Will my eczema worsen after I finish my antibiotic course?

Hello,

Welcome to icliniq.com.

I understand your concern.

Eczema is a condition that tends to recur again and again. In patients with recurring eczema, there is a defective skin barrier, which makes these patients prone to eczema. Also, your IgE (immunoglobulin E) levels are quite high, so you have an atopic tendency, which is why you are so prone to eczema. Also, any kind of stress, like any illness, surgery, or mental stress trigger eczema. Now, antibiotics in eczema are given when secondary bacterial infection develops, eczematous skin, so after stopping antibiotics, your eczema will not flare up, as antibiotics do not play a role in controlling the eczema. Now, Prednisolone is the best treatment option to control eczema, so you should complete the course of it. Then you can switch to a topical steroid cream. Now most important thing is how to prevent the recurrence of eczema. Always use mild soap to take a bath and use moisturizer on your skin. This is the most important step to control eczema.

After taking a bath, apply moisturizer on slightly wet skin and apply it at least two to three times daily. Buy a good ceramide-based moisturizer. Avoid deodorants and perfumes when possible. Do not apply directly on skin; apply to clothes. Take Primosa (high-strength Primrose oil) capsules once daily in the evening; this will help in maintaining the hydration of skin and will reduce the chances of eczema. When you finish your oral Prednisolone course, start applying Fluticasone cream for two weeks. Take one part of Fluticasone cream and nine parts of moisturizer, mix, and apply daily at night for two weeks.

I hope this helps.

Thank you.

Hello,Welcome back to icliniq.com.

I read your query and can understand your concern.

Prednisolone is given to control flare-ups of eczema. So continue that to control this flare. Steroids do not have major side effects when given for a short term, so do not worry.

There are common household irritants that may trigger eczema flares, like wool, synthetic fibers, soaps, detergents, cleaning supplies, dust and sand, cigarette smoke, etc. Some food allergen like milk, eggs, peanuts, wheat, soy, seafood, etc., can also trigger eczema in some patients, so you should keep observing whether these foods are causing flare-ups.

Any internal organ disease is unlikely to exacerbate your eczema, and a high eosinophil count in the blood is because of this atopic eczema. But since you are on so many medications, get your routine investigation done once. Complete blood count, liver function test, thyroid profile, done to rule out underlying thyroid disorder can also contribute to the flare of the disease.

Atopic eczema is a chronic condition with a high tendency to recur. There is no cure for this, but all preventive measures are important to keep it under control and prevent flare. When such patients present to me, I advise them about all preventive measures first, but even after following these measures, if the patient continues to get flare, then I start them on Azathioprine low dose for a long term.

So first, you complete this Prednisolone course to control this flare, and then follow all preventive measures. If you still get frequent flare-ups, then we will plan for Azathioprine, but not now. As I advised about all preventive measures before, also include these precautions.

Do not take hot showers as that causes damage to the oil barrier of skin and causes dehydration. Always apply sunscreen whenever you go out. Avoid stress. Now about IBS and gut microbiome test, you will have to talk to some good gastroenterologist for this. Also, share the photo so I can see how much improvement is there and suggest you further treatment accordingly.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.