Examples
Several
corticosteroid creams and ointments are available for
controlling
atopic dermatitis symptoms. These products are
classified according to potency, ranging from group I (the most potent) through
group VIII (the least potent). They are prescribed according to the
type of rash you have.
Nonprescription
|
| hydrocortisone | Aveeno Anti-Itch, Bactine, Cortaid, Dermolate |
Prescription, low strength
|
| hydrocortisone | Cort-Dome, Dermacort, Hytone, Synacort |
Prescription, medium strength
|
| betamethasone | Diprosone |
| flurandrenolide | Cordran |
| fluticasone | Cutivate |
| hydrocortisone | Westcort |
| triamcinolone | Aristocort, Kenalog |
Prescription, high strength
|
| betamethasone | Diprosone |
| fluocinonide | Lidex |
| triamcinolone | Kenalog |
Prescription, very high strength
|
| betamethasone | Diprolene |
| clobetasol | Temovate |
Corticosteroid preparations are applied to the skin 1 to 4
times a day, depending on the strength of the preparation and your age. These medicines may be available as creams, lotions, or ointments.
How It Works
Corticosteroids are similar to natural
substances the body produces. In atopic dermatitis, corticosteroids reduce
inflammation, itching, and thickening of the skin
(lichenification).
Why It Is Used
Topical corticosteroids are
prescribed for atopic dermatitis rashes. High-strength preparations can be used
on thickened skin. Avoid using high-strength topical corticosteroids on the
face.
How Well It Works
Topical corticosteroids, in
combination with aggressive moisturizing, are the most commonly used and
effective treatment for atopic dermatitis. For most
people, using a topical corticosteroid for 2 to 3 days significantly clears the
rash. Thickened skin requires longer treatment.
To gain the best
results from topical corticosteroid treatment, apply moisturizer after each
corticosteroid treatment and at least one other time during the day.
In some cases, wrapping the area with a bandage, called an occlusive
dressing, may improve atopic dermatitis. But high-strength corticosteroids
combined with an occlusive dressing can increase the risk of skin thinning and
other side effects.
Side Effects
Side effects include the
following:
- A burning sensation, itching, irritation,
dryness, or redness may develop in the area where the medicine is
applied.
- With long-term use, high-strength topical corticosteroids
cause temporary thinning of the skin, making it more easily irritated. But when
used carefully and mostly in low-strength doses, topical corticosteroids can be
used for up to 10 years without severe side effects.
- Corticosteroids can be absorbed through the skin and cause
problems throughout the body. Side effects include headache, indigestion,
increased appetite, restlessness, and increased risk of infection. If your skin
rash gets worse or if you have blurred vision, increased urination, excessive
thirst, or mood changes, see your doctor.
Side effects are associated with long-term use of
corticosteroids. You and your doctor must watch for side effects and weigh them
against the potential benefit of corticosteroid treatment.
The
face is especially sensitive to thinning of the skin. Using topical
corticosteroids on the face can result in enlarged blood vessels
(telangiectasias), bruising, acne, and stretch marks (striae).
See Drug Reference for a full list of side effects. (Drug Reference is
not available in all systems.)
What To Think About
- Avoid stronger corticosteroids on the sensitive
skin of the face, armpits, and genital area.
- When treatment with
topical corticosteroids begins, your doctor may prescribe medicines in a "pulse"
pattern. For example, you may use corticosteroids for 2 weeks. Then you stop
using them for 2 weeks. Then, you apply corticosteroids for another 2 weeks.
This pulse-pattern prescription may help keep the medicine from becoming less
effective over time.
- An
ointment form provides the best moisturizing effect for the skin. But ointments
may be uncomfortable in warm and humid conditions because they don't allow the
skin to breathe well. In these cases, creams or gels may be a better
choice.
- Topical corticosteroids may be alternated with
coal tar preparations if there is concern about
corticosteroid exposure. But this medicine should not be used on skin that is very irritated, because it can make your skin problem worse. Examples of coal tar preparations include 5% coal tar
in a hydro-alcoholic gel (such as Estar) or 5% liquor carbonis detergens in a
cream base.
- When using a topical corticosteroid for longer periods
of time, it is important to phase out its use gradually over 2 to 4 weeks,
replacing it with a moisturizer or a coal tar product.
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Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Alexander H. Murray, MD, FRCPC - Dermatology |
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| Last Revised | April 30, 2010 |
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