Formulations Of Topical Steroid
Several formulations are available for topical steroids, intended to suit the type of skin lesion and its location. Creams and lotions are general purpose and are the most popular formulations.
- The most suitable formulation for dry, non-hairy skin
- No requirement for preservative, reducing risk of irritancy and contact allergy
- Occlusive, increasing risk of folliculitis and miliaria
Gel or solution
- Has an astringent effect
- Stings inflamed skin
As a general rule, use the weakest possible steroid that will do the job. It is often appropriate to use a potent preparation for a short time to ensure the skin condition clears completely.
Whats The Difference Between The Various Topical Corticosteroids
There are more than 30 different topical steroids for the treatment of . There are big differences between them in terms of the strength of their effect . They can generally be divided up into four groups based on their potency:
- Low-potency corticosteroids, e.g. hydrocortisone and prednisolone
- Moderate-potency corticosteroids like prednicarbate, methylprednisolone and triamcinolone.
- High-potency corticosteroids such as betamethasone and mometasone.
- Ultra-high-potency corticosteroids, such as clobetasol
How well a steroid product works will depend on its active ingredient and various other factors, including the following:
Topical corticosteroids have to be prescribed by a doctor, with one exception: Low-dose hydrocortisone. Ointments or creams containing low doses of hydrocortisone are available from pharmacies even without a prescription. Its best to talk to your doctor about which topical steroid to use and how to apply it.
What Are Steroid Creams For Eczema
Topical steroid creams, also called topical corticosteroids, are one of the most commonly prescribed treatments for eczema. These creams help reduce inflammation and itching, allowing the skin to begin the healing process.
There are different types of steroid creams, classified from the most potent to least potent . There are a variety of steroid types, concentrations, and dosages.
All steroid creams are used on the outside of the body only and should never be swallowed or placed inside the body. These creams are meant to be applied directly to an eczema rash.
Follow your doctors instructions or directions on the steroid cream packaging for how much to apply and how often to use steroid cream for eczema. Speak to a healthcare professional or your pharmacist if you have questions about using steroid creams.
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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.
Are There Any Differences Between Topical Steroids
Topical steroids come in various potencies , ranging from very high potency to low potency .
In some instances, absorption of different formulations containing the same active ingredient can vary which can also affect potency.
Skin thickness can also affect absorption.
- The skin of the eyelids, genitals, and skin creases is thin and potent topical steroids should be avoided.
- The skin of the palms and soles is thick and mild topical steroids are usually ineffective.
Absorption is greatly enhanced by occlusion .
Topical steroids are sometimes combined with other ingredients, such as antifungal or antibacterial agents. Combination antibacterial/corticosteroid preparations should only be used short-term to reduce the risk of antimicrobial resistance developing.
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How Should I Use Triamcinolone Topical
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Triamcinolone topical cream, lotion, ointment, or spray is for use only on the skin. Triamcinolone dental paste is applied directly onto an ulcer inside the mouth and left in place.
Do not swallow triamcinolone topical.
Wash your hands before and after using triamcinolone topical, unless you are using this medicine to treat the skin on your hands.
Apply a thin layer of medicine to the affected skin. Do not apply this medicine over a large area of skin unless your doctor has told you to.
Do not cover the treated skin area with a bandage or other covering unless your doctor tells you to. Covering treated areas can increase the amount of medicine absorbed through your skin and may cause harmful effects.
If you are treating the diaper area, do not use plastic pants or tight-fitting diapers.
To use the dental paste, press a small dab onto the mouth ulcer but do not rub in the medicine. The dab will form a thin film that should be left in place for several hours. Triamcinolone dental paste is usually applied at bedtime and/or after meals. Follow your doctor’s instructions.
You should stop using this medicine once your symptoms are controlled.
Store at room temperature away from moisture and heat.
Before Taking This Medicine
You should not use triamcinolone if you are allergic to it.
Tell your doctor if you have ever had:
an adrenal gland disorder.
Steroid medicines can increase the glucose levels in your blood or urine. Tell your doctor if you have diabetes.
Tell your doctor if you are pregnant or breastfeeding. If you apply triamcinolone to your chest, avoid areas that may come into contact with the nursing baby’s mouth.
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When Can Pimecrolimus Or Tacrolimus Be Used
Pimecrolimus has been approved for the treatment of mild to moderate , and tacrolimus has been approved for the treatment of moderate to severe eczema. They can only be used in certain situations. For instance, they can be prescribed:
- if steroids haven’t led to a big enough improvement.
- for the treatment of particularly sensitive areas such as the genitals or face, and especially the eyelids.
- if steroids aren’t well tolerated.
Creams and ointments with pimecrolimus and 0.03% tacrolimus can be used in children aged two and over, as well as in teenagers and adults. Those with 0.1% tacrolimus can only be prescribed for people aged 16 and over.
If treatment with these calcineurin inhibitors is successful, they can also be used intermittently to prevent further flare-ups. This involves applying them to the affected areas of skin on two days per week . You should wait a few days between applications. For instance, pimecrolimus or tacrolimus could be applied once on Mondays and once on Thursdays.
What Are The Side Effects Of Steroid Creams For Eczema
As with any medical treatment, there may be side effects to using steroid creams. Side effects can be local, affecting a specific spot on the body, or systemic, affecting the entire body. Side effects will depend on the strength of the steroid and where its used.
Systemic reactions are rare because the skin doesnt usually absorb enough medication to cause a significant reaction however, they can happen. If side effects do occur, they are often related to topical steroid use over a longer period of time and on areas of the body where the skin is thinner, such as on the face. Skin also thins as you get older.
Local side effects of steroid cream may include:
- allergic reaction
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How Topical Steroids Work
Topical steroids help by reducing inflammation in your skin.
Inflammation is a sign of an immune response. The treatment is applied to an affected area of skin to help reduce symptoms such as rashes, scaly patches, itching, pain, redness, or swelling.
For example, eczema, also known as atopic dermatitis, is a group of skin conditions that lead to itchy and inflamed skin with a scaly rash. Eczema is common in children. If you experience a flare-up of eczema, you can apply a cream to help you stop scratching the area and allow your skin to heal.
Topical steroids may be used for other skin conditions such as:
- Psoriasis, an autoimmune disorder that causes scaly patches of skin
- Seborrheic dermatitis, a skin rash with red patches and greasy yellow scales that typically affects the scalp
- Contact dermatitis, a red rash caused by contact with a substance that irritates the skin or causes an allergic reaction to it
The strength of a topical steroid is determined by a test that measures how much it can cause your blood vessels to constrict in the upper part of the dermis.
As blood vessels constrict, it can reduce swelling and discomfort.
What Is In This Leaflet
This leaflet answers some common questions about Tricortone. It does not contain all the available information. It does not use the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you using Tricortone against the benefits they expect it will have for you.
Ask your doctor or pharmacist if you have any concerns about this medicine.
Keep this leaflet with your medicine. You may need to read it again.
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How To Avoid Topical Steroid Withdrawal
Topical steroid manufacturers have known about topical steroid addiction for decades, which is why doctors usually advise you to gradually cut down on use rather than stopping suddenly. Suddenly stopping use of topical steroids is sort of like running a marathon and avoiding training advice such as drink water/stay hydrated. It can result in serious side effects.
When going off topical steroids, especially if you have used them for long periods of time, you absolutely need to train your blood vessels to cope with the crazy chemical changes that are going to occur.
TSW Program: You can train your blood vessels like you would train your muscles. For example:
Do you see a pattern forming?
Constrict, dilate, constrict, dilate.
Its like working a muscle where you flex as you lift a weight and then relax. The muscle gets stronger. This is how you train your blood vessels to constrict again after dilating excessively. This exercising the blood vessels can reduce the risk TSW/red skin syndrome and speed up recovery from topical steroid addiction. As previously mentioned, supplements that reduce nitric oxide levels in the blood can also help to ease the withdrawal process.
These supplements include vitamin B12 and taurine as they reduce nitric oxide levels in the body.
Skin Friend AM contains vitamin B12 and other nutrients suitable for people with skin inflammation.
How Effective Is Triamcinolone For Eczema
Although the effectiveness of triamcinolone for eczema may vary from case to case, generally speaking, this corticosteroid is successful in minimizing eczema symptoms. This drug, which is marketed regularly as aristocort and kenacort, among others, is often used in correlation with other products to fight the harmful causes and effects of eczema. Some of the regular symptoms that triamcinolone may act to counter are redness, inflammation, and the itching and irritation common to eczema.
Eczema is a fairly common skin disorder resulting from a hypothesized unusually clean environment. This theory states that nonexposure to certain bacterial strains during one’s life prevents the immune system from acquiring necessary resistance, which in turn can lead to overreactions to such bacterial strains later in life. It is important to note that this is strictly a theory, however, and health care providers and researchers have identified no specific cause.
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How Should I Store Triamcinolone Cream
Triamcinolone cream should be stored at room temperature away from light.
General information about triamcinolone cream:
Medicines are sometimes prescribed for purposes that are not in the patient leaflet. Do not use triamcinolone cream for a condition for which it was not prescribed. Do not give triamcinolone cream to other people, even if they have the same symptoms you have. It could harm them.
This page summarizes the most important information about triamcinolone cream. If you would like more information about triamcinolone cream talk with your doctor. You can ask your doctor or pharmacist for information about triamcinolone cream that is written for health professionals.
How To Use Triamcinolone Acetonide Cream
Wash and dry your hands. Before applying the medication, clean and dry the affected area. Apply a thin film of the medication to the affected area and gently rub in, usually 2 to 4 times daily or as directed by your doctor. Do not cover, bandage or wrap the area unless directed to do so by your doctor.
After applying the medication, wash your hands unless you are using this medication to treat the hands. When applying this medication near the eyes, avoid getting it in the eyes as this may worsen or cause glaucoma. Also, avoid getting this medication in the nose or mouth. If you get the medication in your eyes, nose, or mouth, rinse with plenty of water.
Use this medication only for the condition prescribed. Do not use it for longer than prescribed.
Inform your doctor if your condition persists or worsens.
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Appropriate Use Of Topical Corticosteroids
According to treatment guidelines recently developed in Europe, Asia, and the United States, topical corticosteroid remain the mainstay of treatment for adults and children with atopic dermatitis, even in severe cases in which they may be used in combination with systemic therapies. Topical corticosteroids are recommended when patients have failed to respond to a consistent eczema skin care regimen, including the regular use of moisturizers , appropriate anti-bacterial measures, and trying to eliminate any possible allergens that may be contributing to the underlying problem.
Goals for treating atopic dermatitis:
What Are The Side Effects Of Topical Steroids
Steroids can cause thinning of the skin and cause the skin color to change. They may also cause a stinging feeling upon application to the skin. Some children may develop an allergy to the treatment, especially if preservatives are used. Some topical steroids get through the skin and into the bloodstream, and for children who need long term treatment with potent steroids, this can potentially affect the growth of the child. It is important to make sure the childs growth is monitored. Moreover, topical steroids can also possibly produce adrenal insufficiency. Again, steroid use needs to be used under medical supervision.
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How To Use Aureocort Ointment
- 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 side-effects that you may experience from using them.
- Apply a small amount to the areas of skin which are infected. Then gently rub it into the skin until it has disappeared.
- Use it regularly twice daily for one week only, unless you have been directed otherwise by your doctor.
- 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 the ointment, remember to wash your hands .
- If you are using the ointment for infected 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.