However, most parents choose to go ahead and medicate with the milder medications to give the child some relief, even if they initially had reservations. With the proper knowledge and appropriate use of the medications, your child should not have any trouble. A good dermatologist or pediatrician with plenty of experience with eczema is a must in order for the medication to be properly monitored.
Antibiotics, antihistamines, and corticosteroids are the standard in medicating very young children, just as they are in treatment of adults. Since all of these have a wide array of potency, it is not difficult for the doctor to prescribe an age appropriate medicine for your child. Recently, two other topical medications have been introduced and are steroid free: pimecrolimus and tacrolimus. These also seem to be safe for children under the age of two as well as older children and adults.
Whatever medications you and the doctor agree on, it is very important to take them as prescribed/instructed. Optimal benefits will not be seen if too few dosages (or incorrectly spaced doses) are used and side effects will be more pronounced and pose a risk to your child if you give too many doses or give them too close together.
Antibiotics and antihistamines are regularly prescribed for young children of all types, not just eczema patients. Both have proven safe through the sheer numbers of children who have taken them. Taking more antihistamine than has been prescribed is dangerous to your child, so be sure to watch this.
The most popular medication to control the symptoms of eczema are corticosteroids, which help with inflammation, itching, and redness. Since 1951, these medications have been used for eczema patients as well as those with other skin conditions.
The come in a cream or ointment and are applied to the surface of the skin on the affected area only. Side effects are usually only a factor with extended use of high potency corticosteroids. By using a lower dosage medication and following the doctor’s orders, there should be no problems.
Most dermatologists/pediatricians begin with the lowest dosage and work their way up to find the dose lowest dose possible that alleviates the symptoms. If the flare up is severe, a high-potency medicine may be prescribed for a very short while, usually just until the outbreak has calmed.
Calcineurin inhibitors are the newest form of topical medication, are steroid free, and work by keeping chemicals that cause inflammation, itching, and redness from being released into the skin. These medications are not recommended by the FDA for children under two years of age and are not advised for long term treatment. However, recent studies suggest that the medications can safely treat children under the age of two.
The 2005 decision by the FDA to require a black box warning (strongest FDA warning on medicine) on the labels of these medications has been strongly opposed by the American Academy of Dermatology in a highly unusual step.
In March 2005, the Academy president, said, The American Academy of Dermatology is disappointed that the FDA has taken this action, despite the fact that there is no data that proves proper topical use of pimecrolimus and tacrolimus is dangerous in people. These are valuable medications, and if used properly, they significantly reduce the debilitating impact of eczema and allow millions of our patients to live normal lives.
A final form of treatment may be the use of systemic steroids, although this is highly unusual in young children. The only reasons that this may occur is if complications with the eczema arise, such as a secondary infection which is not responding to treatment.
Systemic medications are medications which are taken into the body either orally or through injection. The use of systemic steroids is only done for a few days at a time with a high dose the first day and gradual lessening of dosage from the second day until the final day of treatment (usually 7 to 10 days). Over use or not following dosage instructions can lead to serious problems, so it is very important to follow the doctors orders.
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