Treatment for atopic eczema, topical steroids part 3
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What about side-effects of topical steroids?
Short courses of topical steroids (less than four weeks) are usually safe and usually cause no problems. Problems may develop if topical steroids are used for long periods, or if short courses are repeated often. The concern is mainly if strong steroids are used long-term. Side-effects from mild topical steroids are uncommon.
- Thinning of the skin is the most common possible problem. If skin thinning occurs it often reverses when the topical steroid is stopped.
- With long-term use of topical steroid the skin may develop permanent striae (like 'stretch' marks), bruising, discolouration, or thin spidery blood vessels (telangiectasia).
- Topical steroids may trigger or worsen other skin disorders such as acne, rosacea and perioral dermatitis.
- Some topical steroid gets through the skin and into the bloodstream. The amount is usually small and usually causes no problems unless strong topical steroids are used regularly on large areas of the skin. The main concern is with children who need frequent courses of strong topical steroids. The steroid can have an effect on growth. Therefore, children who need repeated courses of strong topical steroids should have their growth monitored.
What if treatment does not work?
See your doctor if a flare-up of eczema is getting worse or not clearing despite the usual treatments with emollients and topical steroids. Things which may be considered include:
- Should the strength of the topical steroid be increased?
- Are emollients being used often enough to keep the skin supple and moist?
- Has the inflamed skin become infected and needs an antibiotic?
- Allergy. Occasionally, some people become sensitised ('allergic') to an ingredient in a cream (such as a preservative which is included with the steroid or emollient). This can make the skin inflammation worse rather than better.
You may be referred to a skin specialist if a flare-up does not improve with the usual treatments.
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pat banfield, over 2 years
My husband has sufferd from eczema from childhood 4years ago he was cementing a path for a friend after this he developed blisters on his feet which broke and left a bloody crust which in turn left extremly itchy dry skin,as one says if you have an itch scratch it well he did this left him with an infection so he had to have antibiotics. The problem gets better for say a couple of weeks then the whole thing appart from infection starts all over again,he has tried all sorts of alternative therapy nothing worked and costs the earth but then my husband is not a patient man he wants results right away. I have found this article of extreme help and will try some of the suggestions. Thank you for such an interesting article.HERE GOES!!
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