Corticosteroid treatment for eczema: Its mechanism and alternative therapies
Eczema, a common skin condition that causes itch, irritation, redness, dryness, and swelling, can be managed effectively with various treatment options. One such option is hydrocortisone, a low potency steroid medication.
Hydrocortisone cream is a popular choice for temporarily reducing eczema rashes, itching, swelling, redness, and irritation. However, it's crucial to note that children under the age of 10 should not use hydrocortisone treatments without the approval of a healthcare professional. Pregnant or nursing individuals should also consult their doctor before using over-the-counter hydrocortisone treatments.
Side effects from mild hydrocortisone treatments are possible, but they are not common if people use the products for less than 4 weeks. These side effects may include dry, cracked skin, itching, and burning. To use hydrocortisone to treat eczema, a person may apply a small amount to the affected area up to 4 times per day for up to 7 days.
If hydrocortisone proves ineffective, a healthcare professional may prescribe other topical medications, oral steroids, immune-suppressing medications, immune-suppressing injections, or phototherapy. It's important to remember that applying hydrocortisone to infected skin may allow the infection to spread.
Eczema treatment typically involves a combination of skin hydration, immune modulation, and lifestyle adjustments tailored to severity and individual triggers. Moisturizers and barrier repair ointments, containing ingredients like ceramides, colloidal oatmeal, shea butter, coconut oil, and sunflower seed oil, can help repair and hydrate the skin barrier, reducing dryness and irritation.
Topical calcineurin inhibitors, immune-suppressing creams and ointments, help decrease inflammation and prevent eczema flares without the side effects of steroids. For more severe cases, doctors may prescribe systemic corticosteroids, immunosuppressants, or antibiotics if infection occurs.
Antihistamines can reduce itching and help prevent scratching, especially at night, by causing drowsiness. Phototherapy, controlled exposure to ultraviolet (UV) light, can improve symptoms, particularly for widespread eczema. Biologic therapies, injectable medications like dupilumab and tralokinumab, target specific immune pathways involved in eczema and are used for moderate to severe cases.
Wet wrap therapy, applying moisturizer followed by wet then dry cotton layers to affected skin, can enhance hydration and soothe symptoms, though it is time-intensive. Natural remedies, such as oatmeal baths or products with colloidal oatmeal, soothe itchy and inflamed skin, and cool compresses can help alleviate irritation.
Certain foods may trigger a person's eczema. A person should not make any significant dietary changes without speaking with a healthcare professional, who may refer them to a dietitian to help manage any potential allergies. Emotional stress and mental health conditions such as anxiety and depression may worsen eczema symptoms.
Eczema can develop at any age and there are several types, including atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and stasis dermatitis. Strong hydrocortisone treatments, when used on a large area of skin for an extended period, may cause serious side effects such as thinning of the skin, stretch marks, rosacea, perioral dermatitis, folliculitis, changes in skin pigment, and other potential side effects.
In conclusion, understanding eczema treatment involves knowing the various options available, their potential risks, and the importance of a combination approach tailored to the individual. Always consult a healthcare professional for the most effective treatment or combination of treatments for your eczema symptoms.
[1] National Eczema Association. (2021). Eczema Treatments. [online] Available at: https://nationaleczema.org/eczema/treatments/ [Accessed 20 Mar. 2023].
[2] American Academy of Dermatology. (2021). Eczema Treatments. [online] Available at: https://www.aad.org/public/diseases/eczema/treatment [Accessed 20 Mar. 2023].
[3] Mayo Clinic. (2021). Eczema (Atopic Dermatitis): Diagnosis & treatment. [online] Available at: https://www.mayoclinic.org/diseases-conditions/eczema/diagnosis-treatment/drc-20374214 [Accessed 20 Mar. 2023].
[4] American Academy of Dermatology. (2021). Moisturizers. [online] Available at: https://www.aad.org/public/diseases/eczema/moisturizers [Accessed 20 Mar. 2023].
Hydrocortisone cream is a popular choice for temporarily reducing eczema rashes, itching, swelling, redness, and irritation. However, children under the age of 10 and pregnant or nursing individuals should consult their doctors before using over-the-counter hydrocortisone treatments due to potential side effects.
Topical calcineurin inhibitors, such as immune-suppressing creams and ointments, help decrease inflammation and prevent eczema flares without the side effects of steroids.
Phototherapy, a controlled exposure to ultraviolet (UV) light, can improve symptoms, particularly for widespread eczema.
It is crucial to remember that applying hydrocortisone to infected skin may allow the infection to spread, thus it is essential to consult a healthcare professional for an accurate diagnosis and effective treatment.
