Mild topical steroids for eczema

An Alternative Treatment

Decreased tear meniscus in dry eye.
As an alternative to steroids—or as an adjunctive therapy—topical cyclosporine can also be used to control inflammation in dry eye disease. While cyclosporine does not demonstrate the rapid anti-inflammatory effect of steroids, it carries fewer risks and is safe for long-term use.
Because of their complementary efficacy and safety profiles, many practitioners often begin dry eye treatment by prescribing both topical steroids and cyclosporine. Following the recommendation of the Asclepius Panel, the use of combination therapy is instituted with the topical corticosteroid, Lotemax (loteprednol etabonate ophthalmic suspension %, Bausch + Lomb) and Restasis (cyclosporine ophthalmic emulsion %, Allergan). 24 The Asclepius Panel recommends practitioners begin early treatment with an anti-inflammatory agent (such as Lotemax) four times a day to improve symptoms and to prevent disease progression. After two weeks, the frequency of the corticosteroid is reduced to twice daily and supplemented with Restasis twice a day. Treatment with loteprednol was stopped after day 60, while cyclosporine treatment is continued.

As a SkinVestment, Eucrisa holds the promise of effective therapy while eliminating steroid-related side effects in patients using this medication to treat mild to moderate eczema. It will not be appropriate for every case of atopic dermatitis and may not fully replace the need for topical steroids in treatment regimens, especially for severe flares. With all new drugs to market, there are many uncertainties regarding access, affordability, and adoption of this drug for every day use. With retail price around $580 for a 60 gram tube, it will be interesting to see how accessible the manufacturer will make this medication to patients through insurance. Insurance plans may take months to years before adopting Eucrisa to drug formularies, citing that topical steroids are more affordable and equally effective alternatives. As we have seen with non-steroid Protopic and Elidel, just because a non-steroid drug for eczema is FDA-approved and available, insurers may still choose to not make it available to their patients due to costs. As a SkinVestment, this is a great way to treat atopic dermatitis and I hope that Pfizer will make it affordable through partnerships with insurers and cost-cutting rebate cards. Contact your dermatologist or skin provider about Eucrisa if you suffer with steroid-requiring chronic eczema to see if this would be a worthwhile therapy.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of fluocinolone topical in the pediatric population. However, because of this medicine's toxicity, it should be used with caution. Children may absorb large amounts through the skin, which can cause serious side effects. If your child is using this medicine, follow your doctor's instructions very carefully. For the body oil form, safety and efficacy in children 3 months of age and younger have not been established.

A common mistake is to be too cautious about topical steroids. Some parents undertreat their children's eczema because of an unfounded fear of topical steroids. They may not apply the steroid as often as prescribed, or at the strength needed to clear the flare-up. This may actually lead to using more steroid in the long term, as the inflamed skin may never completely clear. So, you may end up applying a topical steroid on and off (perhaps every few days) for quite some time. The child may be distressed or uncomfortable for this period if the inflammation does not clear properly. A flare-up is more likely to clear fully if topical steroids are used correctly.

You can buy some topical corticosteroids "over-the-counter" without a prescription. For example, for dermatitis, you can buy the steroid cream called hydrocortisone 1% from your pharmacy. Do not apply this to your face unless your doctor has told you to do so. This is because it may trigger a skin condition affecting the face ( acne or rosacea. ) Long-term use may also damage the skin. On your face this would be more noticeable than the rest of your body. So usually only weak steroids are used on the face. Those which are suitable are prescription-only.

Mild topical steroids for eczema

mild topical steroids for eczema

A common mistake is to be too cautious about topical steroids. Some parents undertreat their children's eczema because of an unfounded fear of topical steroids. They may not apply the steroid as often as prescribed, or at the strength needed to clear the flare-up. This may actually lead to using more steroid in the long term, as the inflamed skin may never completely clear. So, you may end up applying a topical steroid on and off (perhaps every few days) for quite some time. The child may be distressed or uncomfortable for this period if the inflammation does not clear properly. A flare-up is more likely to clear fully if topical steroids are used correctly.

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