Topical Steroid

Topical corticosteroid is another topical medicine I have been utilizing only during severe flare-up. It is a steroid and undoubtedly it will have adverse effect to our body if applied and used for long term purpose. It is best to opt for the form of ointment instead of cream as ointment indirectly moisturizes the affected part. Corticosteroids will suppress our body’s natural inflammation response, effectively reducing the redness (anti-inflammatory) and itch of the affected part. It is considered the fastest and most effective method of temporarily soothing eczema. However, application in a long term basis will thin the skin, making the skin more sensitive. I will take full precaution when applying any form of steroid on my skin. Also, I will clean the affected parts before proceeding to apply any steroid on them.

Topical steroids are classified in terms of potency. Weaker ones are for thin skin and sensitive areas such as face, armpit, perianal skin and groin. Hydrocortisone is a weak topical steroid I usually use on my delicate skin of the face and neck. However, I will only apply very thin layer of it to avoid any adverse side effect in future. The moderate ones such as Betnovate (Betamethasone Valerate) and Elomet (Mometasone furoate) are commonly used for atopic eczema. These two steroids are a lot more potent than hydrocortisone. Betnovate has a higher strength than Elomet and should be used less frequently. I will use Betnovate on thick skin areas such as my feet. Elomet will be the one I generally use for my body, hands and legs. Steroid does have its negative long-term side effect on our skin and should only be applied as thinly as possible on the affected part during flare-up only. 

Elomet is pricey and I use it in the form of ointment during flare-up and cream if the condition is better. However, I will only apply very thin layer to the affected parts, gently rub and massage the skin surface to avoid any irritation or sensitization. Each gram of Elomet cream contains active mometasone furoate 1 mg that exhibits anti-inflammatory. It is very effective and is sold over-the-counter in Malaysia. However, a prescription is needed in Australia and New Zealand. Betnovate on the other hand is a little cheaper and more commonly prescribed in Malaysia General Hospital or clinics. Betnovate and Elomet can be absorbed into the body even though it is prescribed for skin complications, which in turn lead to side-effects affecting other parts of body. I will wash the steroid off if I feel uncomfortable in it. There is a sensation of skin burning after the application that will go away in a while. I will not apply them on my face and neck either and will reduce the number of times using them as the skin gets better. 

There was a time when my eczema was so severe that it was spreading all over my body. My body was so itchy that antihistamine would not help and topical steroid was insufficient to cover the entire body. Doctor prescribed me prednisone tablet to suppress inflammatory process in my body. It was taken orally to suppress the immune system and inflammation but the dosage was tapered (lowered gradually) after a few days. Prednisone will not be normally prescribed unless it is necessary. The adverse effect of taking prednisone is significant. It might increase the frequency of infections due to immune system being suppressed and prolonged usage will cause adrenal glands to shrink and stop producing body’s natural corticosteroid (especially cortisol). Cortisol is a steroid hormone that stimulates the formation of glucose and it activates anti-stress and anti-inflammatory pathways. Prednisone should not be abruptly stopped if taken for more than seven days; instead, the dosage is gradually reduced.