The important things to remember about topical steroids are:
1. They are used to reduce the inflammation (redness) of the skin and reduce the itch by reducing itch and scratching and allowing the skin to heal.
2. The weakest topical steroid needed to maintain control of your child’s eczema should be used.
3. Ointments are generally the best for eczema unless the skin is wet and ‘weepy’.
4. Always use topical steroids in combination with emollient use but allow at least half an hour for steroids to soak in before applying the emollient or you will dilute the topical steroid and reduce its effectiveness.
5. If used correctly topical steroids should not cause side effects. Thinning of the skin and stretch mark will occur if too strong and if a steroid is used over a prolonged time.
6. When applying a cream or ointment to skin apply it in a downward motion. In general, just a ‘shiny’ layer of steroid on the skin is the right amount, or follow the fingertip measurement.
Strengths of steroids commonly used at the Royal Victoria Infirmary:
- Mild steroids – Hydrocortisone 1% or 0.5% - this is the only steroid used on the face unless instructed by a dermatologist.
- Medium strength – Eumovate or Betnovate RD
- High strength – Betnovate
- Very high – Dermovate – should not be used on children unless instructed by a dermatologist