Eczema treatments:

The new immunomodulators, Protopic (Tacrolimus) and Elidel (Protacrolimus) have been found to be safe and effective in treating young children with eczema. One of the benefits of using this class of topical agents is that unlike topical corticosteroids (topical steroid creams, lotions and ointments), these newer agents do not thin the skin and can be used without fear of developing telangiectasias (new blood vessels). They are approved in children as young as 2 years of age. Protopic is an ointment and Elidel is a cream. These drugs can be used alone, in combination with the topical steroids (to decrease the amount of corticosteroids the child is exposed to = steroid sparing) or in combination with each other (an ointment at night and cream during the day).

Why do treatments fail?

It is very important that the patient and the family or caregivers understand how to use medications, both systemic (taken by mouth) or topical. Treatment regimens may not be unusually difficult, however, they can be complex and require understanding of how and what to administer and when. Compliance (using the medication as prescribed) and adherence to the regimen are of the utmost importance.

Treatment for Vitiligo (loss of pigment):

This can be a very disturbing psychological disease, especially in people of color. Depression, loss of self-esteem, embarrassment, and appearing different from peers can all cause devastating psychological effects. There are many treatments for this disease, none of which are perfect or without side-effects. Medical therapies for this disease include:

1. topical steroids
2. systemic steroids
3. topical photochemotherapy (PUVA)
4. oral photochemotherapy (PUVA)
5. phototherapy (narrow band UVB or broad band UVB)
6. Dovonex (Calcipotriol)
7. immunomodulators (Tacrolimus [Protopic] and Pimecrolimus [Elidel])
8. tar products
9. chemical depigmentation
10. targeted light therapy
11. cosmetic cover-ups (i.e.: Dermablend)

Choosing a therapy should take into consideration the extent of the disease, the age of the patient and whether the disease is stable or progressing. Routine laboratory work should be obtained to rule out any underlying systemic disease which could be the cause of the vitiligo (I.E.: Thyroid disease). Monotherapy and/or combination therapies have been shown to be effective when the disease is diagnosed early and treated early on in the course of the illness. There is no right or wrong therapy, and treatment should be individualized based on the patient's extent of disease and areas to be treated.

This should be used only for information and not in place of a visit to the dermatologist. For additional information, please consult the National Vitiligo Foundation and/or American Academy of Dermatology's website.