Steroid Cream Side Effects
Steroid creams work wonders for conditions like eczema, psoriasis, and itchy rashes. Also known as topical corticosteroids, creams like hydrocortisone are available without a prescription to help with the redness and inflammation common with bug bites, allergies, and other rashes. However, the downside is steroid cream side effects.
Jennifer Thomas interviewed me for her article, What to Expect When Using a Steroid Cream, on the Optum Perks blog. It was published today!
She only included a few of the details I shared with her in the interview, so I included the full interview contents here for you to understand my perspective about steroid creams.
*How do steroid cream medications work?
Steroid cream medications work by turning down the bodys inflammation system. Normally, when you get a rash, there is redness and possibly itching, heat or swelling. Those are signs of inflammation. The steroid cream stops some of the cascade of signals in the body that make the inflammation continue. Its like putting a dam in the stream, blocking the signal from reaching the parts of the body that would release the redness.
*How quickly do steroid creams take effect?
And, what should readers expect to happen in the first week?
*Readers might be confused with the steroids MLB players take to break home-run records. How would you clear up that misconception with a patient?
There are many risks to steroid creams.
How Long Should I Use Steroid Creams?
Which Steroid Creams Can I Get?
What Are The Side
Most people who use topical steroids have no side-effects, or very few. How likely you are to have side-effects depends on how long you use the medicine for, how much is used or applied and how strong the steroid is.
It is not possible to list all the side-effects here. However, listed below are some of the more common and important ones. For a full list of side-effects see the leaflet that comes with your medicine.
- Creams and ointments burning and stinging may occur in the first two days but usually get better after this. Other side-effects that have been reported include:
- Thinning of the skin.
- Hair growth at the site of application.
- The more serious of these would normally only affect you if you use a strong or very strong steroid cream or ointment for a long time.
- Nose sprays and drops dryness and irritation of the nose, as well as nosebleeds, have been reported. You may have to stop your nasal spray for a while if any of these occur. Other side-effects include reddening of the skin, rash, itching, and headache. Some people have reported that their sense of smell and taste is disturbed after using a nasal steroid.
- Eye drops increased pressure inside the eye, cataracts, and blurred vision have been reported. Blurred vision clears very quickly after using an eye drop. People using steroid eye drops are also more likely to have eye infections and inflammation.
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Top 5 Most Common Otc Treatments For Eczema
Eczema treatment can go beyond prescribed medication. There are many OTC products which can provide hydration and itch relief, stop some skin types from becoming scaly and prevent skin dryness. Check out these four OTC products and see how they might work with your eczema therapy and treatment plan.
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Who Can Take Oral Steroids For Eczema
The use of oral steroids can be controversial. In fact, the American Academy of Dermatology Association states that âsystemic steroids should be avoided when possibleâ for eczema treatment. Thatâs because these are strong drugs that can produce serious side effects if you use them long-term or in high doses. Doctors prescribe oral steroids sparingly and reserve them for people who have serious eczema flare-ups.
Most adults and children can safely take oral steroids, as long as itâs for a short time and you monitor for side effects. Usually, your doctor may prescribe around 20- to 30-milligram pills to take once per day for 7 days. Your provider may prescribe a higher dose if necessary but will provide a plan to taper off to a lower dose or switch to milder treatment options once your flare-up is under control.
If oral steroids are not taken properly, itâs possible to have a ârebound effect,â where your eczema symptoms pop right back up after you stop taking the drugs. To avoid this, itâs important to take all of the medications as prescribed and not skip any doses, even if you start to feel better. Talk to your doctor before you stop using them or quit other treatments youâre on to control your eczema.
How To Use Hydrocortisone Skin Lotion
Lotion is better for treating large or hairier areas of skin.
You will usually use hydrocortisone skin lotion once or twice a day.
Use a small amount of lotion on the affected areas of skin.
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Are Steroids Safe In Pregnancy
A group of researchers wanted to find out how safe it is for pregnant women to use corticosteroid creams and ointments. They analyzed the data of more than a million women and their babies. When they compared pregnancy complications in women who used low-potency topical corticosteroids with the complications in women who used moderate-potency creams, no difference was found. They looked at things like congenital defects, birth weight, and which week of pregnancy the baby was born in. The research suggested that babies had a lower birth weight if their mothers used high-potency or ultra-high-potency topical corticosteroids particularly if they used them in larger amounts. But they didn’t find any other links between the different strengths of medication and complications.
Worrying About The Cons
Now we will go into the cons because its what is on everyones mind. So much so, that the term steroid phobia was coined, because some people are so scared of the side effects they wont even consider them. Stop worrying and you will have done what no parent has ever been able to do.
If you cant stop worrying, try the technique of considering what is the worst that could truly happen. Then let it go and ask yourself: how likely is it this will happen? Then think of the pros. How do you feel after youve considered all options. You should have your answer.
If you do not have your answer, go with your gut. Still no answer, go with your partners gut. No partner, go with your doctor or another teammates advice. No advice, however, will be better than your parental instinct.
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What Are The Side Effects Of Topical Steroids
A short course of topical steroids is generally safe and side effects are rare. Problems arise when you continue to use topical steroids for prolonged periods or if strong steroids are used frequently. Side effects are common if strong topical steroids are used long term. The side effects can be local or systemic.
Local side effects
- Burning or stinging sensation This is common when you apply a topical steroid for the first time. Once your skin gets used to the treatment, this feeling will subside.
- Skin atrophy although uncommon with normal regular use, it occurs especially if a potent steroid is used under occlusion .
- Worsening or triggering other skin conditions like acne, Rosacea and perioral dermatitis.
- Develop striae , telangiectasia , easy bruising and discoloration. These are common with long term use of topical steroids.
- Changing of skin color This is noticeable more in people with dark complexion.
- Growth of hair will increase in the treated area of skin
- Allergic reactions This may occur usually to the preservatives used in the steroid product. It can irritate your skin and worsen inflammation.
Systemic effects
This is rare with topical steroids but can occur when strong steroids are used for long periods. The steroid can get absorbed in to your blood stream.
Although there is a common fear of treatment, the risk of side effects is lower than most of us think, as long as it is applied as prescribed and not used longer than necessary.
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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What Should You Be Careful About When Using Steroids
- Do not undertreat because you are too cautious always apply as prescribed to clear your flare up.
- Avoid using too much you might want to continue topical steroids daily, even after your eczema has cleared, in order to prevent a future flare. You should not use steroids for long periods without close supervision by a doctor. However, you can apply moisturizers liberally every day which will help you to prevent a flare up of eczema.
In order to prevent side effects, the strength or potency of the topical steroid needs to be adjusted to the sensitivity and thickness of the skin area which needs to be treated.
Steroids become more potent in your face, eye lids, genitals, inner sides of joints and arm pits because the skin is thin and sensitive. Therefore, steroids of low or medium potency is enough to treat eczema in these regions. Higher potency steroids are needed for scalp, palms and soles as the skin here is thick and the medication should reach deeper layers of skin.
The effect will be stronger when topical steroids are applied to wet skin. It acts better when applied after taking a bath when your skin is damp rather than applying steroids to dry skin. If you cover the area with a wet wrap or a bandage, it will help to absorb the medication more. It is important to keep this fact in mind when applying steroids to diaper covered skin regions in babies.
References:
What Are Topical Steroids Used For
As a rule, a course of topical steroid is used when one or more patches of eczema flare up. The aim of treatment is to clear the flare-up and then to stop the steroid treatment.
It is common practice to use the lowest-strength topical steroid which clears the flare-up. So, for example, hydrocortisone 1% is often used, especially when treating children. This often works well. If there is no improvement after 3-7 days, a stronger topical steroid is usually then prescribed. For severe flare-ups a very strong topical steroid may be prescribed from the outset.
Sometimes two or more preparations of different strengths are used at the same time. For example, a mild steroid for the face and a moderately strong steroid for eczema on the thicker skin of the arms or legs. A very strong topical steroid is often needed for eczema on the palms and soles of the feet of adults because these areas have thick skin.
You should use topical steroids until the flare-up has completely gone and then stop using them. In many cases, a course of treatment for 7-14 days is enough to clear a flare-up of eczema. In some cases, a longer course is needed.
Many people with eczema require a course of topical steroids every now and then to clear a flare-up. The frequency of flare-ups and the number of times a course of topical steroids is needed vary greatly from person to person.
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How Does Using A Topical Steroid Cream Help Me Prevent Getting An Infection
We have mentioned that the skin barrier is damaged in eczema. This barrier keeps invading organisms out. Inflamed skin is easily infected. Cortisone creams rapidly reduce inflammation and restore the barrier and this prevents infection. Well controlled eczema is much less often infected than active eczema.
Do I still need to use a moisturiser while I am using my steroid cream?
Definitely. Using a moisturiser is vital to restore the skin barrier. People with eczema have dry skin. Their skin does not retain moisture naturally and this needs to be replaced with substances that do. Your moisturiser is there to store water in the skin. Applying it over your cortisone creams gets you better more quickly and keeping it going when you are better helps to prevent flares.
Your Eczema Is Tough To Treat
In some cases, for different reasons, eczema is hard to drive into remission. A few obstacles to successful treatment:
- Skin infections. You may need to address a secondary infection in order to get your eczema under control. Staphylococcus aureus, a type of bacteria that causes staph infections, makes a toxin that worsens eczema. Infection with herpes simplex virus, which causes cold sores, can trigger eczema flares.
- Food sensitivities. A food sensitivity may trigger flares in infants and children. This happens less often in adults. Your dermatologist can help you better understand the role of food triggers, if you or your child have any, and decide what steps to take next.
- Topical medications can sting. Some people are highly sensitive to topical treatments for eczema. Ingredients in creams and ointments may cause stinging, burning, and other skin discomfort, sometimes for a few days.
- Creams and ointments arenât always practical. Depending on where on your body your flare is happening, it can be hard to apply your treatment without help. Or you may have to choose between slathering on cream and getting dressed for work. And if you have young children, there may be a battle of wills if they donât like the sensation of a cream or ointment on their skin.
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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.
Oral Steroids For Eczema
If your eczema flare-ups are really bad, oral corticosteroids are one of the treatment options that can help soothe your irritated skin.
Also known as immunosuppressants, oral steroids work really well and can help bring your eczema symptoms under control fast. But these are strong prescription drugs, and long-term use may have downsides. Hereâs everything you need to know about oral steroids before you give them a try.
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How Do Oral Steroids Treat Eczema
When you have eczema, while researchers are not sure why, it causes your immune system to glitch and produce inflammation within your body. Because of this, your skin can have redness, itching, and irritation.
Oral steroids enter your body, attach themselves to special receptors in your cells, and work to quickly bring white blood cell movement under control. This then quickly stops your body from producing harmful chemicals that cause inflammation symptoms on your skin.
Oral steroids also help to stop the possible itch-scratch cycle and give your skin a chance to heal and stop possible skin infection.
Hydrocortisone Cream And Ointment
Creams are better for skin that is moist and weepy. Ointments are thicker and greasier, and are better for dry or flaky areas of skin.
Most people need to use hydrocortisone cream or ointment once or twice a day. If you use it twice a day, try to leave a gap of 8 to 12 hours before putting on any more.
Fire warning
Skin creams can dry onto your clothes and bedding. This makes them more likely to catch fire. Avoid naked flames.
The amount of cream or ointment you need to use is sometimes measured in fingertip units. This is the amount you can squeeze onto the end of your finger.
A fingertip unit is generally enough to treat both sides of your hand.
For babies and children, the right amount depends on their age. Your doctor or pharmacist can advise you.
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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 doctors instructions.
You should stop using this medicine once your symptoms are controlled.
Store at room temperature away from moisture and heat.