It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.
Pathologic phimosis is a common problem throughout the world. In Europe, Asia, South America, and Central America neonatal circumcision is not routinely performed, thus childhood phimosis is not rare. In addition, in the United States and Canada the rates of neonatal circumcision, estimated to be 60% to 90%, 5 are declining. 9 Thus, even in the United States and Canada, phimosis is a commonly faced problem. Obviously, one of the difficulties that arises when studying phimosis is the lack of a clear definition and differentiation between a pathologic phimosis and a physiologic nonretractile foreskin. 10 In our study, nonretractable and pinpoint prepuces correspond to type II and type I of the classification by Kayaba et al. 11 The cases classified as ''retractable'' phimosis might not be considered pathologic by others because of a potential for spontaneous resolution with increasing age. However, all patients included in our study were originally referred for circumcision, they all had a constrictive ring for which they had sought medical attention, and they would have been considered candidates for circumcision if topical therapy had not been offered. [CIRP note: These doctors show the common inability to distinguish between normal in childhood developmentally narrow foreskin and a pathological condition called phimosis.]
The doctor may suggest hospitalization simply because it may be necessary to break the cycle of chronic inflammation, or other problems that are exacerbating the illness. Frequently, five or six days of vigorous in-hospital treatment care can result in a dramatic clearing of the eczema. Food tests, allergy skin testing, and the development of an outpatient therapy plan can all be done during the hospitalization. Unfortunately, getting approval from insurers is often difficult. During an acute flare the number of 15-20 minute baths must be increased to three or four per day. Besides hydrating the skin, baths also increase the penetration of topical medication up to ten-fold if the medicine is applied immediately after the bath. Wet wraps after baths may also help hydration and medicinal penetration. Bedtime wet wraps are most practical, and can be done with elasticized gauze followed by ace bandages or double pajamas. (The first pair of pajamas is worn damp but not soaking wet, and a second pair of dry pajamas is worn over them. For a tighter fit, sometimes a plastic sauna suit is used instead of the dry pajamas.) For feet and hands, socks can be used. Additional blankets or increased room heat may be necessary during this three to seven days to prevent chilling.