Emollient or topical steroid, which order for application

[lovesradio]

I recently saw a dermatologist about the eczema on my feet and legs, which I thought might have become infected. She prescribed a week's course of antibiotics and reckoned that athletes foot infection was exacerbating the condition of the eczema on my feet and lower legs around the ankle and about two centimetres above. So she also prescribed Terbinafine Cream 1% to use twice a day, all round the ankle, foot and toes, and to use Elocon once a day. So.......my question is should I still be using emollient on my feet and if so when to apply?

[Dr Nevianna Bordet]

Thank you for raising this common question. Patients are often confused with regards to the order of applying creams. It does not matter which cream you use first. I would avoid applying them at the same time as if you apply an emollient and a steroid together, the emollient will dilute the steroid and make it less effective. Leave 30 mins between applying the cream. It means that you will have to find more time in your schedule but you will get a better and faster response as your reward! Always carry on with the emollient as this will hydrate the skin and strengthen the skin barrier, but leave another 30 mins between this and the anti-fungal cream, and 30 mins between that and the steroid (Elocon is a potent topical steroid).

[Dr Sree Krishna]

Hello,

Really good question. I would agree with Dr. Bordet's assessment that the two shouldn't be applied at the same time. However, I don't know if there is any difference in absorption/effectiveness between steroids first and emollient second (and vice-versa).

Best wishes,

Sree