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Best Corticosteroid Cream For Eczema

Best Steroid Cream For Eczema

Should You REALLY Use Cortisone Creams For Eczema?

Steroid Cream For Eczema over the counter prescription are topical treatment medications applied to the affected areas of the skin to manage and provide relief to the symptoms.

Topical steroids are one of the most effective treatment for atopic dermatitis because it controls the itchiness, reduces inflammation, heals the skin very fast and prevents infections.

Without beating around the bush, let me quickly show you 10 best steroid cream for eczema over the counter that is effective and is guaranteed to give you positive result in a short period of time.

Fingertip Units And Children

An FTU of cream or ointment is measured on an adult index finger before being rubbed on to a child. Again, one FTU is used to treat an area of skin on a child equivalent to twice the size of the flat of an adult’s hand with the fingers together. You can gauge the amount of topical steroid to use by using your hand to measure the amount of skin affected on the child. From this you can work out the amount of topical steroid to use.

The following gives a rough guide:

For a child aged 3-6 months

  • Entire face and neck – 1 FTU.
  • An entire arm and hand – 1 FTU.
  • An entire leg and foot – 1.5 FTUs.
  • The entire front of chest and tummy – 1 FTU.
  • The entire back including buttocks – 1.5 FTUs.

For a child aged 1-2 years

  • Entire face and neck – 1.5 FTUs.
  • An entire arm and hand – 1.5 FTUs.
  • An entire leg and foot – 2 FTUs.
  • The entire front of chest and abdomen – 2 FTUs.
  • The entire back including buttocks – 3 FTUs.

For a child aged 3-5 years

  • Entire face and neck – 1.5 FTUs.
  • An entire arm and hand – 2 FTUs.
  • An entire leg and foot – 3 FTUs.
  • The entire front of chest and abdomen – 3 FTUs.
  • The entire back including buttocks – 3.5 FTUs.

For a child aged 6-10 years

  • Entire face and neck – 2 FTUs.
  • An entire arm and hand – 2.5 FTUs.
  • An entire leg and foot – 4.5 FTUs.
  • The entire front of chest and abdomen – 3.5 FTUs.
  • The entire back including buttocks – 5 FTUs.

Important Information About All Medicines

Make sure that the person supplying this medicine knows about any other medicines that you are taking or using. This includes medicines you buy and herbal and homeopathic medicines.

Before using this medicine tell your doctor if you have ever had an allergic reaction after taking or using any medicine.

Never use more than the prescribed dose. If you suspect that someone has swallowed some of the medicine by accident, contact the accident and emergency department of your local hospital for advice.

If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking or using.

If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

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What Is Eczema Cream

Eczema cream is a term that describes any moisturiser or medicated treatment applied to the skin to ease the symptoms of eczema. Applying creams to the skin is vital when you have eczema, as the condition is caused by dryness in the skin.

Some eczema creams can be bought without needing to speak to a pharmacist or doctor. Other eczema creams can be obtained in your local pharmacy, bought online or require a prescription from a doctor.

How Should Eczema Cream Be Used

Non Steroid Eczema Cream

Different eczema creams are used in different ways. How and when you apply your eczema cream will depend upon whether youre going through a flare-up, how bad your symptoms are, and where on your body the affected areas are.

If youre not going through a flare-up of symptoms, or if your eczema is very mild, you should simply use emollients. Emollients should be used every day at least twice, but ideally more often, especially if you have very dry skin. You should use a large amount and apply it all over your skin, smoothing it in the same direction your hair grows.

If you are experiencing a flare-up, you should use emollients and topical corticosteroids. Apply a layer of emollient first, wait for it to soak into the skin, and then use your corticosteroid cream or lotion. This should be applied only to the affected areas, as directed in the products patient information leaflet. Typically, you will have to apply corticosteroids once or twice a day.

Other things to consider include the following:

You should always speak to a pharmacist or doctor before you start using eczema creams, to make sure youre using the right kind at the right strength.

Read Also: How To Know If You Have Eczema On Scalp

When Should Topical Steroids Be Used

Topical steroids are mostly prescribed to treat eczema flares. You will usually be instructed to apply topical steroid for short bursts of treatment, and then stop or step down use when the eczema flare settles. If you are prescribed a milder steroid you will usually be told to stop after a burst of treatment, but if you are prescribed a stronger steroid, you may be instructed to step down back to lower potency preparations as your eczema flare settles.

Sometimes people with more severe eczema whose eczema flares very frequently are prescribed topical steroids to apply on two consecutive days a week on the areas where their eczema usually flares. This is known as weekend therapy and can help to prevent the almost continuous flare cycle, meaning that in the long run less topical steroid would be needed to control the eczema than if each flare were treated as it occurred.

How To Know When To Use Topical Steroids And At What Strength

If a low-potency topical steroid doesnt work for you, your doctor may prescribe a stronger one for you to apply, says Dr. Fonacier. A nonsteroidal topical medication, such as crisaborole or tacrolimus, may be added to your treatment as well.

If thats not working, then you go onto other systemic treatments for eczema, she explains. They include phototherapy, Dupilumab, which is an injectable, and then systemic immunosuppressants which are not FDA-approved for severe atopic dermatitis, but we know they work like cyclosporine and methotrexate. You may even try oral steroids, but then youre talking about complications. The steps she outlines belong to a protocol called the Atopic Dermatitis Yardstick, depicted in a chart from a paper published January 2018 in the journal Annals of Allergy, Asthma and Immunology, which Fonacier coauthored.

In these cases, he says, the goal is to minimize drug exposure over the long term, which can mean using a higher class of topical steroid for a shorter period of time than would be needed with one of a lower potency. We probably do more damage to the skin by using even a mild steroid for a long period of time than we do by using a more powerful one to nip it in the bud and then be done with it, Dr. Lio explains.

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Frequency Of Administration And Duration Of Treatment

Once-or twice-daily application is recommended for most preparations.21 More frequent administration does not provide better results.27 The optimal dosing schedule can be determined by trial and error, titrating to the minimum frequency of application that still provides relief.

Chronic application of topical steroids can induce tolerance and tachyphylaxis. Ultra-high-potency steroids should not be used for more than three weeks continuously.21 If a longer duration is needed, the steroid should be gradually tapered to avoid rebound symptoms, and treatment should be resumed after a steroid-free period of at least one week. This intermittent schedule can be repeated chronically or until the condition resolves. Side effects are rare when low- to high-potency steroids are used for three months or less, except in intertriginous areas, on the face and neck, and under occlusion.21

The amount of steroid the patient should apply to a particular area can be determined by using the fingertip unit method.28 A fingertip unit is defined as the amount that can be squeezed from the fingertip to the first crease of the finger. Table 3 describes the number of fingertip units needed to cover specific areas of the body.28 One hand-size area of skin requires 0.5 fingertip units or 0.25 g of steroid. The amount dispensed and applied should be considered carefully because too little steroid can lead to a poor response, and too much can increase side effects.

Face and neck

Face and neck

What Is Hydrocortisone And How Does It Work

Treating your eczema with steroid creams

Its likely that youre wondering, How does hydrocortisone work? or What is the link between hydrocortisone and eczema?. Hydrocortisone is a type of corticosteroid that works to reduce inflammation in the body. This steroid medication reduces swelling, redness, and itching for many different skin conditions. In its topical form, hydrocortisone can be sold as an ointment, cream, or lotion. Its strength can range from anywhere between 0.1-2.5%. Hydrocortisone is sold over the counter at pharmacies with up to 1% strength. Anything higher than that has to be purchased with a prescription.

Hydrocortisone can also come in the form of an oral tablet or as a hydrocortisone injection. Hydrocortisone injections are used to treat severe allergic reactions, multiple sclerosis, lupus, gastrointestinal diseases, and arthritis. In its oral form, hydrocortisone can be used to treat all the following:

  • Rheumatoid arthritis
  • Lymphoma symptoms

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Antihistamines And Pain Relievers

Atopic dermatitis , the most common form of eczema is part of whats known as the atopic triad . In fact, people with AD have a greater chance of developing comorbidities or related health conditions, namely asthma, hay fever and food allergies.

To help combat itch and curb inflammation if you have allergies, a healthcare provider may suggest antihistamines. Some antihistamines also contain sedatives that can help people sleep.

Examples of OTC oral antihistamines include:

  • Diphenhydramine
  • Chlorpheniramine
  • Cetirizine
  • Loratadine
  • Fexofenadine
  • Doxylamine

To address common eczema symptoms such as burning, pain and inflammation, a healthcare provider may also suggest OTC pain relievers such as:

  • Acetaminophen
  • Nonsteroidal anti-inflammatory drugs including ibuprofen

or naproxen

How To Use Mometasone

  • Before you start using the preparation, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about topical steroids and will provide you with a full list of the side-effects that you may experience from using them.
  • Apply a small amount to the areas of skin which are inflamed, once a day. Then gently rub it into the skin until it has disappeared. If you are using a scalp application, apply a few drops to your hair and rub it in gently. You can apply it to either dry or wet hair. Do not use mometasone on any open sores or any infected areas of skin.
  • The amount of topical steroid that you should apply is commonly measured by fingertip units . One FTU is the amount of cream or ointment that is squeezed out along an adult’s fingertip . As a guide, one FTU is enough to cover an area twice the size of an adult hand. Your doctor will give you an idea of how many FTUs you will need to cover the area of your skin which is affected.
  • If you are using more than one topical corticosteroid, make sure you know when and where to use each one. If you are unsure, check with your doctor or ask your pharmacist for further advice.
  • After you have applied mometasone, remember to wash your hands .
  • If you are using mometasone for psoriasis, make sure you follow your doctor’s instructions carefully. It should not be used for large areas of psoriasis or for long periods of time, as these can cause your symptoms to flare up again afterwards.

Recommended Reading: Does Hydrocortisone Cream Help Eczema

How Are Steroids Used

Corticosteroid ointments or creams are applied to the affected areas of skin one or two times a day. A lot of people do this in the morning and/or in the evening. This treatment is continued until the inflammation has gone away. Its hard to say exactly how long that will take. The treatment can last anywhere between a few days and six weeks. This will depend on the strength of the corticosteroid and the affected areas of skin. Steroid medication generally shouldnt be applied to sensitive areas of the body for longer than a few days.

It is important to continue using moisturizing products on the skin during treatment with steroids. Doctors recommend waiting about 15 minutes between applying a topical corticosteroid and applying the moisturizing product. This allows the steroid to be absorbed properly. According to current knowledge, it doesnt matter which order you apply them in.

If the is severe, you can apply the topical corticosteroid first and then cover the affected area with a wet wrap in order to increase the effect of the medication. But there is no good research on the benefits and drawbacks of this approach. Some studies have shown that it is associated with a higher risk of side effects, such as inflamed hair follicles and skin infections. Using wet wraps can also cause greater amounts of steroids to enter your bloodstream. So its important to talk to a doctor about whether to use this approach beforehand.

An Increased Risk For Certain Health Conditions

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There are also possible systemic side effects of topical steroids, particularly with long-term use, adds Fonacier, supporting previous research. If youre putting them on so often, theres a possibility of absorption, especially with children. Systemic side effects, which can be similar to those caused by oral steroid medication, include cataracts, glaucoma, osteoporosis, neuropsychiatric effects, muscle weakness, and diabetes, as well.

In August 2019, the Journal of Dermatological Treatment published an analysis of four observational studies performed between 2006 and 2019, which found a significant association between topical steroid use and higher risk of developing type 2 diabetes, regardless of the potency of the medication being used. The more an individuals dose increased and the longer they took the medication, the stronger the association with diabetes. As the study authors noted, systemic steroid use is known to be associated with insulin resistance. But more research is needed to establish whether theres a causal relationship between steroids applied on the skin and developing type 2 diabetes.

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How Using Topical Steroids Can Help Relieve Eczema

Eczema, known more formally as atopic dermatitis, is not one specific condition, but a group of inflammatory skin conditions that can produce rash-like symptoms, lesions, scaly or leathery patches of skin, swelling, soreness and dry itchiness on various parts of the body. It can appear on the face, hands, feet, wrists, ankles, insides of the elbows, behind the knees, sides of the neck, and around the mouth and other areas of the body.

Scientists haven’t identified any specific cause of eczema, but people with the condition tend to have an over-reactive immune system that produces inflammation as a result of an irritant or trigger, according to the National Eczema Foundation . Common irritants include household products, fragrances, metals, and certain fabrics, such as wool or polyester.

Other triggers of eczema include stress and letting your skin get too dry. For instance, frequent hand-washing in an attempt to help avoid COVID-19 infection can dry out skin and spur flareups, says the NEA. People with seasonal allergies or asthma also tend to be at a higher risk of eczema. So are women and Black Americans, according to the Cleveland Clinic. It usually begins in childhood, but nearly half of children with eczema will outgrow it or have greatly reduced symptoms by the time they reach puberty.

RELATED: 12 Common Eczema Triggers and How to Target Them

Are Topical Steroids Safe

Topical steroids, used appropriately and under supervision, are a safe and effective treatment for eczema. The likelihood of side effects occurring is directly related to the potency of the preparation, where it is being used, the condition of the skin on which it is used and the age of the person concerned. Pregnant women should consult a healthcare professional regarding the advisability of continued use of their usual topical steroid preparation. All these factors will be taken into consideration when a prescription is given to treat eczema.

If used over long periods of time, topical steroids can thin the skin, making it appear transparent, fragile and susceptible to bruising blood vessels may become more prominent, and the skin can lose its elasticity, developing stretch marks. Other possible side effects include increased hair growth of very fine hair and perioral dermatitis . However, it should be stressed that these effects usually only occur when potent steroids have been applied for a long period of time, either to the face or to covered parts of the body such as the flexures.

Skin thinning can also occur when steroids have been applied under occlusion . For these reasons, topical steroid use is limited to short periods of time under the supervision of a doctor or nurse.

For more information on topical steroids, please see our Topical steroids factsheet and an article from our magazine, Exchange, How safe are topical corticosteroids?

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How Long To Use It For

Most people only need to use hydrocortisone skin treatments for a short time. Stop as soon as your skin is better. Sometimes you only need to use the skin treatments for a few days.

For insect bites and stings, nappy rash or contact dermatitis you’ll probably only need to use a skin cream for up to 1 week.

For long-term skin conditions such as eczema and psoriasis you may need to use treatments for longer.

If you buy hydrocortisone from a pharmacy or shop, do not use it for more than 1 week without talking to your doctor.

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