Eczema, also known as dermatitis, encompasses a group of common skin disorders characterized by itchy, red areas that may swell, crust and ooze. Common forms of eczema include contact dermatitis, allergic dermatitis, seborrheic dermatitis and atopic dermatitis. People with eczema often experience an episodic disease course, with alternating flare-ups and periods with few or no symptoms. Treatment for an eczema flare-up, or relapse, depends on the type of dermatitis and the severity of the episode.
Cold Compresses
Intense itching is typically the first symptom of an eczema relapse. Persistent scratching irritates the inflamed skin and often leads to skin breaks and oozing. A secondary bacterial infection may develop in areas with open sores. To help interrupt the cycle of itching and inflammation, the American Academy of Dermatology recommends applying cold compresses to itchy patches of skin. The cool temperature can reduce skin inflammation, leading to reduced itchiness.
Steroid Medications
Both topical and oral steroids are treatments for eczema relapse. Doctors often prescribe corticosteroid ointments, lotions and creams to treat mild to moderate eczema flare-ups caused by atopic, contact or seborrheic dermatitis, notes the Merck Manual for Healthcare Professionals. Corticosteroids are potent anti-inflammatory agents that help interrupt the cycle of inflammation and itching associated with dermatitis flare-ups. With severe eczema relapses, doctors may prescribe a short course of oral steroid therapy, which is discontinued once the episode resolves.
Topical Immunomodulators
Topical immunomodulators are non-steroidal medications applied to the skin. These drugs suppress immune system activity in the skin, resulting in reduced inflammation. Tacrolimus or pimecrolimus are immunomodulators sometimes prescribed in topical form for patients with eczema flare-ups, notes the American Academy of Dermatology.
In 2005, the U.S. Food and Drug Administration issued a public health advisory to warn of a potential increased risk for cancer associated with topical use of tacrolimus and pimecrolimus. The advisory recommends that doctors prescribe these medications only when other forms of treatment have failed or if the patient cannot tolerate other forms of eczema therapy.
Medicated Shampoos
Seborrheic dermatitis frequently affects the scalp. During acute flare-ups, medicated shampoos containing tar, selenium sulfide, zinc pyrithione or other substances can help reduce scaling and flaking, reports the Merck Manual for Healthcare Professionals. Use of medicated shampoos may be combined with other forms of treatment, such as steroid lotions or oral medication.
Phototherapy
Doctors may prescribe phototherapy for moderate to severe flare-ups of contact or atopic dermatitis, notes the American Academy of Dermatology. Treatment involves exposing the affected skin to ultraviolet light. Medication may be applied to the skin before each treatment session to enhance the effects of the ultraviolet light. Patients typically receive two to five treatments per week during periods of active disease depending on the form of phototherapy.
