Treating eczema

I use compounded or blended creams, to treat atopic eczema in children and young adults. I also treat the immune disorder.

Many doctors do not use this holistic approach, but just treat the skin at times when it is inflamed, and this frustrates patients who know it will just come back.

Treating the immune disorder requires addressing the micro-biome or billions of healthy germs found in the gut, and excluding some foods.

The dry skin needs ceramide, and other natural products in the blended cream to gradually repair it.

I compound or mix the ingredients into a cream for flare treatment, and another for skin barrier repair.

Treating Atopic Eczema in young people

Young children with eczema often have atopic eczema. There are other types of dermatitis, but it is atopic eczema that often proves frustrating and difficult to treat, leading to family stress, and far-reaching effects on all aspects of life and leisure.

Why is it so difficult to manage well?

The different disciplines of immunology/allergy, dermatology, and general practice have overlapping but separate roles. NHS GPs are bound to follow prescriptive local or national guidelines, which have a step-up approach and are cautious. These guidelines cover skin management without considering down-regulating the immune system via the gut microbiome.

Eczema treatment for elbowsThere may be fear of using steroid creams because of side effects, or the skin “getting used to it”, or fear of over-prescribing antibiotics and developing resistance. There may be too many tubes of cream in the bathroom to know which one to use and when to use it. The child may be constantly scratching, have disturbed sleep, and may be unable to play sports, or sleep over with friends. And what about environmental factors, the cat or dog, the soft toys, milk or eggs?

Parents and GPs may have only a limited understanding of why atopic patients are also susceptible to asthma, allergies, hay fever, and frequent infections. The role of Staph aureus germs may be under-estimated. Atopic cascade from eczema to asthma and allergies is never discussed.

Typical mainstream management consists of individual tubs or tubes of emollient moisturising creams to combat skin dryness, topical steroid creams to combat inflammation, and occasional antibiotic creams for infection.

Eczema treatment for kneesThere are more specialised creams for those wishing to avoid steroids altogether, such as Tacrolimus or Pimecrolimus creams. Your GP may be unwilling to prescribe these. And there are even more specialised treatments for severe eczema, known as biologics such as Dupilumab, which can be initiated by dermatologists only under very specific guidelines. So clearly it is more complicated than a simple skin condition. Explanations such as an outside-inside and an inside-outside disease don’t help most parents either. Not many wish to grasp the complex immunology. But I do believe that every parent would like to see the condition go into remission, and better understand how to get there.

What I believe is needed is a tailored approach to a particular child or adult’s needs, with a simple one-stop cream used at clearly defined intervals depending upon the activity of the eczema, until such time as one can be sure the disease has gone into remission. Such an approach needs to take account of the extent and severity of the eczema, the child’s age and weight, safety considerations, and social impact.

What is not realised is that there have been very successful treatments using compounded or pre-mixed creams for quite some time, but not available on the NHS. Such an approach will not work for everyone; there will always be those with eczema of such severity, they require a more specialised approach. My hope is that I can help prevent things getting to that stage.

Please contact me to learn more about my methods, or request an appointment if you are ready for a consultation.

Eczema treatment by Dr James Pimm