Dawn M.R. Davis, MD, highlights what factors dermatologists should consider when weighing the different options for a eczema treatment plan, including the importance of emphasizing patient quality of life.
Dr Davis is a professor of pediatric and adolescent medicine and professor of dermatology as well as division chair of clinical dermatology at Mayo Clinic in Rochester, MN.
Transcript
Dr Davis: With regards to quality of life and body surfaces that are involved with dermatitis, there are a couple of factors to consider. Firstly is feasibility and palatability of the suggested medications. It's difficult to get certain formulations of topical products onto particular areas of skin. For example, it can be quite challenging to put an ointment on the scalp if the patient has a lot of hair, and a solution, liquid or lotion, may be preferred. However, based on the additives of those products, they can tend to sting more and an ointment may be preferred for palatability.
Similarly, if the skin on the face is raw, patients may feel very particular about what formulation of product they can tolerate for use on the skin. Be mindful that sometimes when the skin is inflamed and raw, it will require a couple of days of being patient in practicing sensitive skin care and starting a treatment regimen, regardless, before the skin will start to feel better, despite treatment with an appropriate-level topical and emolliation in sensitive skin care.
Other things to keep in mind include the practicalities of the patient's lifestyle, such as insurance coverage and cultural considerations. Certain populations may have concerns about particular side effects, real or perceived, regarding particular medications. They may also have insurance formulary restrictions with regards to the types of medications that are covered or might have geographic constraints or distribution concerns with regards to obtaining topical medicines of choice.
It's very important to inquire to your patient and their caregivers their activities of daily living, their lifestyle habits, their family unit structure, logistical concerns, such as insurance, and also cultural sensitivities that may help determine or clarify which treatment options are best for your patient.
