Asteatotic Eczema Medication

Updated: Aug 07, 2019
  • Author: Christina K Anderson, MD; Chief Editor: William D James, MD  more...
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Medication

Medication Summary

Topical steroid ointments with 24- to 48-hour occlusion with polyethylene or Unna boots are the treatment of choice for the rapid resolution of asteatotic dermatitis. [13] Unna boots with steroid cream or ointment add to therapeutic efficacy and ease of care, especially in the nursing home population. Boots can be left intact usually for 3-5 days. Many patients heal with mild topical steroids (class III-VI) alone, depending on the severity of the dermatitis, the patient's compliance with treatment, and the reduction in the use of soap and hot water to the involved areas. Several studies have reported on the successful use of pimecrolimus or tacrolimus cream in conditions other than atopic dermatitis, including seborrheic dermatitis and asteatotic eczema, among others. However, more research is needed to clarify the role of topical calcineurin inhibitors in treating these other disorders. [14, 15, 16]

The liberal use of moisturizers, especially petrolatum-based preparations, alone or in combination with topical steroids for mild cases of asteatotic dermatitis is recommended.

The soak-and-smear method of hydrating the skin by bathing or soaking the affected area followed by immediate application of steroid ointment once daily has been shown to clear more that 90% of patients in 4-14 days. This is best performed at night. [12]

Note that steroids can thin the cutaneous barrier and lower the threshold for further insults that lead to dermatitis, especially in elderly patients.

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Topical steroids

Class Summary

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.

Triamcinolone (Aristocort)

Triamcinolone is for inflammatory dermatosis responsive to steroids; it decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability. Triamcinolone is available in ointment (0.1%) and cream (0.025%, 0.1%, 0.5%).

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