光學治療濕疹 徹底舒緩痕癢

痕癢與感染的處理

痕癢  鎮靜性抗組織胺並不治療濕疹，亦無抗炎作用；在嚴重發作期或可幫助兒童入睡，但它不是治療。

非鎮靜性抗組織胺僅在同時患有蕁麻疹或過敏性鼻炎時有幫助。

控制濕疹痕癢唯一可靠的方法，就是控制炎症。 真正有幫助的實際措施包括：冷敷、剪短指甲、嬰兒夜間戴棉手套、保持睡房涼爽，以及針對根深柢固搔抓習慣的習慣逆轉訓練。

濕疹 痕癢 香港

感染 明確的細菌感染應使用適當抗生素，盡可能以細菌培養結果指導用藥。對未受感染的濕疹常規使用抗生素並無幫助，並會助長抗藥性。稀釋漂白水浴是常見建議，但證據坦白說並不一致——近期分析顯示，當中大部分益處可能來自浸浴本身而非漂白水。此法安全，部分患者覺得有用，但並非必要。

應避免的做法

  • 在未證實過敏的情況下嚴格戒口。 這不會改善濕疹，會令兒童面臨營養不良風險，更可能因失去耐受而誘發食物過敏。

  • 未受規管的草本或「不含類固醇」乳霜。 標榜天然的產品，屢次被驗出含有未申報的強效類固醇，香港衞生署亦曾就此發出回收公告。若一支乳霜效果驚人而成分不明，這是值得警惕的理由，而非安心的理由。
  • 紅色一退就停藥。 可見的泛紅消退後，炎症仍然存在；過早停藥正是發作在數天內捲土重來的原因。
  • 反覆使用口服類固醇療程。
  • 熱水淋浴，無論當下有多舒服。

第一級治療: 外用抗炎治療

第二級治療: 主動維持治療(常被忽略)

第三級治療: 窄頻NB-UVB 光療

第四級治療: 傳統系統性治療

第五級治療: 生物製劑, 口服JAK抑制劑

Reference:

  1. Davis DMR, Drucker AM, Alikhan A, et al. AAD guidelines of care for the management of atopic dermatitis in adults with topical therapies. J Am Acad Dermatol. 2023.
  2. Sidbury R, Alikhan A, Bercovitch L, et al. AAD guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies. J Am Acad Dermatol. 2023.
  3. Guidelines Development Panel of the Hong Kong College of Paediatricians. Management of Atopic Dermatitis in Children: 2020 Review. HK J Paediatr. 2021;26:42-57. — the key local reference; cite this prominently.
  4. Wollenberg A, Kinberger M, Arents B, et al. EuroGuiDerm guideline on atopic eczema. J Eur Acad Dermatol Venereol. (most recent update).
  5. National Institute for Health and Care Excellence. Atopic eczema in under 12s: diagnosis and management. CG57.
  6. Leung R, Wong G, Lau J, et al. Prevalence of asthma and allergy in Hong Kong schoolchildren: an ISAAC study. Eur Respir J 1997.
  7. Childhood Wheeze, Allergic Rhinitis, and Eczema in Hong Kong: ISAAC Study from 1995 to 2015. — source of the 21-year local trend data.
  8. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology 1993;186:23-31.
  9. Efficacy and Safety of Lebrikizumab in Combination With Topical Corticosteroids in Adolescents and Adults With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial (ADhere). JAMA Dermatol.
  10. ARCADIA 1 and ARCADIA 2 — two identically designed pivotal phase III trials enrolling more than 1,700 patients, evaluating nemolizumab administered subcutaneously every four weeks versus placebo with background topical corticosteroids.
  11. Sanofi. Press release: decision not to submit amlitelimab in atopic dermatitis for global regulatory reviews. Paris, 24 July 2026.
  12. Simpson EL, Bieber T, Guttman-Yassky E, et al. Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis (SOLO 1 and SOLO 2). N Engl J Med. 2016.
  13. Chalmers JR, et al. BEEP trial: daily emollient during the first year of life for preventing atopic dermatitis. Lancet. 2020. — the negative prevention trial cited in the article.
  14. Hong Kong Drug Office, Department of Health — verify local registration status of every systemic agent named.