Parents often ask me how long hormone ointment can be used, This is actually a very difficult question to answer, because it needs to be based on the medical history of different babies and the severity of the condition. After comprehensive evaluation, different drugs and courses of treatment are used. I will write down the evaluation process first. Parents who still have questions, welcome to ask questions in the live broadcast room at 9 o’clock tonight.
Assessment
1. History of eczema
2. Scope of skin lesions
3. Severity
4. The impact of eczema on quality of life and family burden
Principles
1. Heavy moisturizing: use a sufficient amount of moisturizing moisturizer several times a day
2. Avoidance: Avoid triggering or aggravating factors
3. Use the right medicine: standardize the use of hormone ointment
Mild eczema
Low-effect hormone ointment once a day for 2-4 weeks
Reassess in 2-4 weeks
If improved (eczema subsided/almost subsided/ eczema is smaller or less itchy ), continue to use moisturizing emollients and intermittently use low-efficiency hormone ointments.
If No Improvement, then
1. Continue to use low-efficiency hormone ointments or switch to ointments such as tacrolimus or criborole
2. Assess medication compliance and find predisposing factors
3. Assess and treat infection (eg, short-term mupirocin ointment)
Moderate or severe eczema
Use moderate to high-efficiency hormone ointment once or twice a day for 2 to 4 weeks. Use low- or medium-acting hormone creams or creams such as tacrolimus on the face, neck, and skin folds.
Reassess in 2-4 weeks
If improved (eczema subsided/almost subsided/ eczema is smaller or less itchy ), hormone creams or tacrolimus creams are used two consecutive days a week (for example, two days on weekends).
If No Improvement, then
1. Continue to use hormone ointments or switch to ointments such as “tacrolimus” or “criborole”
2. Assess medication compliance and find predisposing factors
3. Assess and treat infection (eg, short-term mupirocin ointment)
Reassess in 2-4 weeks
If improved (eczema subsided/almost subsided/ eczema is smaller or less itchy ), continue to use hormone creams or tacrolimus creams two consecutive days a week (such as two days on weekends).
If not improved
Infants and young children should use dry or wet gauze soaked in moisturizing agent or low-efficiency hormone ointment for short-term wet compresses.
In adults and children over 12 years of age, consider phototherapy or short-term use of systemic immunosuppressants (eg, cyclosporine), or consider dupilumab as an alternative to systemic immunosuppressants.
After discontinuation of phototherapy or tapering of systemic immunosuppressants, resume moderate-strength hormonal creams once or twice daily until symptoms stabilize.
Continue maintenance therapy with steroid cream or tacrolimus two days a week in a row.
Additional Instructions
3. Evaluation of the severity of eczema
Mild eczema — Localized dry skin, infrequent itching, little impact on daily activities, sleep, and mental health.
Moderate eczema – Localized dryness, frequent itching, redness with or without scaling and localized thickening of the skin, significant impact on daily activities and mental health Moderately affected, sleep is often disturbed.
Severe eczema – Extensive dry skin, persistent itching, redness with or without scaling, thickening, bleeding, oozing, cracking, pigmentation Calmness, which has serious implications for daily activities and mental health, and sleeplessness at night.
4. Drugs
1. Criborole is approved to treat mild to moderate eczema in children and adults over 2 years of age.
2. Dupilimumab is approved for the treatment of moderate to severe eczema in children and adults over 12 years of age uncontrolled by topical creams.
3. The medical term for recurrent eczema is atopic dermatitis, so eczema is equivalent to atopic dermatitis in this article.
Clinical content is for professional reference only
Reference: UpToDate
⏰ 9pm-10pm tonight