Other treatments

Wet wrapping is used with children who have eczema that is not getting better after using flare control creams and moisturising creams regularly. It is not generally used for hand eczema.

It is a bit like making a cake, with layers of moisturising creams and bandages.

Put on a thick layer of moisturising creams on the area of skin with eczema on. A bandage is soaked in warm water, squeezed out, and then put on top of the moisturising cream. A dry bandage is then put over this as a top layer. Your doctor or nurse will show you how to do this.

The bandages can be worn under clothes during the day or under nightwear during the night. They are kept on for several hours.

You can also get wet wrapping clothes that can be used instead of bandages. These come as vests or leggings.

You can use wet wrapping with your flare control creams. Wet wrapping should not be done unless your doctor or nurse tells you to do so. It should not be used if your eczema tends to get infected or is currently infected.

The bandages help lock moisture in the skin better for longer. The bandages can also stop you from damaging your skin from scratching.

The wet bottom layer has a cooling effect and can help soothe the itch. This can also help you have a better night’s sleep. The dry layer stops your clothes and bedding from getting wet.

You can find links to more information about wet wrapping in the ‘other resources’ section, which you can get from the ‘ more about treatments ’ menu above.

Antihistamines are medicines used to make the symptoms of allergies better. For example, they may be used to reduce the itch caused by hay fever or insect bites.

Antihistamines do not help reduce the itch in eczema. This is because the chemicals that make eczema itchy are different to the chemicals that make an insect bite itchy. However, we know that different things work for different people. There is no harm in using them if you find them helpful for your eczema.

There is one situation where taking an antihistamine may be helpful – if you have bad hay fever and a lot of itching around your eyes.

The best thing you can do to stop the itch is to get control of your eczema using flare control creams and moisturising creams.

You can find out more about itching and eczema in the ‘beat the itch’ section, which you can get from the ‘ living well with eczema ’ menu above.

You may have heard about people with eczema using antihistamines before going to sleep.

There is no strong evidence that antihistamines help with going to sleep. Although, some people dealing with eczema find it helps.

If you do decide to use antihistamines before bedtime they should be taken about an hour before. They should only be used for a few days at a time. This is because people get used to them quickly and they stop working as well.

You should avoid the ‘non-drowsy’ antihistamines if you are trying them for sleep. You can ask your pharmacist for advice about this.

We do not recommend taking steroid tablets for eczema. Although they work in the short-term, they can make your eczema so much worse in the long-term. Your body then needs more and more steroid tablets, which is bad for their body long term. It is usually given if the flare-up is very bad.

Steroid tablets are much stronger than steroid creams. So you will usually only take them for a few days to get control of a bad flare-up.

How do steroid tablets work?

The body’s defence system works in a different way in people with eczema. It ‘over-reacts’ to things that would not normally harm us, such as soaps and washing up liquid. Steroid tablets work by calming down the body’s defence system.

Steroid tablets are not as safe as steroid creams. Steroid tablets are absorbed into the blood stream. This is why they have a much stronger effect than steroid creams. If used for a long period of time, they can:

• affect growth and development
• increase your blood pressure
• increase your chances of getting diabetes.

They can also affect your mood and sleep and will increase your appetite.

Medicines (tablets, capsules, liquid, or injections) that calm down the body’s defence system can be used to treat severe eczema. They are usually given to people with eczema that is not getting better after using flare control creams and moisturising creams regularly. They are only given to people who are under the care of a dermatologist or immunologist.

These medicines calm down the body’s defence system to stop eczema flare-ups. They are not a cure for eczema, but help to get it under control.

Some medicines are taken for a few months, while others can be taken for years. Some of these medicines may also be given as an injection.

Examples of these medicines are:

• Ciclosporin – takes around 2 weeks to start working.
• Azathioprine – this takes 2-3 months to start working.
• Methotrexate – this is only taken once a week and takes weeks to start working.
• ‘Biologics’ (e.g. Dupilumab) – these are sometimes used as a series of injections.
• JAK Inhibitors – (e.g. Upadacitinib) These usually are oral tablets.

If you need these medicines, your doctor will advise which ones are right for you.

These medicines are safer in the long term than steroid tablets. Many have side-effects, like nausea. This might mean that the amount your child takes needs to be reduced. Some of these medicines can also make you more likely to get infections because they calm down the body’s defence system.

Most of these medicines need regular blood tests to check that they are not having a negative effect on your health.

Light treatment is used to treat bad eczema that is not getting better after using flare control creams and moisturising creams regularly. It is also called phototherapy or ultraviolet light.

Many people say their eczema gets better when they are in natural sunlight. In light treatment, the ultraviolet (UV) rays that are in sunlight, are used to treat eczema.

Light therapy is different to using sun beds or sitting in the sun. In light therapy, the harmful part of the ultraviolet light that gives you a tan has been taken out. Sun beds do not help eczema.

Light therapy works by calming down the body’s defence system. It is not a cure for eczema. Although, it can reduce eczema flare-ups. You may need lots of treatments before you notice any difference. This is because the doses have to be built up slowly to avoid burning.

Your doctor or nurse can give you advice on whether light therapy is right for you.

You can find out more about how sunlight affects eczema in the ‘weather and holidays’ section, which you can get from the ‘ what can make eczema worse ’ menu above.

Generally light treatment is safe. Although, it can cause the skin to age early and increase the risk of skin cancer in lighter-skinned people if light treatment is used across a long period of time.

It can make the skin feel dry and itchy. It may also cause slight redness that looks like sunburn. Rarely, people can get a rash during the light treatment. All of these effects should go away with time.

You can find links to more information about light treatment in the ‘ other resources ’ section, which you can get from the ‘ more about treatments ’ menu above

Complementary and alternative therapies are a range of health care methods or products that are not normally part of mainstream medicine. These may include:

• Herbal medicine – uses plants
• Aromatherapy – uses oils
• Homeopathy – uses highly watered down substances
• Acupuncture – uses fine needles
• Reflexology – a type of massage that applies pressure to your feet
• Hypnotherapy – puts you into a deep relaxed state

These therapies are meant to be used with your child’s normal medical treatments. They should not replace them.

There is no scientific evidence that complementary and alternative therapies help eczema. In fact, some of the products and methods used by these therapies may make your eczema worse. For example, some skin products made with natural oils, such as olive oil, can cause an eczema flare-up.

If you do use any of these therapies, you should first test any of the products on a small area of skin that doesn’t have eczema on it. Although, it is still possible get a reaction from the products, even if you didn’t react when you tested them.

Some people with eczema find therapies that involve relaxation or meditation helpful for dealing with stress and getting to sleep. You can find out more about this in the ‘stress and eczema’ section, which you can get from the ‘itch, stress and sleep’ menu above. There are links to more information on complementary and alternative treatment in the ‘other resources’ section, which you can get from the ‘more about treatments’ menu above.

Diluted bleach baths are considered useful for severe infected eczema and in the case of recurrent skin infections. Bleach baths can be used twice weekly, for up to 10 minutes, for 3 months. 

It is recommended to use a ¼ cup of unscented household White King bleach to a half full, standard-sized bath filled with lukewarm water. Alternatively add 12mL of unscented household White King bleach to every 10L of water. 

Do not rinse off after bathing. Pat dry (preferably using a white towel to prevent towel discolouration). It is important to apply moisturiser to the whole body including the face after bathing. If a flare control cream has been prescribed, apply it to all eczema areas before moisturising.