the treatment?
This depends on how long the patient has had AE and its severity. Most of the patients I treat are in the severe category so a minimum period of 6 months is likely.
Will using the antibiotic cause bacterial resistance?
Bacteria can and do become resistant to the cream but the use of fusidic acid in the mixture produces such an incredibly rapid degree of relief from the itch and burn and redness that any such risk is worth taking. When control is achieved the antibiotic element in the mixture may be removed. If there is resistance to Fusidic acid cream I switch to Mupirocin cream. In America fusidic acid is not yet available so I use mupirocin cream.
What about moisturisers?
Most eczemas, perhaps as high as 90%, are infected with bacteria (staphylococcus aureus) and the use of moisturisers in the bath or directly on the skin, far from helping, may make matters worse.
How do I treat my child’s scalp?
Usually with the same cream as for other areas. CLn Gentle Shampoo may be appropriate for some patients. Dove Cream Bar Sensitive lather may be used in infants younger than one year.
What about antiseptics?
I do not use antiseptic products such as Dermol or equivalent.
What about diet?
It is important to eliminate E-numbers from the diet (colourings, preservatives).In addition, avoid foodstuffs that allergy testing has indicated that the patient may react. This may include dairy, wheat, eggs etc. In general, follow the dietary advice provided to date. Do not make any major dietary change on starting my treatment.
What about bleach baths?
No, the bleach may irritate.
What are some of the possible causes of eczema flares?
Teething, viral illnesses, swimming in chlorine, dietary triggers such as E-Numbers, seasonal changes and inappropriate exposure to irritants
What about PE, games, sports and swimming?
Sporting activities which produce sweat and friction are not consistent with healing inflamed skin and should be avoided until further notice. Swimming should also be stopped.
Bath and antibacterial products?
Most patients tolerate Dove Cream Bar Sensitive variety (fragrance free). The lather may be used in infants as a shampoo.
CLn BodyWash and CLn Gentle Shampoo may be recommended. How and when to use CLn products varies from patient to patient and is advised on an individual patient basis.
Cotton clothing is the best sun protection. However, the choice of sun block is difficult in that there isn’t a single product that suits all. Many mothers find the Sun Care range suitable, but all sun blocks need to be used with caution.