Topical
steroids shared their diamond anniversary with the Queen in 2012. Sixty years
ago they were developed as a new dermatological treatment and remain the mainstay
of eczema treatment today. Topical steroids are used to control eczema flares,
so are not a cure. They are prescribed widely but often parents and people with
eczema are very cautious about topical steroids as a treatment for eczema.
Why
are topical steroids viewed as such a controversial treatment? In my clinic, I
spend time with my patients discussing how they use their treatments. I ask if
they have any concerns about using their treatments. Topical steroids tend to
be a treatment that in most cases is under-used and the one treatment that
everyone is concerned about. Surely, this is a strange for a treatment that has
been available for 60 years.
Topical
steroids are drugs applied to the skin, so like any other drug they have side
effects. However, side effects are unlikely if they are used correctly for
short-term treatment of eczema flares. My patients are very worried about
topical steroids damaging and thinning their skin. Unfortunately, these
concerns are often accentuated by health care professionals, as they are often
reluctant to apply potent steroids and tell patients to apply very sparingly.
In reality, skin is more likely to be damaged from constant scratching and
rubbing, if an eczema flare is not adequately treated.
In
the 1950’s, topical steroids were regarded as a break-through in eczema
treatment. In the 1960-70’s, they were prescribed in large quantities, often
mixed with emollients and used continually. This is when over-use did result in
side effects and in the 1980’s and beyond, health care professionals became
very cautious in prescribing and patients became fearful of topical steroids.
There
have been few significant innovations in eczema treatment over the last 60
years. Topical calcineurin inhibitors were developed in the 1990’s and are a
topical treatment, used for flares and maintenance treatment, alongside topical
steroids. DreamSkin Health garments represent a break-through in eczema
treatment for the 21st century.
