How Do You Know Which Additional Ingredients to Add to the LDN Cream for Itching and/or Eczema?

How Do You Know Which Additional Ingredients to Add to the LDN Cream for Itching and/or Eczema?

The next question is how do you know which additional ingredients to add to the LDN cream for itching and or ETR and or eczema? I'm not really sure at the ETR abbreviation is here. 

You want to look at the symptomatology of the patient.  Another tool you could use to determine which ingredient to add would be if there's a biopsy present.  We use this all the time in Durham.  Sometimes it's really difficult to look at a dermatologic presentation and know exactly what you're looking at because these disease states kind of morph and change over time.  People put treatments on them. They scratch it, they damage it, they do crazy stuff to it. They cover it with Silvadene creamer or you know Neutrogena or products and they just they get it all lathered up and it's hard to recognize.  So a biopsy is going to give you a lot of clarification. The dermatopathologist report will tell you if there's infiltrates like eosinophils so you know whether you want to put Montelukast in it or not.  They'll tell you if mast cells are infiltrating as well.  So you can tell a lot from that biopsy report as to what other actives might be beneficial and they'll give you a definitive diagnosis if they can as to what disease state it is so you'll know you know should I use a calcium inhibitor that is effective for the disease state or not.  

 Think you know presentation is one thing but symptomatology would tell you if there's inflammation involved you'll see it and the patient will tell you.  If its periodic they'll tell you.  You can ask them and they'll tell you.  So using mast cell stabilizers would be something I would use if they said that it itched really bad. So that'd be a good way to determine that one anyway.