Eczema is a frustrating condition because it does not "stay treated". You manage a flare, the rash settles for weeks or months, then a new trigger sets off another. Long-term success comes from understanding your specific triggers and maintaining barrier health between flares — not just chasing each rash with steroid cream. This page explains how we approach eczema at Derma Essence.
The two phases of eczema management
We treat eczema in two distinct phases:
- Active flare control — short courses of topical steroids or tacrolimus to bring inflammation down, plus oral antihistamines for itch
- Maintenance phase — daily moisturiser, trigger avoidance, twice-weekly tacrolimus to prevent flares (proactive therapy)
Patients who only treat flares (without maintenance) have repeated cycles. Patients who maintain barrier care between flares often go 6 to 12 months without a flare.
Treatment toolkit
Topical steroids — short courses
Mid-potency for body, low-potency (or steroid-sparing) for face and folds. Used for flares only, never long-term. We provide a step-down plan and rotation strategy to avoid skin thinning.
Tacrolimus / pimecrolimus (steroid-sparing)
Topical calcineurin inhibitors — safe for face and folds, no thinning risk. Twice-weekly proactive use significantly reduces flare frequency.
Daily ceramide-rich moisturiser
Non-negotiable foundation. Twice daily application, more during flares. We recommend specific products that work with Indian skin and climate.
Oral therapy or biologics (severe cases)
For moderate-to-severe eczema unresponsive to topicals: oral antihistamines for itch, occasional short prednisolone bursts, or dupilumab (biologic injection) for refractory cases.
Identifying your triggers
Common triggers we map on consultation:
- Environmental: dust mites, pet dander, pollen, weather change (winter is worst in NCR)
- Contact: harsh soaps, fragrances, wool, polyester sportswear, nickel jewellery
- Lifestyle: over-bathing, hot showers, swimming pools (chlorine), heated indoor air
- Stress: documented to worsen eczema. Sleep, exercise, mindfulness all help
- Food (children only): dairy, eggs, peanuts in some young children — confirm via allergy testing before eliminating
What works for kids
Paediatric eczema management is similar to adult but with adjustments: gentler topicals, parental education on bath routines, and emphasis on wet-wrap therapy for severe flares. Many children outgrow eczema by adolescence — but the atopic tendency often manifests as asthma or hay fever later.
Eczema needs an ongoing partnership rather than a one-time visit. Book a consultation for a structured trigger assessment and 3-month management plan.
