Generally speaking, ointments must not be used on weeping or exuding
surfaces; all scales and crusts must be removed from the surface; and
acute patches must be soothed, chronic patches stimulated. Water is
harmful and increases the trouble; but it is necessary to use it once,
in cleansing the affected area, in the form of soap and water. If
there are thick, adherent crusts, a poultice of boiled starch, covered
with a muslin cloth, will loosen them in a night. Thickened or horny
layers on the palms and soles may be covered with salicylic plaster
(ten per cent strength), which is removed after two days, and the
whole part soaked in warm water, when the horny layer is to be peeled
off. Thickened surfaces are best treated with wood tar, in the form of
oil of cade ointment, or the "pix liquida" of the drug shops mixed
with twice its amount of olive oil. This should be well rubbed into
the affected part.
Seborrheic eczema of the scalp and neighboring areas is best treated
with a four per cent ointment of ammoniated mercury, rubbed in once a
day for five days, followed by the application of a solution of
resorcin in water, four grains to the ounce. Weeping and exuding
patches should be treated with powdered stearate of zinc, or oleate of
bismuth, or aristol, either one dusted on till the area is fairly
covered. When the surface begins to dry up, the following paste may be
applied:
Salicylic acid 5 to 15 grains
Zinc oxide 2 drams
Powdered starch 2 drams
Vaseline 1 ounce
If weeping returns, stop the ointment and resume the powder treatment,
or use the following lotion:
Zinc oleate 1 dram
Magnesium carbonate 1 dram
Ichthyol 1/2 ounce
Lime water 4 ounces
When the skin after scaling off becomes thin, all swelling having
disappeared, lead plaster is of service, or diachylon ointment
twenty-five per cent, made with olive oil.
An eczema of moderate extent should recover after four to six weeks'
treatment, unless the soles or palms be attacked, when six or more
months of treatment may be necessary.
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