Topical Steroids
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Topical Steroids
I am currently using topical steroids and I am aware that they shouldn't be used long term. However, I'm worried that this might be the only option for treatment for me.
I'm also concerned about topic steroid withdrawal. How would you suggest coming off them? How long would you advise using them for?
Any advice would be appreciated, thank you. Ruth
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- Dr Nevianna Bordet
- Posts: 39
- Joined: Wed May 06, 2020 12:27 pm
Re: Topical Steroids
Dear Ruth,
You are not alone. Many patients worry about using steroids as long-term use can thin the skin. However, short-term intermittent use is usually safe. You did not say for how long you have been applying steroid creams, what site of the body you use them on and what strength they are. So it's difficult to advise you without examining you and knowing this information. If your eczema flares-up when you try to withdraw the steroids then you dermatologist will want to consider a cream or ointment known as a calcineurin inhibitor (also called Protopic ointment or Elidel cream). This class of drug is not a steroid and does not thin the skin and is usually prescribed when long-term steroid use needs to be avoided.
With regards to stopping the steroids, I would recommend that you wean off the amount used slowly. If potent steroid creams are stopped suddenly, you can experience a rebound flare of your eczema. Pulsed steroid use in this way often encourages the eczema to get worse with time. It is better to discuss with your doctor having steroids of reducing strength and using these to wean off the treatment. You can also try to reduce the number of times you use them slowly e.g. from twice daily, to once daily and then to alternate days, each time increasing the emollient you are using instead of the steroid. I hope this is helpful.
You are not alone. Many patients worry about using steroids as long-term use can thin the skin. However, short-term intermittent use is usually safe. You did not say for how long you have been applying steroid creams, what site of the body you use them on and what strength they are. So it's difficult to advise you without examining you and knowing this information. If your eczema flares-up when you try to withdraw the steroids then you dermatologist will want to consider a cream or ointment known as a calcineurin inhibitor (also called Protopic ointment or Elidel cream). This class of drug is not a steroid and does not thin the skin and is usually prescribed when long-term steroid use needs to be avoided.
With regards to stopping the steroids, I would recommend that you wean off the amount used slowly. If potent steroid creams are stopped suddenly, you can experience a rebound flare of your eczema. Pulsed steroid use in this way often encourages the eczema to get worse with time. It is better to discuss with your doctor having steroids of reducing strength and using these to wean off the treatment. You can also try to reduce the number of times you use them slowly e.g. from twice daily, to once daily and then to alternate days, each time increasing the emollient you are using instead of the steroid. I hope this is helpful.
- Julie Van Onselen
- Posts: 48
- Joined: Wed Aug 31, 2016 10:02 am
Re: Topical Steroids
Hi Ruth
Just to add to Dr Nevianna's excellent advice.If you would like more information on using topical steroids and on topical calcineurin inhibitors, please to visit The National Eczema Society, where you can download very helpful factsheets on both these and other eczema treatments at: https://eczema.org/information-and-advi ... or-eczema/
I hope this is helpful. All the best.
Just to add to Dr Nevianna's excellent advice.If you would like more information on using topical steroids and on topical calcineurin inhibitors, please to visit The National Eczema Society, where you can download very helpful factsheets on both these and other eczema treatments at: https://eczema.org/information-and-advi ... or-eczema/
I hope this is helpful. All the best.
Julie Van Onselen
Independent Dermatology Nurse
http://www.talkhealthpartnership.com/on ... nselen.php
Independent Dermatology Nurse
http://www.talkhealthpartnership.com/on ... nselen.php