Treating chronic eczema: The Healing Curve

author/source: DrB


With both the clinic-based and self-help formats, the Combined Approach to treating chronic atopic eczema combines optimised conventional treatment with habit reversal. For Adults and Older Children, the first four weeks of the treatment programme require three levels of treatment.

After these four weeks each level of treatment is reviewed and adjusted according to progress achieved:

Level One: Emollients       This remains vital as atopic skin tends to dry out. This leads to itch and inflammation: flare-ups can be prevented by the correct use of moisturisers. Rather than using an emollient in a routine manner, it is better to adjust the frequency of application according to need. Once all chronic eczema has healed the frequency may be less than before.

Level Two: Topical Steroids     For best results it is important to continue applying topical steroids beyond The Look Good Point. For chronic eczema this involves another one to two weeks to achieve hidden healing, reducing the possibilty of a flare-up on stopping the anti-inflammatory application.

Level Three: Habit Reversal      Use of the hand tally counter and habit reversal is usually no longer important once all eczema has obviously healed: scratching frequencies by now are usually in single figures and do not represent a risk of skin damage. From now on flare-ups will be treated using Level One and Level Two - Level Three is no longer required.

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