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Eczema treatment: Corticosteroids applied to the skin


Brenda Hilligoss

“My son had terrible eczema as a baby. Nothing would heal his skin. When he saw a dermatologist, that changed. I learned how to apply different topical corticosteroids to his eczema. His skin started to clear. When he had a flare, I used topical corticosteroids and oatmeal baths to clear his skin.”

─ Brenda

Why do dermatologists prescribe topical corticosteroids for eczema?

When applied to the skin with eczema, this medicine can reduce the:

  • Inflammation (redness, swelling, heat)

  • Itch

  • S. aureus (bacteria) on the skin

Safety and effectiveness

  • #1 medicine used to treat eczema in adults and children

  • Used for more than 60 years to treat eczema

  • Many strengths available, ranging in strength from low to super potent

  • U.S. Food and Drug Administration (FDA) has approved several topical corticosteroids to treat eczema in children; Some approved to treat eczema in infants.

  • Risk of side effects is low when used as directed by your child’s dermatologist

  • Best results obtained when your child also bathes as directed by the dermatologist and uses eczema friendly moisturizer.

How to use

  • ONLY use this medicine when your child’s dermatologist includes it in your child’s treatment plan. Children are more sensitive than adults are to this medicine.

  • Wash your hands before and after applying this medicine to your child’s skin.

  • Apply the medicine to your child’s skin exactly as directed your child’s dermatologist.

  • NEVER cover your child’s treated skin with a bandage, plastic wrap, etc. unless your child’s dermatologist tells you to do this.

  • You usually apply this medicine twice a day to the eczema until the skin improves.

Possible side effects

Studies show that side effects are rare when this medicine is used as directed by a dermatologist. All medicines, however, have possible side effects. Even a non-prescription topical corticosteroid like hydrocortisone can cause side effects.

Get immediate medical help if your child has an allergic reaction:

  • Hives

  • Problems breathing

  • Swelling on face, lips, tongue, or throat

Most side effects occur on the skin. If you notice any of the following on your child’s skin, contact your child’s dermatologist.

  • Bruising

  • Visible blood vessels

  • Stretch marks

  • Breakouts that look like acne or rosacea

  • Skin looks thinner

Skin thinning is most serious side effect that can occur on the skin due to using a topical corticosteroid. Before the skin starts to thin, you’re likely to see wrinkled skin, blood vessels, and weakened skin. Skin thinning is more likely to occur when a high-potency topical corticosteroid is applied the face or neck.

The risk of thinning skin increases with age. It is less likely to happen to a child and is most common in older adults.

Most side effects that develop on the skin will go away when you stop applying the medicine. It may take months for the side effect to disappear.

Other possible side effects include:

  • Medicine rapidly stops working, so you see little or no change to the eczema

  • Rash, often due to contact dermatitis

  • Child grows too slowly, so height and weight less than normal for the child’s age

When should I call my child’s dermatologist?

You should contact your child’s dermatologist if you notice:

  • Any of the above side effects

  • The medicine does not work within 2 weeks

Related AAD resources

Image: Courtesy of Brenda Hilligoss

Reference
Eichenfield LF, Tom WL. “Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies.” J Am Acad Dermatol. 2014 Jul;71(1):116-32.

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