Topical steroid treatment for eczema

Pathologic phimosis is a common problem throughout the world. In Europe, Asia, South America, and Central America neonatal circumcision is not routinely performed, thus childhood phimosis is not rare. In addition, in the United States and Canada the rates of neonatal circumcision, estimated to be 60% to 90%, 5 are declining. 9 Thus, even in the United States and Canada, phimosis is a commonly faced problem. Obviously, one of the difficulties that arises when studying phimosis is the lack of a clear definition and differentiation between a pathologic phimosis and a physiologic nonretractile foreskin. 10 In our study, nonretractable and pinpoint prepuces correspond to type II and type I of the classification by Kayaba et al. 11 The cases classified as ''retractable'' phimosis might not be considered pathologic by others because of a potential for spontaneous resolution with increasing age. However, all patients included in our study were originally referred for circumcision, they all had a constrictive ring for which they had sought medical attention, and they would have been considered candidates for circumcision if topical therapy had not been offered. [CIRP note: These doctors show the common inability to distinguish between normal in childhood developmentally narrow foreskin and a pathological condition called phimosis.]

Topical steroids are available as creams, lotions, gels and ointments; selection of an appropriate product can also provide good moisturization of the skin. The wide spectrum of potencies and bases allows these mediations to be used both effectively and safely while under the care of an experienced physician.

During flares, over-the-counter moisturizing preparations that include a topical corticosteroid (such as clobetasone butyrate and hydrocortisone) are helpful to control inflammation and restore the skin barrier. The intensive use of emollient-based products can reduce the need for topical steroids.

1. Moisturizers. Some people cannot tolerate any moisturizer during withdrawal – especially in certain stages of withdrawal, but here are the moisturizers many of our forum members like to use.  Please spot test everything to make sure the skin can tolerate the moisturizers or soaps and remember to only try one new thing at a time. Also note that the skin may accept something for a while and then become irritated at another stage of withdrawal when the same product is applied. Most people find emollients, ointments or balms made with simple ingredients to be more comfortable than creams or lotions.

The obvious priority is immediate discontinuation of any further topical corticosteroid use. Protection and support of the impaired skin barrier is another priority. Eliminating harsh skin regimens or products will be necessary to minimize potential for further purpura or trauma, skin sensitivity, and potential infection. Steroid Atrophy [10] [11] is often permanent, though if caught soon enough and the topical corticosteroid discontinued in time, the degree of damage may be arrested or slightly improve. However, while the accompanying Telangectasias may improve marginally, the Striae is permanent and irreversible. [1]

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

Topical steroid treatment for eczema

topical steroid treatment for eczema

The obvious priority is immediate discontinuation of any further topical corticosteroid use. Protection and support of the impaired skin barrier is another priority. Eliminating harsh skin regimens or products will be necessary to minimize potential for further purpura or trauma, skin sensitivity, and potential infection. Steroid Atrophy [10] [11] is often permanent, though if caught soon enough and the topical corticosteroid discontinued in time, the degree of damage may be arrested or slightly improve. However, while the accompanying Telangectasias may improve marginally, the Striae is permanent and irreversible. [1]

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