光學治療濕疹 徹底舒緩痕癢

Managing itch and infection

Itch  Sedating antihistamines do not treat eczema and have no anti-inflammatory effect; they may occasionally help a child sleep during a bad flare, but they are not a treatment.

Non-sedating antihistamines help only where there is coexisting urticaria or allergic rhinitis.

The only reliable way to control eczema itch is to control the inflammation. Practical measures that genuinely help: cool compresses, keeping nails short, cotton mittens for infants at night, keeping the bedroom cool, and habit-reversal techniques for entrenched scratching.

濕疹 痕癢 香港

Infection Treat overt bacterial infection with appropriate antibiotics, guided by swab where possible. Routine antibiotics for non-infected eczema are not helpful and promote resistance. Diluted bleach baths are commonly recommended; the evidence is honestly mixed — recent analyses suggest much of the benefit may come from bathing itself rather than the bleach. They are safe and some patients find them helpful, but they are not essential.

What to avoid

 

  • Restrictive elimination diets without proven allergy. These do not improve eczema, risk nutritional deficiency in children, and can cause food allergy by removing tolerance.

  • Unregulated herbal or "steroid-free" creams. Products marketed as natural have repeatedly been found to contain undeclared potent corticosteroids. Hong Kong's Department of Health has issued recalls on this basis. If a cream works dramatically and its ingredients are unclear, that is a reason for concern, not reassurance.
  • Stopping treatment as soon as the redness fades. Inflammation persists after visible redness settles; stopping early is why flares return within days.
  • Repeated courses of oral steroids.
  • Hot showers, however good they feel.

 

Step 1: Topical anti-inflammatory treatment

Step 2: Proactive maintenance (most often skipped)

Step 3: ＮB-UVB Phototherapy

Step 4: Conventional systemic treatment

Step 5: Biologics and oral JAK inhibitors

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.