Is My Skin Just Dry or Is It Eczema?
Question by miss-elvie: is my skin just dry or is it eczema?
hello! lately i’ve noticed my skin is quite a lot drier than it normally is. it is in patches all over my face especially on my cheeks and forehead. the skin is so dry that it flakes off, and if you pull the skin gently apart, the skin will actually crack. i’ve been using a (very expensive) lotion for dry skin and it is doing nothing. could it be eczema?
Best answer:
Answer by Raj
Ur symptoms suggest that it is mostly a case of eczema.It can be cured only on long term therapy. there are several different treatment methods for eczema.
Medications
Corticosteroids
Dermatitis is often treated by glucocorticoid (a corticosteroid) ointments, creams or lotions. They do not cure eczema, but are highly effective in controlling or suppressing symptoms in most cases.[5] For mild-moderate eczema a weak steroid may be used (e.g. hydrocortisone or desonide), whilst more severe cases require a higher-potency steroid (e.g. clobetasol propionate, fluocinonide). Medium-potency corticosteroids such as clobetasone butyrate (Eumovate), Betamethasone Valerate (Betnovate) or triamcinolone are also available. Generally medical practitioners will prescribe the less potent ones first before trying the more potent ones. In many countries, weak steroids can be purchased ‘over the counter’ (e.g., hydrocortisone in UK, United States, Germany, Czechia, Australia, Iceland), while the more potent ones require a prescription.
[edit] Side effects
Prolonged use of topical corticosteroids is thought to increase the risk of possible side effects, the most common of which is the skin becoming thin and fragile (atrophy).[6] Because of this, if used on the face or other delicate skin, only a low-strength steroid should be used. Additionally, high-strength steroids used over large areas, or under occlusion, may be significantly absorbed into the body, causing hypothalamic-pituitary-adrenal axis suppression (HPA axis suppression).[7] Finally by their immunosuppressive action they can, if used without antibiotics or antifungal drugs, lead to some skin infections (fungal or bacterial). Care must be taken to avoid the eyes, as topical corticosteroids applied to the eye can cause glaucoma [8] or cataracts.
Because of the risks associated with this type of drug, a steroid of an appropriate strength should be sparingly applied only to control an episode of eczema. Once the desired response has been achieved, it should be discontinued and replaced with emollients as maintenance therapy. Corticosteroids are generally considered safe to use in the short- to medium-term for controlling eczema, with no significant side effects differing from treatment with non-steroidal ointment.[9]
However, recent research has shown that topically applied corticosteroids did not significantly increase the risk of skin thinning, stretch marks or HPA axis suppression (and where such suppression did occur, it was mild and reversible where the corticosteroids were used for limited periods of time). Further, skin conditions are often under-treated because of fears of side effects. This has led some researchers to suggest that the usual dosage instructions should be changed from “Use sparingly” to “Apply enough to cover affected areas,” and that specific dosage directions using “fingertip units” or FTU’s be provided, along with photos to illustrate FTU’s.[10]
[edit] Other forms
In severe cases, oral cortisosteroids such as prednisolone or injections such as triamcinolone injections may also be prescribed. While these usually bring about rapid improvements, they should not be taken for any length of time and the eczema often returns to its previous level of severity once the medication is stopped. In the case of triamcinolone injections, a waiting period between treatments may be required.
[edit] Immunomodulators
Topical immunomodulators like pimecrolimus (Elidel and Douglan) and tacrolimus (Protopic) were developed after corticosteroid treatments, effectively suppressing the immune system in the affected area, and appear to yield better results in some populations. The U.S. Food and Drug Administration has issued a public health advisory about the possible risk of lymph node or skin cancer from use of these products,[11] but many professional medical organizations disagree with the FDA’s findings;
* The postulation is that the immune system may help remove some pre-cancerous abnormal cells which is prevented by these drugs. However, any chronic inflammatory condition such as eczema, by the very nature of increased metabolism and cell replication, has a tiny associated risk of cancer (see Bowen’s disease).
* Current practice by UK dermatologists is not to consider this a significant real concern and they are increasingly recommending the use of these new drugs.[12] The dramatic improvement on the condition can significantly improve the quality of life of sufferers (and families kept awake by the distress of affected children). The major debate, in the UK, has been about the cost of such newer treatments and, given only finite NHS resources, when they are most appropriate to use.[13]
* In addition to cancer risk, there are other potential side effects with this class of drugs. Adverse reactions including severe flushing, photosensitive reactivity and possible drug interaction in patients who consume even sma
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