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Coping with difficulties: Adults & Older Children

publication date: Apr 11, 2012
author/source: DrB
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The Combined Approach to atopic eczema has proved successful for many, but it is certainly not succesful for all who have used it. For a very few there may be important difficulties because of marked sensitivities or allergies. This is more often found amongst the very young. Even so, the approach can still improve matters, and in youngsters there is the important possibility that, with time passing, the results of the approach will be more successful.
There are also those who refuse to use topical steroids, fearing possible side effects: without the use of an appropriate
anti-inflammatory treatment at Level 2, the results of The Combined Approach are unlikely to be optimal.
Otherwise, those who do not benefit from The Combined Approach often fall into one (or more) of the following three categories:


a) Those who have difficulty giving the treatment programme enough priority
The approach is a programme of activity and requires some effort and time: if necessary this needs taking into account when deciding when to use the programme.

b) Those who have difficulty understanding the programme
It is important that allowance is made for each individual's way of understanding and learning what is involved: the standard approach is not optimal for all.

c) Those who have difficulty giving up "living with eczema"
After many years with any disability attitudes and behaviour can become entrenched such that circumstances serve to maintain the disability even when ways of improving matters become newly available.

Evidently these are not three entirely separate explanations for difficulties: there is some overlap. Each are discussed in more detail in our book Atopic Skin Disease : 4.6 pp 83-86

The behavioural approach to difficulties in using a programme such as The Combined Approach should always include review of current cicumstances. As things change in the life of the individual, there may be opportunities for succesful therapy later, even when previously all hopes of success seemed out of the question.

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