Dr Noreen Akram
How To Use Steroid Creams and Treatments For Eczema. [A Complete Guide]
Learn about steroid creams for eczema, their proper use, potential side effects, and alternative treatments.
What We'll Cover - Steroids and Eczema.
Key Takeaways
Steroid creams are effective for eczema treatment when used correctly, adhering to the Steroid Goldilocks Rule for proper timing and amount.
Steroid creams come in varying potencies. The chosen potency depends on the severity of eczema, treatment area, and patient's age.
A patch test before starting a new steroid cream can help identify potential allergic reactions.
Using the Proton Health app can support better personal management of eczema, tracking symptoms and treatment progress.
Introduction - Steroid Creams For Eczema
Welcome to our comprehensive guide on using steroid creams for eczema treatment safely and effectively. In this guide, we will explore the essential aspects of topical corticosteroids (TCS), including their proper use, timing, strength, amount, and potential side effects. Additionally, we'll touch upon alternative treatment options, the role of moisturisers, the importance of patch testing, practical application tips, proper storage guidelines, and a brief overview of oral steroid tablets.
Steroid Creams - What Are They?
Steroid creams, also known as topical corticosteroids, are an effective treatment option for eczema flare-ups. However, using them correctly is crucial to avoid potential side effects. Here are some important points to keep in mind when using steroid creams for eczema:
Timing is Key
The Steroid Goldilocks Rule recommends using steroid creams for 5-7 days on the face and neck, and a maximum of 14 days for the armpits and groin. Using steroids for too long or too short a period can be counterproductive.
Applying the Correct Amount
To use steroid creams effectively and safely, it's crucial to apply the correct amount. A finger-tip unit is the area taken up by your finger-tip and should be enough to cover an area the size of 2 palms, which is roughly the size of your whole face. Using more than this can lead to side effects, while using too little might not be effective in treating flare-ups.
Understanding Steroid Strengths
There are four different steroid potencies: Mild, Moderate, Potent, and Very Potent. The strength of the steroid prescribed will depend on factors such as eczema severity, the area being treated, and the patient's age. It's crucial to use the appropriate strength for the specific situation to achieve the desired results and avoid side effects.
Mild Steroids
Use: Sensitive areas like the face and neck.
Cautions: 5-7 days on the neck and 14 days elsewhere
Example: Hydrocortisone
Moderate Steroids
Use: Severe flare-ups on the face.
Cautions: 3-5 days on the face and neck, 14 days elsewhere.
Examples: Betamethasone Valerate, Eumovate, Triamcinolone acetonide.
Potent Steroids
Use: On the body, not the face and neck.
Cautions: 14 days maximum.
Example: Betamethasone full, Mometasone furoate.
Very Potent Steroids
Use: Eczema that hasn’t responded to other treatments.
Cautions: This is 1800x the strength of mild steroids, under expert supervision only.
Example: Dermovate, Clobetasol propionate
Importance of Patch Testing:
Before starting a new steroid cream, it's generally recommended to conduct a patch test. This involves applying a small amount of the product to a patch of skin, typically on the forearm, and observing for any adverse reactions over the next 24-48 hours. Patch testing can help identify any potential allergic reactions or sensitivities to the ingredients in the product, thereby preventing severe reactions on larger areas of skin.
Potential Side Effects Of Steroid Creams
Steroid creams can cause side effects if misused, but these are rare when used correctly. Local side effects include skin thinning, stretch marks, and changes in skin colour. Widespread side effects, more common in children, include adrenal gland suppression and failure to thrive. To minimise the risk of side effects, use the correct strength of steroids, avoid repeat prescriptions, and use the same preparation each time to avoid confusion.
Importance of Following Steroid Use Guidelines and Understanding Topical Steroid Withdrawal (TSW)
Following the proper rules for steroid usage is vital not only for the effective management of eczema but also to minimise potential harmful effects. One condition that may arise due to long-term steroid use, especially when discontinued suddenly, is Topical Steroid Withdrawal (TSW).
TSW can present with symptoms such as red, burning skin and severe itching. It's a complex issue that underscores the importance of correctly using steroids under the guidance of a healthcare professional. To further understand TSW, its causes, symptoms, and management strategies, we recommend reading our comprehensive guide on TSW. However, it's crucial to remember that any changes to your treatment plan, including discontinuing steroid use, should be done under the advice and supervision of your healthcare professional.
Practical Tips For Safe Steroid Use
Using steroid creams effectively requires attention to detail. Here are some practical tips to ensure you are getting the most out of your treatment:
Always wash your hands before and after application to ensure cleanliness and prevent spreading of germs.
Avoid applying the cream on broken or infected skin to prevent increased absorption and potential side effects.
Apply the cream gently in a thin layer, allowing it to be fully absorbed before putting on clothes.
Do not cover the treated area with bandages or other coverings unless advised by a doctor.
Avoid contact with eyes and mouth. If contact occurs, rinse thoroughly with water.
Do not use other skincare products on the treated area without consulting with your healthcare professional.
Discontinue use and contact your healthcare professional if you experience severe or unusual reactions.
Store your steroid creams in a cool, dry place, away from direct sunlight to maintain their efficacy. Always check the expiry date before use and discard any out-of-date creams. Keep the creams out of reach of children to prevent accidental ingestion or application.
By following these guidelines, you can use steroid creams safely and effectively to manage your eczema symptoms. Always remember that while these creams can be highly effective, they should be used under the guidance of a healthcare professional.
The Role of Moisturisers.
Moisturisers play a crucial role in managing eczema and can be considered a first-line defence against flare-ups. Regular application of moisturisers can help to maintain the skin's natural barrier, prevent dryness, reduce itchiness, and limit the penetration of irritants.
It's crucial to understand that moisturising is a fundamental part of eczema management that complements the use of steroid creams. When used together, they can significantly reduce the frequency and severity of flare-ups, potentially reducing the need for higher potency steroid creams. Steroids have been shown to lead to further skin dryness, so its important to moisturise more frequently when applying steroids.
Oral Steroid Tablets - When and How To Use Them
Oral steroid tablets, such as prednisolone, are typically prescribed for severe eczema cases or when topical applications have not yielded the desired results. These are powerful anti-inflammatory medications that can quickly control eczema flare-ups.
A typical course of oral steroids may last for 5-7 days, with doses varying based on the severity of symptoms, your age, and overall health condition. A healthcare professional will give detailed instructions regarding the dosage and timing, and it's crucial to follow these instructions strictly.
Here are some safety tips to consider when taking oral steroid tablets:
Take them as prescribed by your healthcare professional, typically with or after food to avoid stomach irritation.
Never abruptly stop taking oral steroids; doing so could lead to withdrawal symptoms. Your healthcare professional will guide you on how to gradually decrease the dosage.
Regularly communicate with your healthcare professional about your progress and any side effects you might be experiencing.
Store the medication in a cool, dry place, away from direct sunlight.
Keep the tablets out of the reach of children.
Always remember that oral steroid tablets are typically a short-term solution and not intended for long-term use due to the potential for serious side effects. As always, consult your healthcare professional for personalised advice and guidance.
Proton Health App - Your Personal Skin Coach
The Proton Health app can be an invaluable companion in your journey towards better eczema management. The app allows you to track your symptoms, document your flare-ups, and record your treatment progress. This can provide useful insights into triggers and the effectiveness of your current treatment plan, allowing for more personalised and effective management of your eczema.
Conclusion
Steroid creams are an effective treatment option for eczema flare-ups when used correctly. By following the Steroid Goldilocks Rule, applying the correct amount using the finger-tip unit, choosing the appropriate strength, and being aware of potential side effects, you'll be well-equipped to navigate eczema treatment confidently. Remember to consult your healthcare professional for personalised advice and guidance.
Always consult a healthcare professional and follow their advice on steroid strength and duration of use. By following their guidance, you can use steroid creams for eczema treatment safely and effectively.
