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Friday Facts #24 The three stages of healing

author/source: DrB


The Combined Approach to chronic atopic eczema has three Levels of Treatment that last four to six weeks, and involve the first two of three Stages of Healing: see above.

The two stages of healing associated with the use of topical steroids is followed by a third stage lasting two or three months. During this time the skin is relatively unstable and acute eczema is more easily triggered than later. Rather than structural or histological change, this is a period of natural humoural or invisible healing, associated with the skin becoming more stable and resilient through normal physiological processes. As time passes and health returns, relapses can become less troublesome - especially if each relapse is treated quickly and vigorously. This third stage of healing does not require habit reversal, but it is the most important consequence of introducing habit reversal during the first month or so of The Combined Approach. During the third stage topical treament can be intermittent - emollient use is used according to need rather than routine, and effective topical steroid is used only at the first sign of any flare-up, for a few days only - not forgetting to achieve hidden healing after the obvious healing, by treating beyond the look good point!

It is therefore optimal topical treatment at all three stages that is the key to success in the long term when treating atopic eczema.