Health Tips

“No, better not. I’m not keen to use steroid creams on my child.” Ouch. The common rejections I received from parents when they bring their child for skin conditions such as eczema. When I asked what are the reasons, many just say it’s bad. When I prompt further “Like, bad in what sense?”, I will usually get that one standard answer “It’s just bad…”.

Okay, that is not really the answer I want to hear but as long as it makes you happy. I mean, seriously? You can’t say it’s bad because you feel it’s bad. You got to know the reason why you are saying it’s bad, right?

I came across this article not too long ago published by Reuters, and it seems like it is not just a local problem but a worldwide misconception.

“Many people with eczema, a common skin disease, may avoid creams and ointments that can help ease symptoms like itching and inflammation because they’re afraid to try topical corticosteroids, a recent study suggests.“

Does this sound all too familiar? Are you one of those many parents?

“Too often we see infants who suffer and have not slept for months and parents exhausted just because they have wrong fear or beliefs about the treatment or the disease and don’t treat their child.”

Is this fear causing unnecessary distress to both you and your baby? On a side note, if you are unsure what type of rash you are facing, take a look at these common rashes in a newborn.

Fear of steroid creams. Is it really warranted?

Before we go on further, in order to justify these fears you which have, let us take a look at what are the long-term side effects of using steroid creams:

• Stretch marks appearing on the skin
• Skin gets darker
• Skin gets thinner that it breaks easily
• It causes acne to form
• It increases the risk of skin infections

Are these the side effects you fear most? If it’s not on the list, then likely your fear is not justified.

TOO MUCH OF SOMETHING IS ALWAYS NOT GOOD

Okay. I know you are thinking about money here but money aside, it is all about moderation. It is just like consuming too much of sugar will increase the chance of developing diabetes, using steroid creams for a long period of times will cause your baby to have these side effects. Also, a gentle reminder that low strength steroid creams rarely cause such issues in the beginning. Only high strength steroid creams do.

How to use steroid creams safely?

One word. Knowledge. Once you have it, you will be the one in control and thus be minimising the risks involved.

The strength of the steroid creams, from the lowest to the highest (at least the common ones you will see):

• Hydrocortisone acetate 1%
• Betamethasone valerate 0.025%
• Betamethasone valerate 0.05%
• Betamethasone valerate 0.1%
• Mometasone furoate 0.1%
• Clobetasol propionate 0.05%

Hydrocortisone being the lowest and clobetasol being one of the stronger ones. There is a whole lot more to this list but I am not going to list them because it is just gonna be a list of fanciful words. In general, mild cases of eczema would benefit from low strength steroid creams and with frequent use of moisturizers to keep your baby’s skin well hydrated. You can just buy these over the counter at the pharmacy. The stronger ones would require a prescription from a doctor. However, not to forget that we are in Bolehland after all, so anything is possible. So just be wary when you buy these creams. Make sure you are getting the right ones.

Do not be afraid

What I am trying to say is, do not be afraid to use steroid creams when there is a need to use it. Use it correctly and side effects will be unlikely. If you come across articles telling you that steroids are just plain bad and to avoid them at all cost, then I can tell you that these articles are nothing but bull. You have to get your facts right.

Let us take a quick look at this research study that has been conducted:

“In the 2 studies that compared nonadherence between a phobia group and a non-phobia group, patients in both phobia groups were found to have a significantly higher rate of nonadherence (49.4% vs 14.1% and 29.3% vs 9.8%).“

Don’t mind the technical terms. This is what it means. If you are afraid of using steroid creams, chances are that you will stop using steroid creams to treat your child’s eczema earlier as compared to the duration of time prescribed by the doctor. To make it simpler, take this for example. A doctor gives you a 7-day course of antibiotics to take but you take 3 days only. That is an incomplete treatment. This theory applies to the treatment of eczema too. You need to use the steroid creams for a certain duration of time before you see improvement in your baby’s skin condition.

Can I still use natural creams?

No one said about not using natural creams. By all means, go ahead. However, you must also understand that in bad cases of eczema, these steroid creams help to suppress the redness and itchiness (inflammation) of the skin relatively quick, providing a fast relief for your child.

When the rash gets extremely itchy:

• Your child is irritable
• Your child will not be able to sleep through the night
• Your child will not grow well because of interrupted sleep
• You will not be able to get good sleep yourself
• You will get stressed up about it

It sounds very trivial, but when you are in situations such as above, you will want to think twice about using steroid creams. You can refer to another article of ours if you want to learn how to control eczema more effectively.

Remember, steroid creams are not bad. You just have to know how to use them. It is that simple. The choice is yours.

Image credit:

1. https://encrypted-tbn0.gstatic.com/images?q=tbn%3AANd9GcR80fD_wCmngJx0jFmpdT2PzcDPdtdPa_Strw&usqp=CAU
2. https://healthtimes.com.au/administrator/uploads/article_images/steroids1486362840.jpg
3. https://www.hopkinsmedicine.org/-/media/images/health/_-images-to-be-filed/eczemababyistock_000068584761_640_contentimage.ashx?h=358&la=en&mh=360&mw=520&w=520&hash=6F825AE08D76EFEF45C4B43711CB7DF5796F7D38
4. https://www.ethissa.com.my/wp-content/uploads/2017/10/Post82f.jpg
5. https://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/articles/health_tools/childhood_skincare_dos_donts_slideshow/493ss_thinkstock_rf_baby_face_cream.jpg

References:

1. Topical Corticosteroid Phobia in Atopic Dermatitis | The JAMA Network
2. Fear keeps many eczema patients from using steroid creams | Reuters
3. Topical Corticosteroids | Medscape

In collaboration with Ethissa

Written by

Dr. Eric Siew