Avoiding Steroids when treating Eczema and Dermatitis
What is Eczema and Dermatitis?
The terms eczema and dermatitis are often used interchangeably because they are both related to skin inflammation, but dermatitis is the general term: it literally means skin inflammation, while eczema is a subset of dermatitis caused by an inappropriate immune response.
The 2 main types are:
Atopic eczema.
This is caused an inappropriate immune response from within the body.
If you have Atopic Eczema you are born with a tendency for your skin to flare up with inflammation from time to time. Ultimately, eczema isn’t a skin condition, it’s an internal immune disorder being expressed through the skin, so using any topical treatment is simply putting a Band-Aid on the problem.
Resolving eczema is more and involves investigations into and managing triggers as well as (in children) working to rebalance the immune system.
Contact dermatitis.
This is caused by something outside the body triggering an immune response (a topical allergic reaction).
You get patches of inflammation on areas of skin which have come into contact with the offending substance. If you avoid the trigger, the skin inflammation should go away.
Eczema/Dermatitis Treatment
Standard medical treatment normally revolves around using topical steroids (corticosteroids) put on the skin to reduce inflammation. They are usually used in addition to moisturizers to reduce the drying of the skin.
While topical steroids are prescribed because of their anti-inflammatory effect, they are known to have a relatively high ‘risk profile’ when used inappropriately.
If you’re using topical steroids more than 2 days in 7, or for longer than 4 weeks in any 6-month period then you’re probably using them too much and are at risk of side effects that, in the worst-case scenario, may actually be harmful.
Also, it’s important to avoid applying topical steroids to the face, genitals, skin folds, raw or thin skin, and areas that rub together, such as beneath the breasts, or between the buttocks or thighs (the very areas that are commonly affected by eczema) as this skin is more sensitive and therefore more at risk of side effects.
What are the Possible Side Effects?
Long term or improper use of topical steroids can damage the skin much more than the eczema/dermatitis you’re trying to treat. Common side effects of topical steroids include:
Thinning of the skin (atrophy)
Long term use weakens and thins the skin – making it both more prone to outbreaks of eczema/dermatitis and more prone to bruising and skin tearing
Delayed wound healing
On top skin thinning topical steroids suppress the skins immune response (a major mechanism of their effect) an as such can delay wound healing leading to the exacerbation of skin infections
Stretch marks (striae)
Because of skin thinning the elastic fibers in the skin are more prone to damage resulting in stretch marks
Spider veins (telangiectasia)
Topical steroids also affect blood vessels (are vasodilators), causing spider veins in treated areas. This is then exacerbated by skin thinning making the blood vessels more visible.
Acne and rashes
You’re using topical steroids to ‘suppress your rash’, right?
Unfortunately, inappropriate topical steroid use can cause rosacea-like rashes, acne or Perioral dermatitis (a rash around the mouth).
Localized increased hair thickness and length (hypertrichosis)
Treated areas may develop inappropriate hair growth, patches of thicker, faster growing and often darker hair that can contrast dramatically with the surrounding ‘normal’ hair.
Pigment alteration
Topical steroids can also cause changes in skin color (the darkening or lightening of patches of skin) with an accompanying sensitivity to light (sunburn).
Therefore, when using topical steroids sun exposure should be avoided.
Withdrawal rebound
More serious, this is where the effect of the eczema/dermatitis is only being suppressed by the topical steroid, with the condition returning rapidly (and often worse) when treatment is stopped, resulting in ongoing topical steroid use, and increasing the risk of other side effects.
Rare side effects of topical steroids may include:
- Cushing Syndrome: suppression of the Hypothalamic-pituitary-adrenal axis suppression leading to weight gain, potential diabetes, and a range of other potentially serious effects.
- Growth retardation in young children
- Glaucoma (damage to the eye’s optic nerve) and Cataracts (clouding of the eye lens)
- Topical Steroid Withdrawal
Topical Steroid Withdrawal has been reported in people who have used topical steroids for as little as a couple of weeks and then discontinued use, resulting in high levels of redness and inflammation, a burning sensation, and itchiness, and skin peeling which requires a stronger topical steroid to get the same result as the first prescription.
People with eczema are most at risk.
What’s the Alternative?
Given the risks posed by topical steroids, how can you manage your eczema/dermatitis while minimizing the risks?
Look at your triggers and treat the cause
Eczema and dermatitis are symptoms of a deeper condition, so look deeper – what are the triggers, can you avoid or manage them?
And if it’s a young child with eczema (under 5) it may be possible to support and redirect their immune system reduce its volatility and ‘cure’ the eczema symptoms over time.
Minimize the use of topical steroids
The side effects of topical steroids especially used long term, dramatically out way the short-term benefits.
Primal Herbaria DermaCare is specially formulated to support the natural healing of eczema and dermatitis.
As well as containing a natural moisturizer that helps relieve the dryness and itching of eczema/dermatitis, it contains herbs traditionally used for thousands of years to help soothe the skin, relieve the allergic reaction causing the skin rashes and reduce the inflammation and redness of the rashes.
On top of that because it’s steroid free, DermaCare is safe to use long term, giving you a tool in your eczema and dermatitis treatment regime that can minimize or even replace the use of harmful topical steroids.