Examples
Several
corticosteroid creams and ointments are available for
controlling
atopic dermatitis symptoms. These products are
classified according to potency, ranging from group I (the most potent) through
group VIII (the least potent).
Nonprescription
| hydrocortisone |
Aveeno Anti-Itch, Bactine, Cortaid, Dermolate |
Prescription, low strength
Prescription, medium strength
| betamethasone |
|
| flurandrenolide |
Cordran |
| fluticasone |
Cutivate |
| hydrocortisone |
Westcort |
| triamcinolone |
Kenalog |
Prescription, high strength
| betamethasone |
|
| fluocinonide |
Lidex |
| triamcinolone |
Kenalog |
Prescription, very high strength
| betamethasone |
Diprolene |
| clobetasol |
Temovate |
Corticosteroid preparations are applied to the skin 1 to 4
times a day, depending on the strength of the preparation and your age. These medicines may be available as creams, lotions, or ointments.
How It Works
Corticosteroids are similar to natural
substances the body produces. In atopic dermatitis, corticosteroids reduce
inflammation, itching, and thickening of the skin
(lichenification).
Why It Is Used
Topical corticosteroids are
prescribed for atopic dermatitis rashes. High-strength preparations can be used
on thickened skin. Avoid using high-strength topical corticosteroids on the
face.
How Well It Works
Topical corticosteroids, in
combination with aggressive moisturizing, are the most commonly used and
effective treatment for atopic dermatitis. For most
people, using a topical corticosteroid for 2 to 3 days significantly clears the
rash. Thickened skin requires longer treatment.
To gain the best
results from topical corticosteroid treatment, apply moisturizer after each
corticosteroid treatment and at least one other time during the day.
In some cases, wrapping the area with a bandage, called an occlusive
dressing, may improve atopic dermatitis. But high-strength corticosteroids
combined with an occlusive dressing can increase the risk of skin thinning and
other side effects.
Side Effects
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call
911
or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Hives.
- A worsening of the rash.
- A burning sensation, itching, irritation,
dryness, or redness where you applied the medicine.
- Blurred vision.
- Increased urination.
- Excessive thirst.
- Mood changes.
Common side effects of this medicine include:
- Headache.
- Indigestion.
- Increased appetite.
- Restlessness.
- Increased risk of infection.
The
face is especially sensitive to thinning of the skin. Using topical
corticosteroids on the face can result in enlarged blood vessels
(telangiectasias), bruising, acne, and stretch marks (striae).
With long-term use, high-strength topical corticosteroids
cause temporary thinning of the skin, making it more easily irritated. But when
used carefully and mostly in low-strength doses, topical corticosteroids can be
used for many years without severe side effects.
See Drug Reference for a full list of side effects. (Drug Reference is
not available in all systems.)
What To Think About
- Avoid stronger corticosteroids on the sensitive
skin of the face, armpits, and genital area.
- When treatment with
topical corticosteroids begins, your doctor may prescribe medicines in a "pulse"
pattern. For example, you may use corticosteroids for 2 weeks. Then you stop
using them for 2 weeks. Then, you apply corticosteroids for another 2 weeks.
This pulse-pattern prescription may help keep the medicine from becoming less
effective over time.
- An
ointment form provides the best moisturizing effect for the skin. But ointments
may be uncomfortable in warm and humid conditions because they don't allow the
skin to breathe well. In these cases, creams may be a better
choice.
- Topical corticosteroids may be alternated with
coal tar preparations if there is concern about
corticosteroid exposure. But this medicine should not be used on skin that is very irritated, because it can make your skin problem worse. Examples of coal tar preparations include 5% coal tar
in a hydro-alcoholic gel (such as Estar) or 5% liquor carbonis detergens in a
cream base.
- When using a topical corticosteroid for longer periods
of time, it is important to phase out its use gradually over 2 to 4 weeks,
replacing it with a moisturizer, a topical calcineurin inhibitor, or a coal tar product.
Taking medicine
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.
Checkups
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Adam Husney, MD - Family Medicine |
|
Specialist Medical Reviewer
|
Amy McMichael, MD - Dermatology |
|
Last Revised
|
April 17, 2012 |