What is eczema?
One of the problems in discussing the treatment of "eczema" is that this term inherently is nonspecific. For patients, any inflamed rash might be eczema, while for certain pediatricians and some dermatologists, eczema is synonymous with atopic dermatitis but can also refer to allergic contact dermatitis, seborrheic dermatitis, irritant dermatitis, or stasis dermatitis. In any case, there are certain basic approaches to treatment of these sorts of rashes.
Eczema home remedies and prescription treatments
Acute eczema (dermatitis) is characterized by weeping, oozing, and vesicles (small fluid-filled blisters). Treatment involves the application of cool compresses for a short interval followed by evaporation. The compress could be a dilute vinegar solution or just tepid tap water. Evaporation can be enhanced by a fan blowing air onto the affected area. Repeated cycles of soaking and evaporation may be required to stop the weeping and oozing. Once this occurs, then the application of topical steroid creams, lotions, or ointments are likely to enhance the resolution of the problem. In chronic eczema, the weeping and oozing is not present and the vesicles are more difficult to appreciate (they may be microscopic).The skin often appears dry and scaly.
In any case, the application of topical steroids to this sort of dermatitis is often very effective followed by the application an emollient (a substantial cream or ointment). This works best on moistened skin. Occasionally, severe, extensive cases may require the administration of systemic (oral or intramuscular) steroids. Ultimately, it is of utmost importance to determine the type of eczema in order to have any chance of permanently eliminating it. Occasionally it is necessary to treat certain cases of persistent eczema with ultraviolet light. This approach does have a biological rationale. The light is usually administered in a doctor's office under controlled conditions.
Medically reviewed by Norman Levine, MD; American Board of Dermatology
Coenraads, Pieter-Jan. "Hand Eczema." N Engl J Med 367.19 Nov. 8, 2012: 1829-1837. <http://www.nejm.org/doi/full/10.1056/NEJMcp1104084>.