Emollients are often used to treat eczema, but what role do topical corticosteroids play? Today Jean Robinson talks through the harm cause by ‘steroid phobia’.
Topical corticosteroids (TCS) are widely agreed to be the mainstay of managing many children’s eczema and when used appropriately are safe and effective with rare side effects, helping children to achieve maximum clinical benefit from their use.
And yet there is worldwide agreement children’s eczema is often undertreated due to ‘steroid phobia’ mainly related to beliefs about irreversible skin thinning and other unfounded concerns about their adverse effects.
This is often generated by healthcare professionals and many patients also report discrepancies in what they are told by different professionals.
This leads to extended and unnecessary periods of active eczema for children and often untold misery for them and their families.
Contrary to popular belief a recent review of relevant medical literature is clear that TCS do not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines.
Only rarely following prolonged and excessive use of potent TCS (generally months to years) have they have been shown to contribute to striae, short-term hypothalamic pituitary-adrenal axis alteration and ophthalmological disease.
However, they are very effective treatments for eczema.
It is essential healthcare professionals do not contribute to this phobia but offer balanced, consistent and well informed advice in their use without encouraging their indiscriminate use.
When they are used to treat active eczema and only stopped once the active inflammation has resolved, adverse effects are minimal.
Join us again tomorrow for the final instalment of our eczema special week where we look at top tips for emollients, what to consider when using TCS and complementary therapies.