About steroid creams

Steroid creams are essential to treat skin inflammation. If they are too strong, they can damage the skin, and so they need to be the correct strength and quantity. An effective strength of steroid should get rid of the inflammation in 2-3 weeks in most cases, although neglected or severe eczema may take longer.

A steroid cream may be needed to prevent further flares of eczema in a patient who is prone to this, but studies show the dose can be much lower or simply used twice a week.

For the best combination of safety and effect, one needs to have the right steroid in the right amount over the right length of time. This sounds easy, but it is often not. Thicker skin, such as on the hands and feet, usually requires stronger steroids. Facial skin usually weaker steroids.

Using steroid creams for the treatment of Eczema

Steroid creams are the mainstay of treating inflammation; they are extremely effective if used at the appropriate strength for the severity of the condition. Yet many GPs and parents are worried about their use. Why is this?

If a steroid cream is too strong or potent for the area of the body or the type of skin, it can have a harmful effect on the structure of the skin, thinning the layers of skin, or causing stretch marks, or visibility of blood vessels below the skin. For this reason, most GPs and parents will be cautious, and use steroids sparingly or for short periods only. While this is understandable, it is also clear that steroid creams can be used for longer periods quite safely if prescribed in an appropriate dilution, and can be used more frequently during the day when eczema flares.

Because GPs are cautious they will start with the weakest steroid cream and only increase potency if the condition appears to be failing to respond. Such delay in getting to effective treatment strengths causes frustration and lack of confidence.

The underlying cause of the inflammation is often ignored, or over-simplified. With atopic eczema there is an important interplay between loss of barrier function in the skin, infection by germs such as Staph aureus, triggering immune defences, and inflammation. Eczema skin can readily become colonised with Staph Aureus, because of release of toxins which defeat the body’s defences. So using steroid creams on their own, or with emolients, may be unsuccessful in eradicating the eczema.

My approach to the use of steroids in the treatment of eczema

My own approach follows the Dr Aron method, using well-diluted steroid (to a lower concentration than commonly used) combined with emollient and antibacterial. This method is safe, allowing more frequent application of cream, and longer duration of use. The cream is tailored to the individual need, and additional elements such as vitamin E oil or calamine may be added where required.

Click here to learn more about the use of anti bacterials in the treatment of eczema.

Please contact me to learn more about my methods, or request an appointment if you are ready for a consultation.

Using a steroid cream for Eczema treatment