Lichenification of eczema: the dilemma

Lichenification often occurs in people with eczema, it is a medical term meaning, "thickened skin." It can result from frequent scratching and rubbing of the skin which causes the skin to look red, leathery and feel itchy.

Mild lichenification around the ankle area.

My child's dermatologist in Singapore, recommends using potent topical corticosteroids such as Elomet Ointment (Mometasone 0.1%) and aqueous cream with wet bandaging which improves the absorption of the steroid into the skin, aiming to break the itch-scratch cycle. There are different sizes of bandages for arms, legs and the body which fit like a firm stocking on the skin. Placing a wet stocking over the skin may be uncomfortable at first but the treatment is highly effective.

Wet bandaging with application of topical corticosteroids and aqueous cream on affected area

Improvement of skin around ankle area after four days of treatment

Topical steroids are highly effective to control eczema and have an anti-inflammatory effect. The dilemma is that some health professionals believe the overuse of corticosteroids stunts growth and development, thins out the skin, causes stretch marks, easy tearing of the skin, enlarged blood vessels, localized hair thickness and easy bruising.

I don't believe any of these adverse side effects have affected my children dramatically. I was worried about applying the topical steroids especially on my son's face believing it may have a thinning effect.  He does sunburn easily, however I don't think there is a direct correlation due to overuse of steroid.

The peaceful sleep your child receives after a wet bandaging treatment cannot compare to the torture they experience due to the itch-scratch cycle of eczema keeping the whole family awake with their shouts of agony!

The dilemma continues to sleep...to itch...to treat...to heal!!