13.5.1 Preparations for eczema

Topical preparations for eczema

First-line management in primary care

Emollients +/- antimicrobials (see section 13.2.1 )

Topical corticosteroid (see section 13.4 )

Prescribing Notes

  • Refer to COMPASS therapeutic notes-‘Primary Care Pharmacological Management of Atopic Eczema.’
  • All patients with eczema should use emollients along with soap substitutes (and/or bath oil if appropriate).
  • Emollients with antimicrobials may be considered in patients with infected eczema only.
  • Exacerbation of eczema may represent secondary bacterial or viral infection. Appropriate swabs should be taken, and topical anti-bacterials applied. Systemic antibiotics may be required in widespread infected eczema.
  • Bandages (including those containing zinc and ichthammol) are sometimes applied over topical corticosteroids or emollients to treat eczema of the limbs. Zinc and ichthammol cream is available as a “special” on a named patient basis.
  • Lichenification, which results from repeated scratching, is treated initially with a potent corticosteroid. Bandages containing ichthammol paste (to reduce pruritis) and other substances such as zinc oxide can be applied over the corticosteroid or emollient.