The skin is inflamed, itchy, and red, it may have fever in it as well as open lesions, usually from scratching. It affects approximately 17 million American people, the majority of which have less severe forms of the disease. Many of these suffer from Atopic Dermatitis, which is what most people refer to when they say the word eczema.
Of these people, less than 20% of the skin is affected. The symptoms can be: itchiness, inflammation, cracking, open lesions, scaling and extreme pain. These can usually be alleviated through the use of steroidal medications.
Many people are fearful of steroidal treatments for eczema because of side effects that they have heard about in association with steroids. Good communication with an experienced dermatologist who will monitor your use of corticosteroids (the topical steroidal treatments frequently prescribed for eczema) will lessen your risk of side effects. Treatment with these medications has proven very useful in alleviating the symptoms of eczema.
Treatment is designed to alleviate current symptoms or prevent future symptoms from arising (flare ups). It takes a combination of patient cooperation in avoidance of triggers, skin care, and proper use of prescribed medications to achieve these goals.
Medications like corticosteroids should always be monitored by your physician or dermatologist. It is important to have an experienced doctor to be the monitoring party. Through careful monitoring, the possibility of severe side effects is nearly eliminated, even with long term use. Your part in this is to use the medication exactly as prescribed. Too few applications will not produce desired results and too many will bring the more serious side effects into play.
Topical corticosteroids:
Ointments and creams which are applied to the skin’s surface are topical medications. Topical corticosteroids are the favorite form of prescribed medication for alleviating symptoms of eczema. You can find extremely mild forms of these in non prescription products like Cortaid, but they seldom give much relief for eczema sufferers.
Prescription strengths have a wide range of potency and your doctor/dermatologist will generally attempt to alleviate symptoms with a very mild dose (like hydrocortisone) initially and work up from there. Only very mild forms can be used in sensitive areas and around eyes.
Corticosteroids in mid range potency are available in a lotion and are excellent for symptoms on the torso area. High range potency is usually saved for more severe symptoms that refuse to respond to other less strong treatment. This dosage is only used to clear the rash and should not be sustained any longer than necessary to achieve this effect.
Depending on the severity of the eczema flare up and the prescription strength, your rash should clear within one to three weeks. Highly potent medications are usually prescribed to be used for a few days, then left off for a few days, then used again with the cycle repeating until the eczema symptoms are gone.
Systemic corticosteroids:
Systemic medications are medications which are taken into the body through oral doses or through injection. Treatment with systemic corticosteroids is a final phase attempt to treat symptoms of eczema that will not respond to either topical treatments or phototherapy.
Usually, you will have a high dose the first day followed by about half that dose for a few days, and then half of that again for the final days of treatment. Systemic corticosteroid usually lasts no more than 10 days and provides nearly immediate relief for the patient, although complete clearing takes longer.
Systemic corticosteroids should never be taken by anyone who has not had them prescribed or by pregnant women (birth defects are possible). Children may use them through doctor orders, but should not be on them repeatedly.
Possible side effects:
It is important to remember that listed side effects are directly related to dosage strength, method of administration, patient age, affected area, duration of therapy, and monitoring by your doctor. With careful dosing and monitoring, the more serious side effects should not affect you.
Corticosteroids can cause: cataracts, Glaucoma, nausea, vomiting, growth retardation, peptic ulcers, hypertension, osteoporosis, stretch marks, spider veins, weight gain, infection, thinned skin, and dilated blood vessels.
