Managing Eczema: Should You Continue Oral Medications or Use Topical Creams?

Q: Managing Eczema: Should You Continue Oral Medications or Use Topical Creams?

Hello： When the skin lesions are extensive or severe, the improvement will be faster when combined with oral medications. <br>If the skin condition does not improve or worsens, it is advisable to consult a nearby dermatologist for diagnosis and to assess whether further examinati

Is it necessary to continue taking oral medication for widespread eczema, or is it sufficient to use topical ointments to relieve itching?

Initially, the back of my hand was very dry, which led to peeling and hardening of the skin, followed by a mild allergic reaction in a small area.
I thought it was an allergy due to dry skin, which caused it to spread.
Later, I realized it might have been caused by applying an unknown burn ointment, as the area around the burn wound became red and swollen, with a ring of red rash surrounding the wound.
Eventually, both of my arms developed rashes of various sizes, with more rashes around the right hand where the injury originated, making it look like a large birthmark.
The initially small allergic area on the back of my hand has also transformed into the largest patch resembling a birthmark.
After researching online, it seems like it could be subacute eczema.
One patch of eczema has become dry and slightly scaly, and it has turned a bit brown.
Now, it has spread all over my body, with small red spots on the front of my upper body, and even scratching my knees causes red spots to appear.
I visited a clinic and was prescribed a three-day course of oral medication, and I have seen the doctor intermittently three times over the past month.
Is it necessary to continue taking medication without interruption for eczema? If so, should I go to a larger hospital to obtain a larger quantity of medication? Or should I continue applying ointment to the more severe areas on my arms?

Xiao Ming, 20~29 year old female. Ask Date: 2021/06/06

Dr. Li Yufen reply Dermatology

Hello: When the skin lesions are extensive or severe, the improvement will be faster when combined with oral medications.
If the skin condition does not improve or worsens, it is advisable to consult a nearby dermatologist for diagnosis and to assess whether further examination and treatment are necessary.
Thank you!

Reply Date: 2021/06/06

More Info

Managing eczema can be a complex process, especially when it involves the interplay of topical treatments and oral medications. Your situation, characterized by dry, peeling skin that has progressed to a more widespread rash, suggests that you may be dealing with a form of eczema, potentially exacerbated by environmental factors or inappropriate topical treatments.

First, it’s essential to understand that eczema, or atopic dermatitis, often results from a combination of genetic and environmental factors. The skin barrier is compromised, leading to increased moisture loss and susceptibility to irritants and allergens. In your case, the initial dryness and subsequent rash could indeed be linked to both the dry climate and the use of an unknown topical medication that may have caused irritation or an allergic reaction.

When it comes to treatment, topical corticosteroids are commonly prescribed to reduce inflammation and itching. However, they should be used judiciously, as overuse can lead to skin thinning and other side effects. In your case, it seems that you have been using a topical cream, but the effectiveness may vary depending on the severity of your eczema and how well you are applying it.

Regarding your question about whether to continue oral medications or focus solely on topical treatments, it is generally advisable to follow a comprehensive approach. Oral medications, such as antihistamines, can help manage itching and reduce inflammation, while topical treatments directly address the skin's condition. If your eczema is widespread and persistent, it may be beneficial to continue both forms of treatment.
Consulting a dermatologist is crucial, especially if you feel that your current treatment is not effective. A dermatologist can provide a more tailored approach, potentially prescribing stronger topical steroids or other medications, such as calcineurin inhibitors, which are effective for sensitive areas and do not carry the same risk of skin thinning. Additionally, they can evaluate whether your eczema is indeed exacerbated by the use of the unknown topical medication you applied initially.

In terms of moisturizing, it is vital to incorporate a good emollient into your daily routine. Moisturizers help restore the skin barrier and prevent further dryness. Applying a thick cream or ointment immediately after bathing can lock in moisture and provide a protective layer. Look for products that are fragrance-free and designed for sensitive skin.

If you are considering switching to a larger hospital for more extensive treatment, that could be a good option, especially if you feel that your current care is insufficient. Larger facilities may have more resources and specialists who can provide a comprehensive evaluation and treatment plan.

In summary, managing eczema often requires a multifaceted approach that includes both topical and oral medications. Regular follow-ups with a dermatologist can help ensure that your treatment plan is effective and adjusted as needed. Additionally, maintaining a consistent moisturizing routine is critical in managing eczema and preventing flare-ups. Always communicate openly with your healthcare provider about your concerns and treatment efficacy, as they can guide you in making the best decisions for your skin health.

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