Our Therapy
If you or your child has eczema that keeps coming back despite creams, steroids and everything the internet suggested, this page explains a different approach and what it involves.
What is the Aron Regimen®?
The Aron Regimen is a way of treating severe and chronic atopic eczema developed by Dr Richard Aron, a dermatologist who spent decades working out why conventional treatment so often fails.
Rather than treating inflammation alone, it treats three problems at once, because in severe eczema all three are usually present:
Inflammation, which causes the redness, heat and itch
A damaged skin barrier, which lets moisture out and irritants in
Bacterial overgrowth, usually Staphylococcus aureus, which drives flares and keeps the cycle going
The treatment is a single compounded preparation containing a dilute topical steroid, a topical antibiotic and a large quantity of emollient, mixed together by a pharmacy and applied frequently across the affected skin.
The frequency and strength are adjusted for each patient over the first weeks, which is why regular review matters more than the prescription itself.
Why the bacteria matter
This is the part most people have never had explained.
Skin affected by atopic eczema is very commonly colonised with Staphylococcus aureus, far more so than healthy skin. The bacteria aren't necessarily causing a visible infection, but they contribute to the inflammation and help drive flares.
Treat the inflammation without addressing the bacteria and the improvement is often short-lived. That's the pattern most patients recognise: skin improves on steroids, then flares again within days of stopping.
By combining all three elements in one preparation, applied together, the regimen addresses inflammation and colonisation at the same time while repairing the barrier.
"Isn't that a lot of steroid?"
This is the question nearly every parent asks, and it deserves a straight answer.
The steroid in the compound is heavily diluted, far weaker than what's in the tube most patients have already been prescribed. It's mixed into a large volume of emollient, so although it's applied frequently and over larger areas, the concentration at any one point is low.
The usual pattern is that strength and frequency are stepped down as the skin improves, so most patients are using markedly less by a few weeks in than they were at the start.
Topical steroids do carry real risks, particularly with strong preparations used long-term on thin skin, and that's precisely why reviews are built into the treatment. Your skin is reassessed at two weeks, four weeks and then annually, to assess progress and to make treatment adjustments.
If you've been worried about steroid use, that worry is reasonable and it should be discussed properly at your consultation rather than dismissed.
What to expect, week by week
The first few days. Most patients apply the compound frequently, as directed. Some notice improvement within days; others take longer. A short period of worsening as heavily colonised skin settles isn't unusual.
The first two weeks. This is usually when the visible change happens: less redness, less weeping, and for many patients the first decent night's sleep in a long time.
The two-week review. An online review where the skin is reassessed and the effectiveness of the preparation is assessed
Weeks two to four. Frequency typically comes down as skin improves. Most patients are applying less than they started with.
The four-week review. The important one. By this point most patients have a clear sense of whether the regimen is working for them, and the plan moves towards maintenance with the lowest effective strength.
After that. Many patients manage with occasional use, stepping up briefly during a flare. An annual review keeps the treatment appropriate as skin changes.
Who it's for
The regimen is generally suited to people with:
Moderate to severe atopic eczema
Eczema that returns quickly after topical steroids are stopped
Frequent skin infections or courses of oral antibiotics
Eczema disrupting sleep, school or work
Children, including infants, using appropriately dilute preparations
It isn't right for everyone. Some skin conditions look like eczema but aren't, some patients have specific contraindications, and some are better managed with other treatments. That's what the consultation establishes.
How treatment works here
1. Book an online consultation. UK Patients - £180. Video from home, wherever you are in the UK. Photographs of the affected skin are required. (For USA Patients please go to the booking page for USA patients for pricing)
2. Assessment. Your history, what's already been tried, what's happening now, and whether this regimen is right for you.
3. Your prescription. If appropriate, a preparation is prescribed for you specifically and made up by a compounding pharmacy. Medication costs are separate from the consultation fee.
4. Reviews. At two weeks and four weeks, £100 each, and annually thereafter. These aren't optional extras. Adjusting the treatment is how it works. (For USA Patients please go to the booking page for USA patients for pricing)
Common questions
How much does it cost in total? The initial consultation is £180 and reviews are £100. The medication is prescribed and paid for separately through the compounding pharmacy. Most patients pay for the initial consultation, two reviews and medication in the first two months.
Do I need a referral from my GP? No. You can book directly.
Can you treat my baby? Yes. Infants are treated using very dilute preparations. Children make up a large proportion of the practice.
Where do I get the medication? The prescription goes to a compounding pharmacy that makes the preparation up for you. Details are given at your consultation.
Can I stay under my NHS dermatologist as well? Yes, and many patients do. It's worth telling them what you're using so everyone's working from the same information.
How long will I need to use it? Most patients use the compound frequently at first, then reduce substantially over the first month. There is no timeline for how long the compound is used for. Every patient is different. Our clinician guides you on your journey of tapering applications over time. Many settle into occasional use, stepping up briefly during a flare.
What if it doesn't work? By the four-week review it's usually clear. If it isn't working, that's discussed honestly and other options considered. Not every eczema responds to every treatment.
Is this available on the NHS? The individual components are ordinary treatments, but this specific compounded combination isn't routinely available on the NHS, which is why patients come privately.
Is it safe long-term? The regimen is designed to step down to the lowest effective strength, which is why reviews matter. Long-term use of strong topical steroids carries known risks, and the regimen's approach is to reduce steroid exposure over time, not to maintain it.
Your Questions Answered:
1. How long does the treatment last?
The AR should not be viewed in the same context as a course of oral steroids, antibiotics, immunosuppressants or phototherapy with a finite end point. It is a management programme for atopic dermatitis that consists of a specific treatment designed by Dr Aron (the compound cream) and a method of application that is guided by our clinician using clinical judgement and expertise.
2. Is this management therapy curative?
No, eczema cannot be cured. However, some patients achieve remission from the disease for extended periods of time - in some cases lifelong. The tendency towards atopic dermatitis will never disappear, nor will the potential to flare (albeit nothing like before therapy) if in contact with a trigger.
3. What is the ultimate goal of AR?
Management of the eczema - keeping the itch and rash suppressed and the skin healthy using a safe & minimal amount of medicine.
4. How do I start the AR treatment?
Contact Eczema-Doc via the links on this website to take you to the registration portal specific to where you live.
5. I've started the treatment but have questions - what should I do?
Any questions following the start of the treatment can then be either emailed to your prescribing doctor at no extra charge. You will be advised to book a follow up consultation a few weeks into the treatment to check on progress and make any necessary adjustments to the Regimen. Subsequent follow up consultations will be provided so that the Regimen can be adjusted to meet the ongoing clinical needs of the patient.
6. How long will I have to use the compound cream for?
This varies from patient to patient, just as the history, presentation and pattern of eczema varies widely between patients. Some will stop using the compound after six months, some a year. Some will see rapid results and be able to taper earlier on, some will be down to less than one application of compound per day within six months. Some will experience no flares or setbacks but many will. Some may experience long periods of remission and then return to the compound for a short spell, or for a longer maintenance period to get the skin back in check. Every patient is different. It is a marathon, not a sprint - however, there is one noticeable pattern - patients improve and use less & less of the compound over time. The eczema does not return to it's pre-treatment state.
7. Is the treatment suitable for babies / children & adults?
Yes, the compound is adapted to suit the age of the patient.
8. Are there case studies you can share?
Yes, our Dr Aron Eczema Treatment Discussion Group on Facebook has nearly 100k members. You will find many case studies with before and after pictures. Please follow the Facebook link at the bottom of this page.
9. Will the patient be able to go to the beach, or swim during treatment?
This will depend on the advice of your prescribing doctor. Many patients are now able to enjoy normal activities again such as swimming or beach exposure but those early on in treatment may be advised not to. Best consult with your prescribing doctor before doing so.
10. Will my NHS doctor prescribe the cream for me?
Once you have had your initial consultation and the compound has been prescribed, it may be possible to ask your NHS doctor for repeat prescriptions. We have a doctors pack available & are happy to send it to your GP who will decide whether or not they wish to support the treatment by prescribing the compound for you. The creams supplied by your GP will need to be mixed by yourself and we can supply with instructions on how to do this. However, we will still need to control the management of your treatment via follow up consultations, since this can only be done through an AR trained doctor.
12. Is AR only available in the UK?
No, there are trained AR doctors around the world. We are currently also consulting with USA patients on an advisory basis - we use a USA based prescriber to generate the prescription as our doctors are currently not licensed to prescribe in the USA. Patients outside of these regions should contact the Dr Aron Facebook Group for further information.
