Does eczema have medicine that can cut off roots? Is hormone-containing ointment really useless? Is breast milk the main cause of eczema? People ask me such questions every day on Weibo. Baby eczema has troubled millions of parents in Qian Qian. I did my best to answer countless parents’ questions about eczema. And will reply to the question and answer summary growth article, through the parents more than 40,000 times of forwarding spread to more suffering from baby eczema novice parents, has played a very good popular science effect. Now I will eczema nursing and medication knowledge to everyone to popularize, hoping to help more parents.
There is no medicine to cure eczema.
Eczema is high in preschool children under the age of 5, The exact cause of eczema has not yet been fully studied. At present, there is no drug that can cure eczema. However, more than 50% of babies grow older, Eczema can heal itself. In this process, parents can do is to obtain professional knowledge through formal channels, through scientific care and necessary drugs to control the recurrence of eczema, in order to reduce the impact of eczema on the quality of life and growth and development of the baby, and do not listen to various folk remedies and secret recipes to delay the treatment of the baby.
There are many causes of eczema, and it is generally believed that there are two main causes:
One is heredity. For example, there are people suffering from asthma, allergic rhinitis, eczema and other allergic diseases in the family.
The second is allergy. Baby’s eczema is often related to the immaturity of the autoimmune system. Adult eczema is often related to the imbalance of the immune system. There is no radical cure for diseases related to allergy, including eczema, allergic rhinitis, asthma, etc. Why can’t it be cured? This starts with what allergy is.
Allergy refers to the fact that under certain circumstances, Abnormal overreaction of some people’s bodies to normal external factors. These normal external factors may be eating seafood, Or the skin comes into contact with irritating washing and protecting products, As well as inhaling pollen, dust mites and other things through breathing. The normal human immune system will not make special reactions to these things. Only when some people’s immune system is immature or out of balance, Only then will these things be regarded as [foreign bodies] that destroy the normal function of the body (that is, [allergens] in medical terms), Then overreaction is made to produce antibodies, which will remain in the blood. After a period of time, the body comes into contact with [foreign body] again, and the antibodies will resist [foreign body], thus producing allergic reactions and releasing inflammatory substances to cause dermatitis or allergic rhinitis and other symptoms.
It can be seen from this that the defense system of the human body-diseases induced by immature immune system or imbalance-cannot be treated by destroying the defense system of the human body, and there is no radical cure. The treatment method adopted can only be to avoid contact with allergens as much as possible, control symptoms by nursing or drugs, and prevent recurrence.
Since there is no complete cure for eczema, Parents should be psychologically prepared to fight a protracted war with eczema. It is often said that mother and child are linked, Parents’ anxiety state is easy to affect the baby, causing mental pressure to the baby. Mental stress is also one of the causes of eczema, so parents must be calm in the face of eczema and create a pleasant and healthy family atmosphere, so it is more conducive to the control of baby eczema.
Do a good job in skin care to treat eczema with twice the result with half the effort.
Eczema is translated into Chinese as eczema, Many people think that eczema is caused by too wet skin, On the contrary, Suffering from eczema, The skin is especially afraid of dryness, Always keep it moist. For eczema skin care, Moisturizing is the foundation. Moisturizing well can get twice the result with half the effort. Even mild eczema can be cured by moisturizing well. If the baby’s skin is only a little red, peeling, or mild eczema with only a few small rashes, it can be controlled by using only skin moisturizing cream care. If you apply skin moisturizing cream frequently many times a day to keep the skin moist all the time, eczema can subside.
I know that there are many parents in the network of Shanghai to find eczema cream, Although the seller claimed to be [eczema cream], But in fact, the vast majority of products are overseas moisturizing creams. This kind of product is also available in China. There is no need to go across the sea to find out. For example, expensive imported cosmetics such as STAF and Ayang have low sensitivity moisturizing products. The local Yumeijing and Silicon Cream recommended by cheaper domestic dermatologists all belong to this kind of products. Try to use ointment or cream dosage forms when using them. Unless the eczema is on the scalp, At this time, it is necessary to use the dosage form of moisturizing lotion, which is easy to smear. Because moisturizing lotion is mostly an oil-in-water dosage form, water is easy to evaporate when it comes into direct contact with skin, and moisture evaporation will make skin drier and moisturizing time is relatively short. Therefore, eczema skin should use water-in-oil moisturizing ointment or moisturizing cream, and moisturizing time is relatively long.
In addition to moisturizing, Attention should also be paid to the sensitive skin of eczema babies. The requirements for clothes are very high. The clothes that touch the baby’s skin must be pure cotton, breathable and non-pilling. Including the baby’s skin can touch the nursing staff’s clothing should also be pure cotton material. Silk clothes are not for eczema baby to wear, also can’t let eczema baby contact with silk products, otherwise will stimulate eczema attack. In addition, hair, hemp, chemical fiber and other clothes should also avoid let the baby contact.
In addition, the sudden change in temperature is also a stimulating factor that causes eczema. As the weather becomes hot, the skin surface temperature of the baby rises, and water evaporation is easy to dry the skin and induce eczema. Attention should be paid to appropriate clothing reduction for the baby, less quilt cover at night, keeping cool at room temperature, and often applying low-sensitivity moisturizer specially developed for sensitive skin.
But not because of fear of heat and dryness, Do not give the baby bath. The baby suffering from eczema can take a bath, but the water temperature should be slightly lower, 37 ℃ and body temperature equivalent water temperature is more appropriate. Bathing time should be controlled within 15 minutes as far as possible, not excessive cleaning, and do not use irritant shower gel at the same time. After bathing, the baby should immediately dry his body and apply moisturizer in time.
Here, I would like to explain a misconception in particular: some parents think that since eczema is caused by allergy, baby eczema can be prevented as long as they stay away from eczema allergens; Some people also say that nursing mothers cannot eat eggs and milk, otherwise babies will be prone to eczema. Other old people said that many children will recover from eczema after weaning.
These views are not scientific. More and more clinical evidence shows that Food allergy is a widespread problem, Avoid foods necessary for the growth and development of these babies that may cause allergy, It is not completely effective to prevent the occurrence of eczema in infants. Lactating mothers can try their best to avoid irritating food. But you don’t have to skip milk and eggs at all. For mild to moderate eczema, It doesn’t make much sense to find food allergens, Only babies with large-scale eczema attacks need to consider the cause of food allergy. Avoiding recurrence focuses on care, Pay attention to skin moisturizing, pay attention to avoid stimulation, such as avoid silk, hair and other items contact skin, avoid skin overheating sweating, avoid excessive sun exposure, avoid the use of alkaline soap liquid, etc. Don’t wean your baby easily, breast milk is the best food for your baby. Baby’s eczema does not necessarily affect growth and development, but baby’s lack of nutrition will definitely affect growth and development.
In addition, eczema is not a contraindication for vaccination. If eczema is not serious, vaccination can be carried out normally. Only in the acute phase of severe intractable eczema can vaccination be postponed.
For eczema, external hormone ointment is the first choice.
Clinical experience at home and abroad shows that, For mild eczema, It can be treated with low sensitivity moisturizing cream, However, for the treatment of moderate and severe eczema, External hormone ointment is the first choice. However, using keywords to search [eczema] and [hormone] on Baidu, The vast majority of the information shown is not to use hormones. Such information can easily mislead parents. Delaying the treatment of baby’s eczema makes the small area eczema that is easy to control at first drag into refractory large area eczema. In addition, the word “hormone” often reminds people of [precocious puberty] [endocrine disorders], etc. Parents instinctively choose to avoid, lest the drug will inhibit the growth of the baby and other side effects.
In fact, hormone ointment used for external use does not have the side effects associated with the above parents, Usually only long-term high-dose oral hormone or injection hormone, It will produce side effects that affect the endocrine system and inhibit growth. However, oral or injected hormones are generally not recommended for the treatment of eczema. The adverse reactions of long-term use of external hormones are only limited to skin. The most serious side effect is hormone-dependent dermatitis, The premise of such serious side effects is also long-term and large-dose abuse of potent hormone ointment. However, short-term use of weak hormone ointment may only cause side effects such as skin thinning and pigmentation. In addition, Even if hormone ointment is not used, the skin suffering from eczema will have skin pigment changes during the recovery period. This situation is the skin color change caused by the disease itself, not necessarily the color spots caused by hormone. With the passage of time, the color spots will slowly fade.
There are many kinds of hormone ointments commonly used in daily life, But the intensity is different. 1% hydrocortisone is as strong as eudrol, Relatively weak. The active ingredient of Liyanzhuo is 0.05% desonide, The strength is weaker. Usually, the external dexamethasone ointment made by the hospital is a weak hormone. However, dexamethasone taken orally or intravenously is a medium-strong hormone. The order of commonly used external hormones from weak to strong is: 1% hydrocortisone, 0.1% hydrocortisone butyrate (eutrol), 0.1% mometasone furoate (elosol), betamethasone 0.05% desonide clobetasol are self-made ointment containing dexamethasone in regular hospitals to treat infantile eczema. Usually the last two potent hormones are not selected, Generally 1% hydrocortisone can relieve itching and inflammation, Unfortunately, 1% hydrocortisone is not available in the Chinese market. Therefore, we often use Udrol, which is equivalent in intensity to it. When hormones weaker than Udrol are needed, You can consult the pharmacy, Usually the pharmacy will prepare it itself. For patients with inconvenience in seeking medical treatment, You can dilute it with a mild, non-irritating moisturizer, Dilution ratio is 1: 1 or the lowest 4: 1. People are familiar with 0.025% fluorine acetate easily belongs to moderate intensity hormone containing fluorine, which is not recommended for babies. At the same time, fluorine-containing hormones are not recommended for adults to use on the face, which is easy to cause pigmentation and leave color spots. When using weak external hormones, symptoms disappear and can be stopped without gradually withdrawing drugs.
Hormone ointment is the first-line drug for eczema, Immunosuppressants are the second line of choice, Such as tacrolimus. When severe eczema requires long-term use of potent hormones, In order to avoid the side effects of hormones, Tacrolimus drugs will be used for a short period of time or intermittently to avoid long-term use of potent hormone ointment. Or when taking drugs in sensitive parts such as eyes and genitals, In order to avoid side effects caused by excessive absorption of hormone ointment, Tacrolimus drugs will also be used for a short period of time or intermittently. There is a warning in the product manual of tacrolimus. Pointing out the risk of such drugs causing skin cancer is a factor that needs to be considered in a balanced way. Only when the benefits it brings outweigh the risks will it be considered. For babies, especially babies under 2 years old, they should avoid using such drugs as much as possible.
Precautions in Using Hormone Ointment
The use of external hormone ointment for baby eczema should follow the following five principles:
First, weak-effect ointment should be selected as much as possible during treatment, unless it is to control the acute attack of moderate and severe eczema. At this time, slightly strong hormone ointment can be selected for short-term use. Once the acute symptoms are controlled, weak-effect hormone ointment should be replaced for maintenance treatment.
Second, hormone ointment is generally applied only 1-2 times a day, Don’t apply it too often. If the eczema symptoms are mild, Apply once a day can achieve the purpose of relieving itching and eliminating red rash, that should only be applied once, if the symptom control is not ideal, apply twice a day at most. This kind of ointment maintains the curative effect for a long time, if applied too many times, not only will it not greatly increase the curative effect, but it will increase the risk of side effects.
Third, when smearing the whole body, the use area should not exceed 1/3 of the body surface area as far as possible. Large-scale smearing of the whole body will increase the risk of side effects. At the same time, if eczema breaks out in large areas of the whole body, factors such as food allergy should be considered to find out the cause and avoid it.
Fourth, when nursing eczema by oneself in the family, hormone ointment should be used for 5-7 days. If eczema symptoms do not improve after 7 days, doctors should be consulted in time to evaluate the disease condition and adjust medication. Under the guidance of doctors, the use time of hormone ointment can be appropriately prolonged, but it should be used strictly according to doctor’s advice.
Fifth, if more than two ointments are used at the same time, the time interval between each ointment should be more than half an hour. For example, the hormone ointment Udrol is also required to use the anti-infection ointment Baiduobang, and the two ointments should be applied at an interval of half an hour.
Other drugs and instructions for the treatment of eczema
For mild eczema, it can be controlled to keep skin moist with low sensitivity skin cream. For moderate and severe eczema, weak external hormones should be used together with moisturizing. For eczema with crevasse flowing water complicated with bacterial or fungal infection, anti-infection ointment should be used together, such as Baiduobang for bacterial infection and Perisone for fungal infection.
When the baby itches badly, Antihistamine antiallergic drugs such as chlorpheniramine, loratadine and cetirizine can be taken orally to relieve itching. The difference between the three drugs is that, Chlorpheniramine is a generation of antihistamines, The antipruritic effect will be slightly stronger. However, the first generation of antihistamines (which also include diphenhydramine and cyproheptadine in the same generation of antiallergic drugs) have adverse reactions such as drowsiness and fatigue. Suitable for bedtime. In order to reduce the adverse reactions of the first generation, the second generation of antiallergic drugs loratadine and cetirizine came into being. In addition to the small adverse reactions of drowsiness and fatigue, the second generation also has long-term effects, usually only need to be taken once a day.
In particular, Although this part of the content is aimed at baby eczema, However, the treatment, care and medication of eczema involved here are also applicable to adult eczema. The only difference is in the choice of hormone ointment, Adults with severe eczema can choose ointment with higher hormone intensity, Such as clobetasol, However, it should be used under the guidance of doctors, because long-term and large-scale use of potent hormones is easy to form hormone-dependent dermatitis. Nursing needs to pay attention to avoid physical stimulation such as sun exposure and overheating, avoid chemical stimulation of irritant washing and protecting products, avoid dietary stimulation of seafood and spicy food, and mental stimulation such as tension and anxiety.
Treat eczema, I advocate going to a regular hospital, Use drugs according to treatment guidelines under the guidance of professional dermatologists. Don’t think of external hormones as scourges, Also don’t abuse potent hormone ointment, Let alone believe that the so-called pure traditional Chinese medicine does not contain hormones. According to reports, In some Chinese medicine clinics in Britain and Hong Kong, So-called hormone-free ointments are often detected to contain hormones such as dexamethasone. In China, it is more serious to secretly and illegally add hormones to some eczema ointments that promote hormone-free. Instead of abusing hormone ointments without knowledge, it is better to use hormone ointments clearly and rationally.
This article is taken from the book “Ji Lianmei Talk: Chinese Should Use Drugs This Way”, which is reprinted by the author’s authorized clove garden.