Topical steroids used for eczema

Topical corticosteroids withdrawal (sometimes called “topical steroid addiction” or “Red Skin Syndrome”) appears to be a clinical adverse effect that can occur when topical corticosteroids are inappropriately used or overused, then stopped. It can result from prolonged, frequent, and inappropriate use of moderate to high potency topical corticosteroids, especially on the face and genital area, but is not limited to these criteria. In reviewing the studies that were used for the systematic review, it is thought that adult women who blush easily are a population particularly at risk. Very few cases have been reported in children, but no large-scale studies have attempted to quantify the incidence. Thus, continued vigilance and adherence to a safe, long-term treatment plan developed in conjunction with your dermatology provider is advised.

Many people are concerned about using topical corticosteroids because they have read or heard about these treatments from a range of sources including friends, family, the internet, media and even healthcare professionals such as pharmacists and general practitioners. It is important to remember that side effects predominately relate to high doses of systemic or topical steroid treatment in people who are seriously ill. In fact, topical steroids can be used for long periods with complete safety as long as you understand what strength to apply, how often to apply the treatment, how much to apply and how long to continue the treatment . It is a mistake to be too cautious about using topical steroids as sometimes this can mean that your skin condition may be inadequately managed and you then might need a stronger medication such as a tablet, for a longer time to get the disease under control. In general, topical treatments are considered safer than systemic (oral) treatments.

The following local adverse reactions are reported infrequently when topical corticosteroids are used as recommended. These reactions are listed in an approximately decreasing order of occurrence: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae, and miliaria. Systemic absorption of topical corticosteroids has produced reversible HPA axis suppression, manifestations of Cushing syndrome, hyperglycemia, and glucosuria in some patients. In rare instances, treatment (or withdrawal of treatment) of psoriasis with corticosteroids is thought to have exacerbated the disease or provoked the pustular form of the disease, so careful patient supervision is recommended.

As a result of this, expert panels are reluctant to endorse topical steroids being sold over-the-counter. They fear that parents wouldn't understand the risks when buying the drugs to use at home. While in most cases the effects of topical steroids on the HPA axis means only the child is at minimal risk, if they undergo a stressful physiologic (rather than psychologic) event such as trauma, surgery, or serious infection, they might have life-threatening complications. The effects on the HPA axis are reversible and usually return to normal within weeks.

Topical steroids used for eczema

topical steroids used for eczema

As a result of this, expert panels are reluctant to endorse topical steroids being sold over-the-counter. They fear that parents wouldn't understand the risks when buying the drugs to use at home. While in most cases the effects of topical steroids on the HPA axis means only the child is at minimal risk, if they undergo a stressful physiologic (rather than psychologic) event such as trauma, surgery, or serious infection, they might have life-threatening complications. The effects on the HPA axis are reversible and usually return to normal within weeks.

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