treatments for eczema

It is estimated that about 31.6 million Americans have some form of eczema. Here we discuss the top nine over-the-counter treatments for eczema.

 

It is estimated that over 10% of the American population, about 31.6 million people, have some form of eczema. Nearly half of individuals with eczema report feeling frustrated by this disease. One-third report that they spend one-to-three hours per day treating it. Here, we discuss the top nine over-the-counter treatments for eczema.

The word eczema comes from the Greek word “ekzein” that means “to boil”. In patients with eczema, the skin becomes dry, scaly, red, and itchy. In severe cases, the skin starts crusting and bleeding, leaving it prone to infection.

Skin with eczema has a reduced ability to retain water

The layers of our skin contain skin cells, water, and fats, all of which protect and maintain the health of the skin. In people with eczema, the skin does not produce enough fats and oils and has a reduced ability to retain water, thereby lowering the skin’s ability to protect against allergens and irritants.

Products such as soap, bubble bath, and detergents can trigger inflammation of the skin in people with eczema. Other environmental triggers may include excess water, temperature changes, stress and anxiety, that may lead to periods of flares.

Typical symptoms of eczema include intense itching, blisters, skin redness and inflammation, rash, leathery appearance of the skin, raw areas of skin formed due to excessive scratching, and secondary infections at the broken skin site.

First-line treatment is over-the-counter emollients

A healthcare provider can diagnose eczema based on family history and examination of the skin lesions. Other tests are usually not required. The most important first-line treatment for eczema is moisturization of skin using over-the-counter emollients. For managing flared cases, the health practitioner may prescribe anti-itch medication or topical steroids.

What are emollients?

A cornerstone of managing and treating eczema is to keep the skin soft and supple by frequently and generously using emollients. Emollients are non-cosmetic moisturizers that come in the form of creams, ointments, lotions, and gels. They contain a very low percentage of water and are free of any fragrance, preservatives, or dyes. Most emollients contain humectants, such as glycerin, that help to keep moisture in the top layer of the skin and agents such as urea that keep the skin smooth.

The type of emollient to be used depends on how a person’s eczema reacts to each ingredient of the emollient. It is advisable that the emollients be used as directed by the physician.

In most cases, emollients are the only treatment needed to keep eczema under control.

Here are the top nine over-the-counter emollients recommended by dermatologists.

1. Aquaphor

Aquaphor contains petrolatum as the active ingredient. It helps temporarily protect against chapped or cracked skin and helps protect from the drying effects of weather. Petrolatum forms a semi-occlusive barrier on the skin that enables transmission of water and oxygen, thus forming a protective moist healing environment.

Before applying Aquaphor, the skin should be cleaned thoroughly. A small amount of Aquaphor should be applied to the affected area while the skin is still wet or damp and rubbed in gently. The emollient should not be applied over a large area of skin or on a deep puncture and wound. It is best to follow the directions on the label and the patient should seek medical advice if the skin condition does not improve after using emollient for the recommended time.

You should avoid getting Aquaphor in your eyes, nose, or mouth. Some Aquaphor products can make your skin extra sensitive to sunlight.

Side effects: Some side effects of using Aquaphor include hives, difficulty breathing, swelling of face, lips, tongue, or throat. If any of these adverse effects occur, the patient should seek emergency medical help. You should stop using Aquaphor if severe burning, stinging, redness, or irritation of skin occurs.

Drug interactions: Although it is unlikely that topical emollients interact with other oral drugs, it is advisable to discuss all the medications a patient is taking with his physician before starting the use of Aquaphor.

2. Aveeno

Aveeno Anti-itch cream is a topical anesthetic. The active ingredients are calamine and pramoxine. They are useful in easing pain caused by skin irritations.

The cream should be applied to dry skin and it may be loosely covered with a bandage or dressing if needed. The emollient should be kept away from mouth, nose, and eyes.

Side effects: An allergic reaction to Aveeno may cause rash, hives, itching; red, swollen, blistered, or peeling skin with or without fever. It may rarely cause wheezing, tightness in the chest, trouble in breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. A very bad skin irritation may also occur. Although most users do not experience any adverse effects, medical help should be sought if you experience any of these side effects.

Drug interactions: It is advisable to talk to your doctor about all the drugs and supplements you are taking before starting Aveeno.

3. Carmol

Carmol is a urea topical that is used as a moisturizer to soften rough, scaly or dry skin and provide relief from skin irritations caused by eczema. Topical urea is available under different brand names, Carmol being one of them.

Urea is a component of the natural moisturizing factor (NMF) produced by the skin. It is a humectant that absorbs moisture from the environment and draws it to the outermost layer of the skin.

Carmol is applied topically to affected skin once a day or every 8-12 hours. The lotion or the cream should be rubbed gently into skin until it is absorbed completely. If using for nails, avoid getting Carmol on the cuticles or the skin around the nails. Allow the medicine to dry completely. It may help to cover the nails using a bandage or a gauze.

Side effects: In case of severe irritation or redness of the treated skin, the patient should discontinue the use of Carmol. Other common side effects include mild itching, burning or stinging of the skin.

Drug interactions: Other oral or injectable drugs do not have any known serious interaction with urea. However, it is best to discuss all your medication with your provider before starting Carmol.

4. Cetaphil

Within the Cetaphil line, the manufacturer offers a variety of lotions, creams, washes, and much more. For eczema, Cetaphil lotion containing glycerin and petrolatum is usually prescribed. It provides lightweight hydration to replenish skin moisture.

Cetaphil lotion should be used exactly as prescribed or directed on the label. It should be used only in the right amounts and for the duration that is recommended.

Cetaphil lotion should be applied on clean skin, that is still wet or damp. Apply a small amount and gently rub on the affected area. Do not apply to deep puncture wound or severe burn unless directed by the physician. Applying more than recommended quantity or frequency may cause the skin to appear gray and soggy.

Side effects: Medical help must be sought in case of serious side effects such as hives, difficult breathing, swelling of face, lips, tongue, or throat. Other adverse effects include severe burning, stinging, redness, or irritation at the site of application. If these side effects occur, you must  discontinue use of Cetaphil and consult with your doctor.

Drug interaction: No serious drug interactions of Cetaphil with other drugs have been documented. But many drugs may interact with each other. Therefore, it is best to tell your doctor about all the medications that you take.

5. CeraVe

All CeraVe products contain essential ceramides and colloidal oatmeal that help restore and maintain the skin’s natural protective barrier. The product should be applied to clean, wet skin and massaged gently to absorb into skin. Avoid getting CeraVe in your eyes, nose, or mouth. Some Cerave products can make your skin more sensitive to sunlight.

Side effects: Some serious side effects that may need medical attention include hives, difficult breathing, and swelling of face, lips, tongue, or throat. Other adverse effects that must be reported to your physician are severe burning, stinging, redness, or irritation at the site of application.

Drug interaction: There are no known serious drug interactions of CeraVe with other drugs. However, it is best to tell your doctor about all the medications that you take.

6. Curel

The Curel anti-itch lotion contains ceramides and glycerin as the active ingredients. It restores skin’s ceramide levels to help retain moisture and prevent symptoms of eczema such as dry, itchy and scaly skin. For best results, Curel should be applied to dry, itchy skin right after the shower or bath. It can be reapplied as necessary.

Side effects: As with other brands of emollients, Curel rarely causes serious adverse reactions such as hives, swelling, difficulty breathing, wheezing or fever. The minor side effects may include skin irritation and redness. It is best to consult the physician if you are concerned about the side effects of Curel.

Drug interactions: There are no known drug interactions of Curel. However, all drug usage must be discussed with the physician before starting any emollient.

7. Eucerin

Eucerin contains colloidal oatmeal as the main ingredient. It is used as a moisturizer to treat or prevent dry, rough, scaly, itchy skin as well as relieving minor skin irritations.

Eucerin should be used as directed by the physician or the pharmacist. It must be applied to the affected area of the skin regularly to get the most benefit. Since most moisturizers need water to work well, Eucerin must be applied when the skin is still damp after shower or bath. For very dry skin, the doctor may advise you to soak the area in water before applying Eucerin.

Side effects: Like other emollients, Eucerin can be used safely and effectively without any serious side effects. However, in a small number of people, some side effects may occur such as burning, stinging, redness, or irritation. If any of these side effects persist or worsen, you must seek medical help. Some rare adverse reactions include unusual changes in the skin, skin infection, severe dizziness, or trouble breathing.

Drug interactions: There are no known drug interactions of Eucerin. However, all drug usage must be discussed with the physician before starting any emollient.

8. Lubiderm

The main ingredients in Lubiderm are mineral oil and glycerin. Mineral oil works as an emollient and glycerin is the humectant that draws water to the outer layer of skin.

Lubiderm advance therapy lotion is for relieving symptoms of eczema. It should be used on wet or damp skin and all the dosage instructions must be followed as per the instructions.

Side effects: Lubiderm can be used safely and effectively without any serious side effects. Some side effects such as burning, stinging, redness, or irritation may occur in a small number of people that must be discussed with the doctor. Some rare adverse reactions include unusual changes in the skin, skin infection, severe dizziness, or trouble breathing that need immediate medical attention.

Drug interactions: There are no known drug interactions of Lubiderm. However, all drug usage must be discussed with the physician before starting any emollient.

9. Vaseline

Vaseline is a common household name and has been used for many years for various skin conditions. The main ingredient in Vaseline is petrolatum which is a powerful emollient. It is a semisolid mixture derived from refining crude oil.

Over-the-counter Vaseline products are used to relieve symptoms of eczema. However, it should not be used for deep wounds as it may lead to a risk of skin infections.

Side effects: Petrolatum is generally considered safe and effective. However, other ingredients in Vaseline may lead to some minor side effects or allergic reactions. Although rare, they include rash, hives, red, swollen, and blistered skin; trouble breathing, and swelling of the mouth, lips, and throat.

Drug interactions: There are no known drug interactions of Vaseline. However, all drug usage must be discussed with the physician before starting any emollient.

The above mentioned emollient brands make the top nine over-the-counter emollients for eczema.

Some important facts that are applicable for all emollients include:

  • Paraffin-based emollients are flammable and should be kept away from anything that may cause a fire
  • Using fingers in the emollient jar or bottle may cause risk of contamination and spread of infection
  • Use of emollients during pregnancy and lactation must be only after consultation with the doctor
  • The emollients should be stored properly away from direct sunlight and as directed by the manufacturer.
  • Avoid getting the emollient in your eyes, nose or mouth. If that happens, immediately rinse with water

It is important to note that this is not a complete list of product side effects and drug interactions. In case of any concerns, you should consult your health care provider.

Written by Preeti Paul, MS Biochemistry

References:

  1. Eczema information from Drugs.com, medically reviewed by L. Anderson, last updated on Jan14, 2019, : https://www.drugs.com/eczema.html
  2. Eczema prevalence, quality of life and economic impact. National eczema association. Retrieved from http://nationaleczema.org/research/eczema facts/#
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