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Tuesday, 12 September 2017

Healing Eczema Without Steroids

Recently, one of my patient with very severe eczema on methotrexate asked: "Can I heal my eczema without any steroids?"

Yes, you can.

Just like how your chickenpox can heal without antiviral, your runny nose can heal without any antihistamines, your sore throats can heal without any antibiotics, some women can even deliver at home, your eczema can heal without any steroids.

"Steroids is not a cure for eczema, they said," she told me. She was invited to join a support group for "healing eczema without steroids". And she has came across many natural healing advocates who strongly urge everyone to avoid steroids.

And I do not beg to differ.

What I want you to know is that "dermatologists readily dish out steroids" to help you getting over the most difficult time, and we have absolutely no intention not to harm you. In case some may have forgotten, our oath says "First do no harm" and our motto is "To cure sometimes, to relieve often, to comfort always".

I am not against natural path. But if you want to go absolutely steroids free, these are what I would suggest,
  1. Avoid all irritants and your known allergens
  2. Keep your bathing brief (<5 minutes) and not too frequent, using slight lukewarm water
  3. Use gentle cleanser instead of soap (no natural handmade soap please and no bubble bath)
  4. Always keep your skin moist, frequent re-application of moisturiser is the key
  5. Seal in the moisture with occlusives (parrafin, vaseline ointment, dimethicone if you hate that greasy feeling)
  6. If you feel really itchy, replace that scratch with applying cold pack or cold cream (no need to buy any particular brand of cold cream, just keep your hypoallergic moisturiser in the fridge)
  7. Use immunomodulators such as topical tacrolimus, pimecrolimus
  8. Ask your doctor about phototherapy (controlled light treatment) to see if you are a good candidate
  9. If you are going for alternative medicine, please go for facilities with proper registration and certification (although I have no idea how to check that these are in place), and do ask them if their treatments may have any potential short term or long term side effects (Perhaps they might not actively discuss with you if you don't ask? Well, the reason I said this is because I have a teenage boy with eczema who came to me after 2 years of herbal remedies which was initially very effective and now he is suffering from stunted growth and a few other problems)

Whatever your choice is, take good care of your skin and get better soon!
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