general treatment
Patience education
To understand the nature of the disease, the possible outcome, the impact of the disease on health, whether it is contagious, the clinical efficacy of various treatment methods and possible adverse reactions. Under the guidance of a doctor, look for and avoid common allergens and irritants in the environment and avoid scratching. Pay attention to doctors' attention and suggestions on clothing, food, housing, transportation, washing and other aspects of life.
Avoid inducing or aggravating factors
Cooperate with doctors through detailed medical history collection, careful physical examination and rational use of diagnostic tests to carefully find out all kinds of suspicious causes and inducing or aggravating factors, so as to achieve the purpose of eliminating causes and treating diseases, such as moisturizing dry eczema and treating primary infection with infectious eczema.
Protect skin barrier function
The skin barrier function of eczema patients is damaged, which is easy to cause irritating dermatitis, infection and allergy, which will aggravate the skin damage, so it is very important to protect the barrier function. It is necessary to use moisturizing emollients correctly and prevent and deal with secondary infections in time.
medicine
Drug treatment of eczema includes local treatment and systematic treatment.
Local treatment
Local treatment is the main means of eczema treatment, and doctors will choose the appropriate drug dosage form according to the stages of skin lesions.
Acute treatment is as follows:
When there is no blister, erosion or exudation, it is recommended to use calamine lotion, glucocorticoid cream or gel;
When a large amount of exudation occurs, cold wet compress should be used, such as 3% boric acid solution, 0. 1% berberine hydrochloride solution, 0. 1% ethacridine solution, etc.
Zinc oxide oil can be used when there is erosion but not too exudation.
Zinc oxide paste and glucocorticoid cream are recommended for subacute skin lesions.
It is suggested that glucocorticoid ointment, hard ointment, emulsion or tincture should be used externally for chronic skin lesions, and moisturizers and keratolytic agents, such as 20%-40% urea ointment and 5%- 10% salicylic acid ointment, can be used together.
Glucocorticoid preparations for external use are still the main drugs for eczema;
In the initial treatment, glucocorticoid with appropriate intensity should be selected according to the nature of skin lesions;
For mild eczema, it is suggested to choose weak glucocorticoid, such as hydrocortisone dexamethasone cream;
Moderate eczema is recommended to choose moderate hormones, such as triamcinolone acetonide and mometasone furoate.
For severe hypertrophic skin lesions, it is suggested to choose powerful glucocorticoids, such as hanade and halometasone cream;
Generally speaking, glucocorticoid is effective in children, face and skin wrinkles.
Continuous use of strong glucocorticoid is generally not more than 2 weeks to reduce acute tolerance and adverse reactions.
Calcineurinase inhibitors, such as tacrolimus ointment and pimecrolimus cream, have therapeutic effects on eczema without glucocorticoid side effects, and are especially suitable for the treatment of eczema on head, face and rubbing parts.
Bacterial colonization and infection can often induce or aggravate eczema, so antibacterial drugs are also an important aspect of external treatment. Under the guidance of a doctor, we should choose a suitable external preparation of antibacterial drugs or a compound preparation of glucocorticoid and antibacterial drugs.
Other drugs for external use, such as tar, antipruritics, non-steroidal anti-inflammatory drugs, etc. , you can choose the application according to the situation.
Systematic therapy
Antihistamines: Doctors will choose appropriate antihistamines according to patients' conditions to relieve itching and diminish inflammation.
Antibiotics: For patients with widespread infection, doctors will suggest that antibiotics should be used systematically for 7- 10 days.
Vitamin c, calcium gluconate, etc. It has certain antiallergic effect and is used for patients with acute attack or obvious itching.
Glucocorticoid: Generally speaking, routine oral administration is not recommended. But for patients with definite etiology that can be eliminated in a short time, such as contact factors, drug factors or allergic dermatitis. Used for severe edema, systemic rash, erythroderma, etc. In order to control symptoms quickly, doctors will recommend short-term application. After the symptoms are controlled, the drug should be stopped in time under the guidance of a doctor to avoid adverse reactions.
Immunosuppressant: It is mainly used for critically ill patients. Doctors will generally strictly grasp the indications, and only use it when other therapies are ineffective, or short-term systemic application of glucocorticoid is obviously relieved, and glucocorticoid needs to be reduced or stopped. Commonly used drugs are cyclosporine, methotrexate, mefentanil, etc.