emollient dilema!

[meggymoo94]

hello,

I am new to this so bare with me

I have had eczema my whole life 21 years, I have regularly been treated for infections as I have a low immune system due to pernicious anaemia, I have recently started phototherapy because it had progressed and got quite a lot worse, I was using emulsifying ointment which I cant explain enough how much it ruined my skin it went from being moderately dry to the point where I could rub my arm and skin just collect everywhere may I ask is this ever happened to anyone else? Should it even be prescribed without being combined to make aqueous cream?!? I am currently using fucibet and hydromol ointment has anyone else used these two combined and can any other creams be suggested.

Thank in advance

[Justine Greenwood]

Dear Meggymoo94,

Thank you for your post. I am sorry to hear of your eczema and that you are having trouble with your creams. I hope to be able to explain a little about them all to help.

Emulsifying ointment is a regularly prescribed emollient for eczema. It contains emulsifying wax, white soft paraffin and liquid paraffin. It also contains the ingredient sodium lauryl sulphate which is a surfactant. This ingredient is known to occasionally cause local skin reactions, such as contact dermatitis, which is what you could be describing when using this product.

NHS Choices recommends that although aqueous cream is often prescribed, it should not generally be used as an emollient treatment. There are better emollients available, as some people may have a reaction to aqueous cream used as an emollient. It also has a high water content, making it less effective than other products as a leave-on emollient.

How are you finding the hydromol ointment? Is this working better for you?
Your emollients should be applied as liberally and frequently as possible. They are best applied when the skin is moist but they can and should be applied at other times as well. Ideally, emollients such as Hydromol should be applied every 4 hours or at least 3–4 times per day.

Fucibet is a topical steroid betamethasone combined with an antibacterial ingredient fusidic acid. It is used to help treat eczema which is infected. Long-term continuous topical therapy should be avoided with this type of cream; it should only be used in the short term whilst the infection clears up to reduce the
risk of drug resistance or skin sensitisation. A single treatment course should not normally exceed 1 to 2 weeks.

It makes sense to use the two creams - the hydromol as a regular emollient and the fucibet to clear up any infection.

NICE guidance also recommends:
◦To avoid scratching the eczema (if possible), and simply rub the area with their fingers to alleviate itch.
◦To keep the nails short (and use anti-scratch mittens in babies with eczema).
◦To avoid trigger factors known to make the eczema worse, such as clothing (avoid wearing synthetic fibres), soaps or detergents (use emollient substitutes), animals, and heat (keep rooms cool).

I hope you find this information useful. If you have any further questions please do get in touch.

Best wishes,

Justine