<http://schema.org/articleBody>
"If you suffer from eczema, looking after your skin is vital to control the condition and reduce the number of flare-ups you experience.  General skin care, applying moisturisers and avoiding factors that trigger your eczema are the most important things you can do. After that, treatment of eczema often involves several different approaches to control the condition and all its symptoms, and medicines of several different types may be used in combination. Dry skin  Aside from avoiding trigger factors, the most important element of eczema treatment is to keep the skin hydrated by regularly using moisturisers and moisturising soap substitutes.  These help to maintain the barrier function of the skin and reduce itching, scratching and the penetration of irritants, allergens and micro-organisms.  Moisturisers should be used regularly, even when using other treatments and when the condition seems to have cleared up.  They have been shown to reduce the number of flare-ups of eczema, which are experienced, and therefore reduce the need for topical corticosteroids. Inflammation  Flare-ups of eczema are traditionally treated with topical corticosteroids. These reduce inflammation in the skin and are safe and effective medicines when used correctly.  Topical steroids come in various strengths, and the least potent product that is effective should be used to control the inflammation.  Mild corticosteroids are generally used for children and on the face and flexures, eg crease of the elbow or behind the knees etc.  More potent corticosteroids may be needed for adults with discoid or lichenified eczema, or with eczema on the scalp, limbs, and trunk.  Once the inflammation is under control, topical steroids should be reduced in frequency of application, or reduced to the mildest strength needed to control the eczema, or if possible, stopped. People using topical steroids should be regularly reviewed by their doctor. There are two steroid-sparing treatments for reducing inflammation and controlling flare-ups, called tacrolimus and pimecrolimus. They are calcineurin inhibitors and work in a different way to steroids to suppress the inflammatory reactions in the skin.  They&amp;#039;re not associated with the same potential side-effects of steroids and are an important advance in the treatment options for eczema. However, they are usually reserved for when corticosteroids have not been effective or cause unacceptable side-effects. Sometimes, they can cause an initial burning sensationon the skin.  It&amp;#039;s advised that they should be applied intermittently at the first symptom of itch, to active areas of eczema only, and patients should limit sun exposure, in order to reduce any potential skin cancer risk. They should not be applied to infected eczema.  Lichenification  Lichenification is thickening of the skin with exaggeration of the normal skin markings, which gives the skin a leathery, bark-like appearance.  It&amp;#039;s a result of repeated scratching and is initially treated with potent topical corticosteroids. Bandages are sometimes applied over the topical steroids to treat chronic, lichenified eczema, because these increase the absorption of steroid into the thickened skin and break the &amp;#039;itch-scratch&amp;#039; cycle of eczema. They should only be used under the supervision of a doctor.  The bandages may sometimes contain zinc, ichthammol or coal tar, used for their anti-itching and mild anti-inflammatory effects. Occlusive dressings or tape can also be used.  Infection Chronic eczema may often become infected, particularly with the bacteria Staphylococcus aureus, which is found in large numbers on skin affected by eczema.  Eczema in moist areas of skin such as skin folds is also more susceptible to fungal infections. Infection worsens the inflammation of the skin and may require treatment with antimicrobial medicines, such as antibiotics, antifungals or antivirals.  Depending on the severity of the infection, antimicrobials may be either applied to the skin or taken by mouth. If the eczema is frequently infected a doctor may prescribe moisturisers and moisturising bath additives that also contain antiseptics to try and prevent infection. Itching Many people complain that itching is the worse symptom of their eczema.  Scratching makes itching worse because it increases inflammation and increases the likelihood of the skin becoming infected.  So, short courses of sedating antihistamines are sometimes prescribed to help reduce severe itching during acute flare-ups of eczema.  These are mainly of value because they cause sedation, and are usually taken at bedtime to help sufferers sleep without scratching. Some children may become hyperactive on these medicines. Unresponsive or very severe eczema Occasionally, eczema may respond poorly or not at all to all the treatments mentioned above, and in these cases the patient will be referred to a hospital specialist.  There are various treatments that can subsequently be tried for very severe eczema. A course of corticosteroids taken by mouth may finally bring the inflammation under control. Alternatively, immunosuppressant medicines, such as ciclosporin or methotrexate, may be tried to modify the skin&amp;#039;s inflammatory responses.  These are powerful medicines that require a good deal of monitoring to minimise the risk of side-effects. But adults and children with severe eczema, who do not respond to other treatment, can benefit greatly. Light treatment (phototherapy) is another option for unresponsive and severe eczema.  People with eczema often comment that sunshine improves their skin, and light treatment is sometimes offered in hospital dermatological centres.  UVB light therapy can be extremely beneficial \u2013 as can PUVA which involves a combination of a drug called psoralen taken by mouth, followed two hours later by UVA light treatment.  Short-term side-effects of light treatment include sunburn-like reactions, and potential long-term side-effects include premature skin ageing and skin cancer. Alitretinoin capsules are another option for chronic hand eczema, a form of eczema that&amp;#039;s notoriously difficult to treat. However, it&amp;#039;s a new treatment and not widely used yet.  Alternative treatments  Gamolenic acid (evening primrose extract) has been an alternative remedy sometimes used to treat eczema.  It&amp;#039;s thought that it may work by increasing the levels of the essential fatty acid, which may be deficient in, and perhaps responsible for the symptoms of, atopic eczema.  However, there&amp;#039;s increasing evidence that it&amp;#039;s ineffective. Two products containing gamolenic acid, Efamast and Epogam, used to be licensed as medicines for the treatment of eczema. However, their product licences were withdrawn in October 2002 following a review by the UK Medicines Control Agency (MCA) and the Committee on Safety of Medicines (CSM).  These bodies concluded that the available evidence did not support the current standard of efficacy required for these products to be authorised as medicines.  Traditional Chinese herbal medicines have been another alternative treatment for eczema, though at present it is unclear whether they do more harm than good.  Results from several studies have suggested that patients with atopic eczema benefit from these therapies. But there&amp;#039;s also concern about the side-effects of some of the herbs on the liver and heart.  Cases of strong corticosteroids being illegally added to Chinese herbal creams have also been reported, and this is hard to monitor because the production of such herbal products is not standardised or regulated.  For these reasons, it&amp;#039;s recommended that Chinese herbal remedies should only be used under specialist supervision. Other people also read: Eczema: Eczema is an itchy inflammation of the skin, associated to a varying degree with other features. Atopic eczema: Here are the features of atopic eczema. Topical corticosteroids: Why are there different strengths of corticosteroids?  Based on a text by Helen Marshall, pharmacist  Last updated 29.04.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/skin-and-hair/a3660/treatments-for-eczema-overview/>