Eczema treatments: using steroids
The steroids young people had used for their eczema varied in terms of:
- main steroid type/ingredients – for example, hydrocortisone or clobetasone (Eumovate, Trimovate) or betamethasone butyrate (Betnovate)
- form (cream/ointment, tablet, injection, eye drops)
- potency (the strength of the steroid) and concentration (some steroids are available in diluted strengths)
- for different body parts
People were aware of the risks of steroid creams, which include thinning of the skin (skin atrophy) and making eczema worse in the long run. Some people thought that overuse of steroids had made their skin more fragile and damaged their immune system. Aisha gets a lot of colds and thinks this is because steroids have “worn sort of my natural defence down”. Vicky says she was given strong steroids as a child before doctors were as aware of the risks. Some people worried that doctors gave out stronger steroid creams than necessary. Anissa would like doctors to be clear that you should always use an emollient even if a steroid is needed. Some people we talked to tended to put steroid cream on first and then their emollient on top or not any emollient at all. Other people found that doctors wouldn’t prescribe them strong enough steroid creams to treat their eczema. This could be very frustrating. Aisha says that it was only when her dad argued with the GP that she was prescribed a suitable steroid cream. Some people worried they used too much steroid cream. The advice from doctors is to use it sparingly (after letting emollient soak in) and for short periods of time. It’s especially tempting to “slather” and “plaster” it on when you are in pain or feel self-conscious though. Aadam occasionally puts steroid cream on his face because he wants “to conceal it, even with the risk.” He sometimes uses more steroid cream and eye drops when he’s feeling stressed to try to prevent flare-ups. Others also said they sometimes used their steroid creams more often than their doctors advised, in the hope of their eczema healing quicker.
Sarah, Aisha and Georgia have researched ‘topical steroid withdrawal’: when your body has got too used to steroids (addicted) and you have ‘rebound flares’ when you stop taking it. Some people experienced side effects which included burning or stinging when they applied steroid creams. Ointments can help this problem as they are less likely to cause stinging. Georgia’s skin sometimes became more red, inflamed and warm after using steroid creams. Ele had to instantly wash off one steroid cream she tried and now avoids using it. Molly doesn’t like how steroid creams smell and feel (greasy) which can get on her hair.
People weighed up risks and benefits for steroid treatment. Gary wants his eczema treatment to “be as natural and as healthy as possible”, but accepts he may sometimes need steroid creams. Sarah’s approach during university exams was to “do what you’ve gotta do to get it maintained through that period of stress and then afterwards you can maybe try to be a bit more holistic about it”.
Help and advice from others about steroids for eczema
Like with emollients, people sometimes had help with applying steroid cream when they were younger, in pain or couldn’t easily see the body part affected. Some parents reminded the person to use the steroids when needed, others were more ‘hands off’ and tended to let the young person get on with using the emollients and steroid creams.
A few people knew that they could buy weak steroid creams from pharmacies and only visited their doctors if they needed something stronger or wanted one specific to them.