Improving outcome with atopic eczema
Member: I am now 26. I had chronic eczema since I was a baby. I finished the four week programme of The Combined Approach a year ago. I am happy that my skin has been much better. Although I continue to get flare-ups they are never as bad as they were. But I am worried about continuing to use topical steroids as I think that they will weaken my skin. Also, in the cold weather I seem to have had more problems, with a hive-like rash. It could be allergic.
DrB: Although the special part of The Combined Approach for chronic eczema is adding habit reversal to optimal topical treatment for four weeks, the long-term best outcome is achieved after this by ensuring topical treatment remains optimal. Once the chronic eczema has been successfully treated, habit reversal is not required, and the use of topical steroids is only required from time-to-time. Moisturiser is the most important treatment, but it is best to adjust it’s use according to need, rather than it becoming a regular routine. Remember, in cold weather moisturizers need to be used more often! Understanding acute flare-ups and using treatment promptly and vigorously will mean the skin gradually becomes stronger, and less sensitive to allergic type reactions. Gradually less creams will be required, as long as when they are used, they are used correctly. This way the risk of side effects from topical steroids will be avoided.
I hope that helps!