Answer to Aron Advocates

The Aron forces are out in number and well versed in ranting and raving. Theirs is not well thought out science – just harmful ranting and raving. John Stuart Mill, a 19th century libertarian, would be proud of their defiant independent approach to self destruction. It is okay for them to continue in their own addictive process for the rest of their lives, but reprehensible to tell others to follow their lead. Mill wrote that man has free will and if the alcoholic wishes to drink so be it as long as he does not harm anyone else.

I will try one more time to explain steroid addiction to the ranters and ravers. I use mid strength steroids in mild early eczema patients for a few days and then stop – never applied on the face. If there is a recurrence of eczema – note not flare of redness, but recurrence of arm and leg rash then a few more days of therapy in 3-4 weeks, not sooner. Lubrication in between and sunshine exposure and maybe a drop more of steroid some time in the next few months if needed.

I never allow for red flaring and addiction. Those patients who come to me from other doctors are already red, needing more and more steroid and larger areas of the body are involved. That is called addiction – not mild eczema – the patients were not carefully monitored and addiction set in – no more steroids for them.

Mild eczema does not need body steroids and Dr. Aron’s rigamarole of wrappings harking back to Egyptian times like mummy treatments, nor should the totally discredited homeopathic approach of 150 years ago be utilized. All of these therapies are snake oil remedies with no real medicinal value yet promoted as a remedy for the “chronic or bad” eczema that these patients do not have! All Aron has to do for the mild eczema patient is a few days of an appropriate topical steroid, lubrication and sunshine.

The zealots who follow him and who have recently tried to vilify me need to open their eyes. If they want to be addicted for life that is certainly their choice, but leave the vast majority of suffering steroid addicted patients alone and stop advocating actions that will most certainly make them worse. Giving steroids to addicted patients is like giving alcohol to an alcoholic or sugar to a diabetic. Stop the madness!

About the Author: Dr Marvin Rapaport, MD

In 1978 I initiated and set up the contact and photo dermatitis clinic at UCLA. There was a need to evaluate a large group of patients who exhibited severe eczematoid rashes, especially on the face. Patients were referred from all over Southern California. All patients underwent a lengthy history and examination. Further evaluations included blood studies, allergy patch testing, special sunlight (photo) testing and skin biopsies. From the start it was apparent that most patients experienced a mild dermatitis on various parts of the body that progressively worsened. Their histories always included numerous doctor visits, multiple physicians, and therapy consisting of an increasing amount of corticosteroids. My testing failed to reveal any specific culprit chemicals, cosmetics, perfumes, workplace or recreational exposures. It became increasingly clear that the physician’s therapy, the corticosteroids, was invariably causing the problem. I wrote 7 scientific articles that were published in the most august peer-reviewed dermatologic journals and I gave many lectures at various dermatology meetings. To this day an unfortunate reluctance exists on the part of most physicians to accept this simple concept.