Are Corticosteroids Safe for Use in Atopic Dermatitis?

Atopic dermatitis is a common skin condition affecting people of all ages that causes inflammation and itching. Corticosteroid creams are commonly used to treat this condition, but are they safe? The risks and benefits of using these medications are explained in this article.

Key takeaways:
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    Topical corticosteroids are safe and effective for use in atopic dermatitis.
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    To prevent side effects such as cortisol suppression and skin changes it is important to use the lowest potency for the shortest duration of time.
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    Intermittent use of topical corticosteroids is safe and effective in preventing atopic dermatitis outbreaks.
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    Children are more susceptible to the adverse effects of topical corticosteroids, but these can be minimized with their proper use.
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    Talk with your doctor to determine the best regimen and agent for you.

Are corticosteroid creams safe to use?

There are many different corticosteroid creams available for use in many different skin conditions, one such medication is Advantan cream. These creams use a synthetic version of the body's natural hormone, cortisol. These produce an anti-inflammatory effect that is beneficial in atopic dermatitis.

Although like all medications, there are risks to using corticosteroids, following these simple guidelines can help to minimize these risks.

  • Talk with your doctor about using the lowest potency and strength of corticosteroid necessary to manage the symptoms of atopic dermatitis.

  • Follow the directions on your prescription and do not use them more frequently than prescribed.

  • A general guideline for applications is the use of a finger-tip unit, apply a dose of cream from the tip of the finger to the distal interphalangeal joint (the first crease encountered). This amount should be applied over an area equal to 2 adult palms.

  • Monitor for any changes in the skin and report them if they occur to your doctor.

Skin changes such as thinning, bruising, stretch marks, acne, and telangiectasia (spider veins) can occur but are infrequent when using low-potency corticosteroids as prescribed. If any of these conditions are seen, they should be reported to your physician, as early treatment is essential to minimizing the long-term effects.

Finally, suppression of the body's production of natural cortisol is a concern when using these medications. However, using the lowest dose and potency and using the creams intermittently can reduce the risk of this occurring. The suppression is greater if using oral or inhaled corticosteroids in conjunction with the creams, therefore, you must tell your doctor about every medication you are taking.

Overall, the use of topical corticosteroids is safe and effective for the treatment of atopic dermatitis.

How often can I use topical corticosteroids?

Topical corticosteroids are often prescribed to be used on the affected areas twice daily. This frequency is typically used for symptomatic atopic dermatitis lesions to help them heal. The use of the cream as prescribed is important to prevent the side effects described above.

The once-daily use of corticosteroids, especially the more potent ones, has also been shown to be effective in treating atopic dermatitis. The use of these medications 1–2 times a week on areas of the skin that experience frequent and repeated outbreaks can be very effective for prevention. This infrequent use reduces the side effects while improving patient outcomes.

Are corticosteroids effective in atopic dermatitis?

Corticosteroids have been used in patients with atopic dermatitis for over 60 years. They are effective in relieving red, dry patches of skin. They are also helpful in rashes that bleed, ooze or weep clear fluid and prevent the thickening and hardening of the skin in atopic dermatitis patients.

Are corticosteroids safe to use in children?

Children have a greater surface area to weight ratio making them more susceptible to the suppression of cortisol secretion with the use of topical corticosteroids. However, the risk is low but increases with prolonged use of corticosteroids especially in children using other medications with corticosteroids.

There is some concern that height is affected by long-term corticosteroid use. But, studies have shown that the overall adult height of children is not affected.

Overall, the benefits of corticosteroids outweigh the risks in children. It is important to discuss any concerns with your child's physician before and during the use of corticosteroids.

Are there safer options to treat atopic dermatitis?

The safest option in treating atopic dermatitis is the use of non-pharmacologic treatments such as:

  • Moisturizers — these can improve the dry skin and inflammation seen in atopic dermatitis and reduce the need for medications.
  • Bathing — a minimum of once-daily bathing using warm water for 5–10 minutes is recommended to help remove serous crusts and improve symptoms. However, the application of moisturizers immediately after bathing is required to prevent the drying effect of bathing.

The use of corticosteroids is safe and effective in the treatment of atopic dermatitis when non-pharmacologic treatments fail to control symptoms. They should be used as sparingly as possible using the lowest potency agent that is effective. It is important to discuss your treatment options with your doctor to make sure you have the safest, most effective treatment regimen.

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