What if treatment does not work?

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See your doctor if a flare-up of eczema is getting worse or not clearing despite the usual treatments with emollients and topical steroids. Things which may be considered include:

Should the strength of the topical steroid be increased?
Are emollients being used often enough to keep the skin supple and moist?
Has the inflamed skin become infected and needs an antibiotic?
Allergy. Occasionally, some people become sensitised ('allergic') to an ingredient in a cream (such as a preservative which is included with the steroid or emollient). This can make the skin inflammation worse rather than better.

You may be referred to a skin specialist if a flare-up does not improve with the usual treatments.

Other treatments

Tacrolimus ointment and pimecrolimus cream are new treatments introduced in 2002. They work by suppressing some cells involved in causing inflammation. (They are 'topical immunomodulators'.) They are not steroids. They seem to work well to reduce the skin inflammation of eczema. At present they are licensed for use in people aged two years and over who have eczema which is not controlled very well with usual treatments. The long-term safety of these new products is still being evaluated.
Antibiotics are sometimes prescribed if eczema patches become infected.
Hospital treatment is sometimes needed for severe cases. Treatments which are sometimes used include: 'wet wraps', tar and/or steroid occlusion bandages, light therapy, and immunosuppressive medication.
Tar shampoos are useful to lift scale from affected scalps.

'Alternative' remedies are sometimes tried by some people. There is little proof that any alternative treatment helps. But, turning to these remedies is understandable if conventional treatments fail to control severe eczema. Beware of extravagant claims of success which cost large amounts of money.