Treatment.—The treatment of eczema puzzles a physician, and only specialists in skin diseases are able easily to diagnose the subacute or chronic forms. It may appear different, and need different treatment almost from day to day, and consequently only general suggestions can be made for home management of a case of this disease.
The outlook is always good; and even in the case of weak and debilitated patients, there is excellent chance of cure.
The diet must be regulated at once. Meat should be eaten in small quantities once a day only, and none but very digestible meats should be eaten, as fowl, beef, and lamb. Sugar and sweet food need be cut down only when there is indigestion with a production of gas. Fresh air and exercise are imperative. Five grains of calomel, at night, followed by one heaped tablespoonful of Rochelle salts dissolved in a full tumbler of water the next morning before breakfast, should be repeated twice a week till marked improvement is seen. Meanwhile, external treatment must be pushed.
Generally speaking, ointments must not be used on weeping or exuding surfaces; all scales and crusts must be removed from the surface; and acute patches must be soothed, chronic patches stimulated. Water is harmful and increases the trouble; but it is necessary to use it once, in cleansing the affected area, in the form of soap and water. If there are thick, adherent crusts, a poultice of boiled starch, covered with a muslin cloth, will loosen them in a night. Thickened or horny layers on the palms and soles may be covered with salicylic plaster (ten per cent strength), which is removed after two days, and the whole part soaked in warm water, when the horny layer is to be peeled off. Thickened surfaces are best treated with wood tar, in the form of oil of cade ointment, or the "pix liquida" of the drug shops mixed with twice its amount of olive oil. This should be well rubbed into the affected part.
Seborrheic eczema of the scalp and neighboring areas is best treated with a four per cent ointment of ammoniated mercury, rubbed in once a day for five days, followed by the application of a solution of resorcin in water, four grains to the ounce. Weeping and exuding patches should be treated with powdered stearate of zinc, or oleate of bismuth, or aristol, either one dusted on till the area is fairly covered. When the surface begins to dry up, the following paste may be applied:
| Salicylic acid | 5 to 15 grains |
| Zinc oxide | 2 drams |
| Powdered starch | 2 drams |
| Vaseline | 1 ounce |
If weeping returns, stop the ointment and resume the powder treatment, or use the following lotion:
| Zinc oleate | 1 dram |
| Magnesium carbonate | 1 dram |
| Ichthyol | 1/2 ounce |
| Lime water | 4 ounces |
When the skin after scaling off becomes thin, all swelling having disappeared, lead plaster is of service, or diachylon ointment twenty-five per cent, made with olive oil.
An eczema of moderate extent should recover after four to six weeks' treatment, unless the soles or palms be attacked, when six or more months of treatment may be necessary.