Allergies, Anaphylaxis, Eczema, Topical Steroid Withdrawal & Asthma

Top 10 Health Blogs 2022 Top 10 Health Blogs 2021 Free From Hero 2021 Top 10 Health Blogs 2020 Best Blogs Award 2020 20th in the Top 60 UK Health Blogs Best Free From Blog 2014
  • Home
  • About
    • In the news!
    • Advocate
    • Testimonials
  • Books
    • Anaphylaxis – The Essential Guide.
    • The Shape of Skin
  • TSW
  • Advertise
  • Discounts
  • Links
  • Contact
  • Subscribe

Eczema treatment pathway in the UK

16/01/2022 by Ruth Holroyd Leave a Comment

What are the current treatment pathways for adults with eczema? You might be surprised to know that there are actually no NICE guidelines for adults with eczema, so it’s no surprise doctors and dermatologist simply follow the protocols, that have not changed for far too long.

We all know are how outdated the current guidance can be and we need change.

What is the future for eczema treatment?

There is change coming, in the form of new treatments and more forward thinking about holistic solutions, talking therapy, diet and allergy testing. But what we also need is recognition that Topical Steroid Withdrawal is a real condition and furthermore, help, support and research to help those facing this condition.

topical steroids
Just a selection of the topical creams I was prescribed

You can read the NICE guidelines for eczema here.

Current treatment pathways for eczema in the UK

This is traditionally what will happen in the UK

  • Emollients – the first line if defence. Often starting with the cheapest, least effective alternatives. Push harder for options without paraffin and no preservatives. They do exist. Epimax do a paraffin free emollient. If you can afford to, try to incorporate some natural skin care products such as Balmonds and lyonsleaf balms. Click here for Discounts and Promo codes.
  • Topical Steroids – Beginning with the weakest, Hydrocortisone, and increasing the the strongest, Dermovate and Betnovate to name a few. For transparency I am no longer using any topical steroids. I stopped using them in January 2019 and have been in steroid withdrawal ever since.
  • Topical Immunosuppressants – (Tacrolimus) Elidel or Protopic for treating eczema, can work really well. I used it on my face for about five years but I think this is causing me the most challenges with healing after stopping using them in April 2019, I am still going through quite severe withdrawal three years later. You might be thinking, is it worth it for all the pain? Well it’s not always been like this, I have had periods of quite stable skin and almost normal life experiences but this healing isn’t linear it would seem. Read Protopic Withdrawal and TSW.
  • Immunosuppressants – Oral immunosuppressants such as ciclosporin, methotrexate, azathioprine and mycophenolate mofetil, can work well at supressing the immune response. I used methotrexate for about six months, a drug administered to cancer patients on much larger doses. It was highly monitored, you had to have regular blood tests and check the dose you took was correct each week. I was never happy using it and gave up when my immune system hit rock bottom and l it gave me shingles, the most hideous painful experience of my life, without a doubt. I decided I didn’t want to suppress my immune system any more and am choosing to heal naturally. It did improve my skin slightly but my dermatologist wasn’t really happy with the results. Perhaps it gave me an easier time during TSW, or maybe it just delayed healing, I’ll never really know.
  • Biologics – Dupixent (Dupilomab) –  for treating moderate to severe atopic dermatitis in adults. A biologic is a drug made from biological (living) sources like cells from humans, animals, plants, fungi or microbes. Biologic drugs are sometimes called “biologic response modifiers” because they change a process already occurring in cells or for a particular disease. In AD, new biologic drugs can modify the elevated immune response driving the disease. In my opinion this is STILL an immune suppressant, albeit perhaps more targeted. I’m not every so keen on what it’s made from either as I’ll bet it doesn’t say, ‘made from humans’ or ‘made from animals’ on the label. A vegan might not want to use this if it was derived from animals.

Less invasive treatments – if you’re lucky

These are often not offered by doctors or dermatologists unless patients push for them. The general thinking is that we all ‘just have eczema’ and that it’s not caused by anything. That it’s just random. This outdated now as we know that it can be triggered and exacerbated by many things, including contact and food allergens, skin care products, pollution, stress, alcohol and lifestyle, to name just a few. The following treatments may help you get the bottom of your skin journey but you’ll generally have to push and ask for them.

  • Patch testing
  • UVB therapy and PUVA phototherapy
  • Skin prick testing for allergies
  • Paste bandages and wet wraps.
  • Blood testing for allergies
  • Blood tests for vitamin, mineral deficiencies and other potential problems
  • Dietary advice
  • CBT Therapy

Future treatments and therapies

  • Topical Steroid Withdrawal Support – This isn’t available in many places. Guy and St Thomas’s London dermatology clinics has a High Acuity Day Centre, for anyone really struggling with help on wet wrapping, baths to help eczema, how to bandage wounds and rest and respite. Thanks to Olivia for telling me about this, they do and will push steroids and other mainstream treatments, but did listen to her and explain what else might help. She also had blood tests and was prescribed Folate, iron and vitamin D – I think these sort of tests are often overlooked and could help lots of people with eczema. On the whole though, there is nothing to support anyone going through Topical Steroid Withdrawal unless they wish to choose one of these new drugs to try. What I’d love to see is some kind of therapy and holistic support of some kind. It’s very hard doing it on your own. The medical profession also needs to see this condition under a microscope if it is ever to accept, understand and manage it in the future. I fear it is a problem that could grow in the future.
  • Tralokinumab: a new biological drug that is some time away from widespread release. This medication will be very similar to Dupixent, but where Dupixent blocks two targets, this new medication will only block one. To this point, the trials have been highly successful and promising.
  • Baricitnib – People with moderate to severe atopic dermatitis that has not responded to at least 1 systemic immunosuppressant are usually offered either dupilumab or best supportive care. Dupilumab does not always work, and some people stop taking it because of side effects.. Baricitinib is an alternative to dupilumab and best supportive care. It is likely to be offered alongside topical corticosteroids.
  • Targeting enzymes – A new class of medications to target enzymes: Pfizer is working on an oral medication that a person can take once each day to control eczema symptoms. If successful, this medication will target a new group of enzymes related to the inflammation that coincides with the condition
  • Cibinqo® (abrocitinib), from manufacturer Pfizer, has been approved by the U.S. Food and Drug Administration (FDA). Cibinqo is an oral Janus Kinase (JAK) inhibitor medication for adults (18+) living with refractory, moderate to severe atopic dermatitis (AD) whose disease is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable. JAK inhibitors can target one or more of these family members to block these immune signals and inhibit the inflammatory effect of key cytokines involved in AD.  Cibinqo works by selectively blocking JAK1 resulting in improvement in AD signs and symptoms.
  • Tezepelumab is currently in phase 2 studies and look at inhibition of t-cell activity .
  • New research into new antihistamines that work on a different histamine response and could help eczema itch more than the ones we currently have.
  • Bleach baths – there is some evidence that dilute bleach and similar chemicals can have anti-inflammatory properties on the skin. It’s an area that needs more work – one of those areas that’s included in old textbooks but which hasn’t been properly assessed. ( I really don’t like this one – how can bleach on the skin be good even in diluted quantities?)

There may be more treatments that I’ve not identified yet and I will update this blog as I find them. For instance, Red Light Therapy, which I’m trying at the moment (April 2024)

And please let me know if I’ve got anything wrong or missed anything off.

What do we need in the future? Are these future treatments better than what came before? Are they safer?

Further reading

Read A dermatologist discusses the future of eczema care here, By Jonathan Silverberg. He has set up a multidisciplinary treatment centre in America looking at allergists, neurologists and sleep specialists, in addition to board-certified dermatologists. Also visit his website at https://revolutionizingad.com/

Also Eczema Research Pipeline from the National Eczema Society

Related posts:

bandaging skin can help heal eczema20 tips for coping with an eczema flare up medical gaslighting dermatologistHow to respond to TSW and eczema gaslighting skin self care with jade roller20 Resolutions for eczema & TSW people!

Filed Under: Eczema, Topical Steroid Withdrawal Tagged With: different eczema treatments, eczema treatment pathway, future eczema treatments, future of eczema

About Ruth Holroyd

Author of 'Anaphylaxis: The Essential Guide: An Action Plan For Living With Life-Threatening Allergies' and 'The Shape of Skin, both available as paperback or Kindle on Amazon. Ruth is a Writer, Blogger and Patient Expert in allergies, asthma, anaphylaxis, eczema and topical steroid withdrawal.

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Welcome to my blog!

https://whatallergy.com/wp-content/uploads/2021/04/IMG_2853.mp4

Hello, I’m Ruth, author and blogger

Ruth

 

Hi I'm Ruth. I've grown up with eczema and multiple life-threatening allergies and collected more as I've got older.  It started with a peanut allergy and now I'm allergic to milk, wheat, soya and many more. In this blog I share tips, advice and things I've learnt living with allergies, asthma and eczema with a focus on topical steroid withdrawal. You can buy my books, which are brilliant by the way! The first is Anaphylaxis: The essential guide and the second, The Shape of Skin, healing poems for eczema and sensitive skin. The reviews speak for themselves. If you want to chat you can find me on Instagram, Facebook, Twitter and LinkedIn (links below). Do get in touch. And please comment on blogs, it makes a humble blogger do a little happy dance!

Subscribe today for Free Resources

Share and Connect

  • E-mail
  • Facebook
  • Instagram
  • Pinterest
  • Twitter
  • YouTube

Categories

Allergies Anaphylaxis Asthma Awards Coeliac Cold Sores Cooking Digestion Eating Out Eczema FreeFrom Awards Hay Fever Indoor Allergies Industry News Mental Health Natural remedies Nutrition Poetry Product Review Rant Recipes Restaurant Review Skin care Topical Steroid Withdrawal Travelling Vegan

The Shape of Skin – poetry for eczema

The Shape of Skin poetry for eczemaThe Shape of Skin

Strange, striking and sensitive poems for people with eczema, psoriasis, topical steroid withdrawal and troubled skin.

Readers comments include: "Powerful, relatable, Absolutely bloody fantastic (pun intended)..."

Buy it now on Amazon

Buy ‘The Anaphylaxis Guide’ Now

Anaphylaxis - the essential guideAnaphylaxis - The Essential Guide. An action plan for living with life threatening allergies.

"This book is such a great wealth of information and a delight to read! A must read for anyone with allergies or connected to an allergy sufferer. Congratulations!" Tanya Ednan-Laperouse, Natasha Foundation

Find out more

get help - in distress?

Pollen Free Flowers and Plants

Read my blog, "Allergen and pollen free, artificial plants for your home"Faux la fleur artificial pollen free plants

Please Review my book on Goodreads

Ruth Holroyd's books on Goodreads
The Reluctant Allergy Expert: How to kill the fear that anaphylaxis could kill you The Reluctant Allergy Expert: How to kill the fear that anaphylaxis could kill you
reviews: 3
ratings: 3 (avg rating 5.00)

Get Free Resources

Get Free Resources

  • Food, Mood and Symptoms Diary
  • Topical Steroid Withdrawal handout for doctors
  • Anaphylaxis Action Plan
  • 50 x Food Real Challenge
  • Eat the Rainbow Food Challenge
  • More coming soon!

Click here to Subscribe and you'll receive a link to download!

Follow What Allergy on TikTok

For even more hilarious content, check out my new TikTok account

tiktok logo

Chocolate, cake mixes & more – Top14 Free

Read my product review for Gnawbles, like Maltesers and Ferrero Rocher rolled into one.

Gnawbles freefrom top 14 allergens

Use Coupon Code WHATALLERGY10 FOR 10% OFF everything you buy!

Natural skincare for Eczema / TSW

Balmonds Natural SkincareBalmonds Natural Skincare - Use code: WHATALLERGY for 20% off

Testimonials

Find out why people love this blog!

“I think your blog is fab – I send it to everyone who has skin problems and allergies.” 
Sarah

Read more testimonials here.

Archives – Find old blog posts

Mental Health

Set intentions not resolutions for 2024

Why do we think eczema is ugly?

OMG! Me in a film on eczema and mental health

Eating Out

My coffee shop allergy – reacting to milk vapour?

Coeliacs and Vegans have it easy

Milk and wheat allergen free fish and chips

Asthma

Do you need Health Insurance for Allergies & Asthma?

Did Covid cause asthma and eczema flare?

What if you couldn’t have your Ventolin inhaler?

Copyright © 2025 · Terms Of Use · Privacy Policy

Copyright © 2025 · [footer_Privacy_Policy #"privacy policy"] Magazine Pro Theme on Genesis Framework · WordPress · Log in