Constant eczema and medicine to treat it

[wttw1551]

For approximately a year and a half I have had recurring eczema due to a previous course of accutane coupled with my already sensitive skin, and the harsh climate I live in. It is quite widespread accross my body including the face, chest, arms, and pubic region. I have tried a wide variety of things to control it. Doing nothing and natural treatments (oatmeal, honey lotion, etc.etc.) have had no affect and have caused the condition to become worse.

The one thing I have found to control it and actually make me feel comfortable in my skin is hydrocortisone. I have been using the lowest formula of it (0.5%) for an extended period of time (probably since I got on the original accutane course) in these areas. I stopped it every now and then due to potential side effects, but nothing else worked, and it became too unbearable to manage, so I was forced to go back on it. I am already terrified of what could potentially happen if used for a long time (glaucoma is the main thing scaring the crap out of me) that I am trying to stop using it on my face with mixed results...

As the natural stuff I have tried does not work (I have tried basically every over the counter product available), and through my internet research, I am wondering if either Protopic (Tacrolimus) or Elidel (Pimecrolimus) would be a good thing to try out. I am especially wary of applying hydrocortisone around the eye area, but as I have eczema there as well I am at a loss of what to do about it.

I have read that either Elidel or Protopic can be used around the eye area, but on the other hand I have read that both drugs actually INCREASE the amount of redness and itching which is what I am trying to get rid of. Whenever I arrive home I need to apply something to ease the itchiness which I have been feeling all day... Advice would be appreciated on what course of action I should take.

Thank you.

[wttw1551]

I appreciate your response. I recently had an appointment with my dermtaologist who gave the exact same answer regarding Elidel and Protopic, however I failed to garner any definitive information regarding how safe it is to continue using Hydrocortisone consistently. From what I have read it is very difficult to control itchiness/redness with those two drugs which is exactly what I am trying to do... Hydrocortisone is the only topical which gives me any relief.

I am not up to date with Light Therapy or whether it would be appropriate or not, it has not been recommended to me by my dermatologist. A more natural alternative to my problem than Hydrocortisone would be a great find...? I am just not sure how good I feel about continuing to use the lowest dose of it extensively and/or whether it will cause problems later on.

Thank you.

[Bhupinder Kaur, MD]

Hello,
Eczema is a form of chronic dermatitis (rash).Allergic reaction is one of the important causes of eczema. In most cases of eczema no one treatment will be effective. A combination of treatments should be used. Along with topical steroids, you should use good quality moisturizers on the area. Immunomodulators like tacrolimus and Pimecrolimus are not without side effects and should be used after a dermatologist’s prescription.

If the eczema is more severe, phototherapy (a type of treatment that uses light therapy) or systemic (circulates throughout the body) medication like oral steroids may need to be prescribed.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.