Althea Cream for Eczema/Dermatitis
I cannot locate any evidence for "Althea cream" as a recognized treatment for eczema or dermatitis in the medical literature, FDA drug labels, or clinical guidelines provided. If you are seeking treatment for eczema or dermatitis, I strongly recommend using evidence-based topical corticosteroids as first-line therapy, which are the mainstay of treatment with overwhelming high-quality evidence supporting their efficacy and safety.
Evidence-Based Treatment Approach for Eczema/Dermatitis
First-Line Treatment: Topical Corticosteroids
Topical corticosteroids are the mainstay of treatment for atopic eczema and should be your primary therapeutic choice 1. The 2023 American Academy of Dermatology guidelines provide high certainty evidence with a strong recommendation for their use 1.
Selecting the Appropriate Potency
Mild eczema (Grade 1): Start with hydrocortisone 1% cream applied 3-4 times daily to affected areas 2. This is FDA-approved for temporary relief of itching associated with eczema 2.
Moderate eczema (Grade 2): Use medium-potency corticosteroids such as prednicarbate cream 0.02% or hydrocortisone butyrate 1. Apply twice daily initially 1.
Severe eczema (Grade 3): Escalate to potent corticosteroids like betamethasone dipropionate 0.05%, which demonstrates 94.1% good-to-excellent clinical response versus 12.5% with placebo 1. Very potent options include clobetasol propionate, achieving clear/almost clear skin in 67.2% versus 22.3% with vehicle 1.
Application Strategy
- Use the least potent preparation required to control the eczema 1
- Apply no more than twice daily; once daily may be sufficient for potent corticosteroids 1
- Stop for short periods when possible to minimize adverse effects 1
- For children under 2 years, consult a physician before use 2
Maintenance Therapy to Prevent Relapses
After achieving control, use intermittent medium-potency corticosteroids (fluticasone propionate 0.05%) twice weekly to prevent flares 1. This approach reduces relapse risk 7-fold (95% CI: 3.0-16.7; P < .001) with low adverse event rates 1.
Essential Adjunctive Measures
Skin Hydration and Barrier Protection
- Use emollients liberally after bathing to provide a surface lipid film that retards water loss 1
- Bathe with soap-free cleansers or dispersible cream as soap substitute 1
- Apply urea- or glycerin-based moisturizers for dry skin 1
- Avoid hot showers and excessive soap use 1
Irritant Avoidance
- Avoid woolen clothing next to skin; cotton is preferred 1
- Keep nails short to minimize trauma from scratching 1
- Avoid extremes of temperature 1
Managing Pruritus (Itching)
- Sedating antihistamines (diphenhydramine, clemastine) provide short-term relief during severe pruritus, primarily through sedative properties 1
- Use at night to minimize sleep disturbance; avoid daytime use 1
- Non-sedating antihistamines have little value in atopic eczema 1
- Polidocanol-containing creams can soothe pruritus 1
Treating Secondary Bacterial Infection
If crusting or weeping is present, suspect bacterial infection 1.
- Flucloxacillin is the most appropriate antibiotic for Staphylococcus aureus (the commonest pathogen) 1
- Use erythromycin for penicillin allergy or flucloxacillin resistance 1
- Treat for at least 2 weeks 1
Alternative Topical Anti-Inflammatory Agents
If corticosteroid concerns exist or as adjunctive therapy:
- Topical calcineurin inhibitors (tacrolimus 0.1%, pimecrolimus 1%) can be used in conjunction with corticosteroids 3, 4
- Crisaborole 2% and ruxolitinib 1.5% are newer FDA-approved options but are cost-prohibitive for most patients 3, 4
- Note: Tacrolimus 0.1% and crisaborole 2% have higher rates of application-site reactions compared to corticosteroids 4
Critical Safety Considerations
Short-Term Corticosteroid Use (Median 3 weeks)
No evidence of increased skin thinning with mild, moderate, potent, or very potent corticosteroids used short-term 4. Application-site reactions are least likely with corticosteroids compared to other topical anti-inflammatories 4.
Long-Term Corticosteroid Use (6-60 months)
- Increased skin thinning observed with mild-to-potent corticosteroids versus calcineurin inhibitors 4
- Risk of hypothalamic-pituitary-adrenal axis suppression with prolonged continuous use of high-potency corticosteroids on large surface areas 1
- Minimize periocular steroid use due to unclear association with cataracts/glaucoma 1
Common Pitfalls to Avoid
- Undertreatment due to steroid phobia: Explain benefits and risks clearly to improve adherence 1
- Using potent/very potent corticosteroids for extended periods: Reserve for severe disease and limit duration 1
- Applying more than twice daily: Does not improve efficacy and increases adverse effect risk 1
- Ignoring secondary infection: Failure to respond to treatment may indicate bacterial or viral superinfection 1