Every patient or parent is looking for an eczema cure. Although doctors cannot guarantee a permanent cure, I am confident that your skin can look better and feel better within four weeks if you use a bespoke cream for your condition containing diluted steroid, antibacterial, oily cream, white soft paraffin, and argan oil. It is impossible to get a cream containing all these ingredients as a prescription cream on the NHS, and it would be exptremely difficult to have a pharmacist make up such a cream. However, this blend combines all the essential ingredients to guarantee a clear looking skin within four weeks. I am so confident that I can get your skin clear, that I will refund your money if you purchase my cream and are not satisfied after four weeks.

Naturally, with moderate or severe eczema, one must continue to use such a cream for several months, and this may extend to a year, while the underlying immune disorder is treated. However, this gives mothers confidence and peace of mind to see their children growing without sleepless nights and constant scratching.

How can I be more confident of a clear skin with eczema in four weeks, when others will not promise this? Why do other doctors persist in using only one drug in their formulary? Why do patients have to endure side effects of over-using steroids? The answers are complex, but I will use a tennis analogy to explain my approach.

I recently watched Novak Djokovic play in the Australian tennis finals against Rafael Nadal. Both players are very good, but Novak was better, and played every type of shot well. His serves did not need to be the fastest, he just got more of his first serves in. He played his forehands and backhands early, not allowing any extra time for his opponent to be ready for them. Every shot counted. He used every type of shot well, making no mistakes.

Watching someone like Roger Federer is a joy, as he plays every shot well. You would never expect a professional tennis player to enter an important match, and say “I don’t play back-hands, only forehands”. Yet there are doctors who treat eczema, and never use a topical antibiotic, only ever steroids.  Or if they use antibiotics, say “you may only use this for one week”, when the eczema has lasted months. You wouldn’t expect a tennis player to rely only on a good serve, with no other shots, yet doctors frequently say: “all you need is to use the moisturiser every day, and plenty of it, you don’t need steroids”.

My argument is that just as a good tennis player needs a good serve, back-hand, fore-hand and volley, and needs to run and react quickly to the direction of the ball, a good doctor needs to be using all the drugs in the formulary that work well, and use them in combination. There is more than one cause for the skin to be inflamed, itchy, and red, with broken skin and bleeding from scratching. You cannot expect good results using only a moisturiser and a steroid.

Here then is the secret to getting a cure for your eczema, and why I combine each ingredient:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. The Serve – A good tennis player must be able to get the serve in at least 70% of the time. For good eczema results, patients must apply a good moisturiser to the skin every day, and perhaps the 70% rule should apply – at least 7 days in 10. Your skin requires extra protection with oils and extra water for hydration, since there is more water loss through eczematous skin. Emollient or moisturiser (same thing) should never be forgotten.

2. The forehand – this sounds obvious, and every tennis player learns this, just as doctors should use steroids on the skin to combat inflammation. However, just as many tennis players never learn a correct forehand topspin, many doctors never learn to use steroids correctly, which is why many patients either get side effects from over-use, or rebound phenomena after using steroids too strong, and then suddenly stopping. One needs the correct strength for the right period of time.

3. The backhand – tennis players often neglect their backhand stroke, and cut or slice the ball on this stroke. The equivalent for doctors is using antibiotics too sparingly, or for too short a period, or just by mouth. A good tennis player learns a backhand topspin, which allows a strong shot, which will usually go in. A good dermatologist of GP will provide a good anti-staph antibiotic for long enough to stop staph breaking through damaged skin barrier, and therefore stop staph toxins being released beneath the skin surface. Moderate flares of eczema are always accompanied by very large numbers of the germ Staph aureus.

4. The net shot, or volley – unless a tennis player is confident with this shot, there is always vulnerability to a short return. A good doctor is aware that the skin barrier defect needs to heal properly, and will use a ceramide compound in the emollient or moisturiser. Surprisingly few moisturisers contain this element, and one usually needs to spend more money to get the ceramide component. These are derived from plant oils, such as coconut oil, shea butter, or argan oil, and help repair the flattened surface skin cells into an impenetrable matrix. The skin must be able to breathe, but still repel water and germs. The ceramide I usually use is argan oil, although I will use coconut oil and shea butter too.

5. Finally, one should start playing tennis young to develop good skills with the racquet, good anticipation and court position. For a doctor to cure eczema, one needs to start young, and develop immune responses which protect the skin. The gut microbiome is essential for this. We know from good academic research that the correct probiotics in the diet will stop atopic eczema by giving the immune system the awareness and anticipation of unhealthy germs or pathogens, by training to be tolerant to healthy germs, or non-pathogens that we need in the gut microbiome. If we start young, by giving infants and young children good probiotic drinks such as kefir, or live yoghurt, they will develop a healthy microbiome, and they will be free of eczema.

I therefore use all these elements in my approach. There is good scientific evidence for each step. The skin component can therefore be made in a blend – good moisturiser, correct strength steroid, and the correct antibiotic, with plant ceramides to repair the surface structure of the skin. At the same time, I treat the gut microbiome, by adding probiotics to tune the immune system to fight the right enemy, skin germs, while ignoring the wrong enemies such as milk proteins.

I wish more doctors would use blended mixes of such ingredients, or at least use all the elements of this approach. Why don’t they do this? The answer lies with following guidelines in a robotic manner, rather than reading the academic research.  When the skin is weeping or encrusted, everyone knows there are germs getting through the skin, and staph is implicated in every flare of eczema. Yet antibiotics are used by mouth rather than on the skin, and are used for just a week or maybe two – periods that are much too short.

The irony is that for decades Chinese medicines for eczema have contained blends of steroids with additional skin healing elements, and anti-bacterials, and yet western doctors have warned patients against using these methods.

The other irony is that nations which address the gut microbiome correctly either don’t see any atopic eczema, or see hardly any at all. Eastern European and middle Eastern countries where Kefir is taken routinely from childhood see eczema rates of less than 1%, whereas European and American cultures regularly see the incidence of eczema at 15%.

Let’s start using all the elements that we know work, and use them together, reacting quickly. Then watching doctors treating eczema will be like watching tennis players like Novak Djokovic or Roger Federer. Champion tennis players use all the strokes, and play them well.