There are different stages of eczema which play heavily into treatment. It is important to understand what the different stages are as certain treatments work better during different stages of a rash. The three stages of eczema are the acute stage, the subacute stage and the chronic stage. All three stages respond well to topical steroids and antihistamines like Benadryl and Zyrtec. That is why doctors prescribe you products including these. If the bacteria has invaded the skin during any stage, an oral antibiotic such as cephalexin or dicloxacillin is useful too.
“Acute” refers to the fact that the rash has just started. Some characteristics of acute eczema include:
- Extreme redness
- Intense itching
An over the counter hydrocortisone cream or antihistamine can be used to suppress the immune system. Antibiotics can be prescribed to reduce inflammation and treat infection. Eczema tends to be very intense during this initial phase, and in some cases, steroids are used.
The subacute stage is the transitional phase between the acute stage and chronic stages. The eczema rash evolves and takes on these new characteristics:
- Flaky, scaly skin
- Less redness
- Cracks in the skin
- Itching, burning and/or stinging
Symptoms are still present during the subacute stage, but they are much less intense than the acute stage. Moisturisers can be used to hydrate dry, flaky skin, coal tar can be used to relieve itching and antihistamines can be used to reduce inflammation.
Eczema doesn’t spend a certain amount of time in the subacute stage. Each case of eczema transitions from stage to stage differently. The chronic stage refers to eczema flares that last 3 or more months. Chronic eczema is quite different from the other two stages in the following ways:
- Thickened, leathery-looking skin, or lichenification
- Accentuated skin lines
- Cracks in the skin
- Skin appears dark and dull
- Larger areas of skin breakdown called excoriations
Symptoms are at their most severe during the chronic stage which affects the course of treatment. If over the counter products cannot ease the symptoms, prescription topical steroids can be used. They are often more effective when covered with a barrier such as plastic wrap. Keep using moisturisers regularly can also very helpful during this stage.