Is steroid cream safe?

Elomet cream

In my post on “Are you suffering from Steroid-Phobia?”, I have encouraged parents to be open to using steroids under the doctor’s supervision. My baby girl Marcie has taken a one-time 3 weeks oral steroid course and has been applying steroid cream prescribed by her specialist doctor, like the o.1% Elomet Cream.

A recent research study confirmed that there is no major negative effect on the skin of children who have applied topical steroid over approximately 10 months. I couldn’t find the original study, supposedly published in Pediatric Dermatology. You can however find a summary of the report, widely published by numerous online news websites here. Main points reported by the online news are:

– 70 children tested versus a control group of 22 children

– 10 months’ usage with experts checking on skin transparency, flattening, shiny ‘glazed’ appearance or dilated blood vessels

– Result is no evidence of skin thinning, stretch marks or scars

– Do note that there is also comment that the sample size is too small, with information such as their age, doses not provided

For parents fearing the use of too potent steroid, below is a potency ranking chart from National Skin Centre’s website.

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Last update was on: 21 September, 2018 2:17 am

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20 Comments
  1. Hi Mei, my 3 month old baby is having very dry skin and rashes ans itchiness at whole body, face and scalp which is eczema. After i found your post, i want to try elomet cream on my baby. I just want to know should i apply QV cream first or elomet cream first? Can you share with me how you take care of baby’s eczema? Appreciate your effort to share with your view and experience. Thanks a lot.

    • Hi Maryam, thanks for dropping by my blog and sorry to hear of the eczema. Have you been prescribed elomet cream? For 3 months old, you may wish to start off with the lowest potency steroid cream (liquid hydrocortisone cream) rather than Elomet. Do see a pediatric dermatologist and also take allergy test to identify triggers (the common ones such as dust mite, egg, milk, peanuts, cats dander, dog dander) are tested for skin prick test.

      So to emphasize..
      1. Make sure the usual skincare routine is done correctly, i.e. not using soap, and diligently moisturizing
      Videos on basic skincare
      http://eczemablues.com/2013/10/aad-skincare-video-series-sunscreen/
      Learn about moisturizers
      http://eczemablues.com/2012/04/sensitive-skin-product-series-how-to-manage-the-diaper-area/

      If the normal skincare is not done correctly, then even with steroid cream, the dry skin will still remain and be itchy..

      2. Steroid cream use
      – Start with lowest potency
      – No more than twice a day
      – No more than two weeks, i.e. if it doesn’t work, something has to change.. can’t keep piling the same steroid cream that does not work as steroid cream has side effects
      – To answer your question > generally, the advice is apply steroid cream first so that it can act on the skin directly; then moisturize
      – Don’t apply wet wrap or dry wrap over the steroid cream on skin as that would increase the absorption onto the skin more than the medication is formulated to (be absorbed)
      – Avoid thin areas of skin

      3. Other treatments that are worth noting
      – Wet wrap (I use just one layer, which is known as dry wrap)
      – Clean the skin with chlorhexidine gluconate (diluted) before applying steroid cream
      More on the above two:
      http://eczemablues.com/2011/12/easy-to-use-wet-wrapping-to-keep-childs-skin-hydrated/
      http://eczemablues.com/2012/11/staph-bacteria-series-with-dr-clay-cockerell-understanding-staph-bacteria-on-eczema-skin/
      Staph bacteria colonizes eczema skin and increasing research link staph to promoting skin inflammation, which in a way is sabotaging the treatment efforts or effect of any prescription if the bacteria is not first reduced

      Hope above helps!
      Mei

      • Thank you so much dear Mei. Really helpful. I will follow your suggestions. No, I have not seen ped for he only prescribed Aqua cream which is very low effectiveness. But I intend to meet him soon. So i am start applying QV cream for my baby and see how it goes.
        Thanks again.

        • Welcome Maryam and hope your son’s skin improves soon, hang in there! And yes, Aqua cream is quite basic; if you can afford, can use creams that contain ceramides/ skin lipids – see this post on moisturizer selection
          http://eczemablues.com/2015/09/selection-of-moisturizer-ii-moisturizer-and-ingredients/

          It’s important to protect the skin from young as increasing research are showing the possibility that a defective skin barrier can lead to food allergy (as opposed to conventionally when it was thought food allergy causes rashes).

          Take care, hugs,
          Mei

  2. […] How long should a patient use the prescribed corticosteroid before giving feedback to the physician of no noticeable improvement in […]

  3. what about the redness of laser operation , does it effect on that or no ?? i did a laser operation the then i misused wrong cream then my face got redness all the area that i did laser on since three months till now redness still on myface !!

    • Hi Sadeq,

      No experience with that, but I guess that after a laser, your skin is more vulnerable and thus more exposed to ingredients in the cream you use which may normally not irritate.

      Hope all’s ok now, take care,
      Mei

  4. Hi Mei, your blog is very informative! Thanks for sharing your experiences and I think you have done a good job for Marcie. Anyway, could you tell me which are the steroid creams that you are using of different potency (besides Elomet)? My 2 year old daughter has quite serious eczema and I am only using Fucicort cream as prescribed by her GP.

    • I’m using the mild ones for my daughter, Elomet and Hydrocortisone. Fucicort is a high potency I think.. you may want to visit a pediatric specialist who would have lower potency creams, allergy testing as well as other medication (non-steroidal, wet wrap) for your child. From experience, GP usually don’t carry lower potency and continually using a strong cream may not be the optimal treatment option for a 2 year old. Take care, hugs,
      Mei

  5. hi can I pls check wat is de charges lik for dr hugo if I make a direct appt with him instead of gg thru referral? also do all kids with eczema meed to go thru de skin test?? thks alot 🙂

    • Hi Yee!

      I can’t quite remember the charges, but I think it’s standard fees for different grades of consultants and whether by referral/not. Can simply call up NUH to ask.

      Whether or not eczema kids need to go through skin prick test depends on the conversation you’d have with the doc, say you suspected some foods, the condition is more than mild case, based on family medical history – it may be a good idea to investigate further the allergens. Personally, I’d say go for it just so to have some ideas on how to manage the eczema going forward.

      Cheers!
      Mei

  6. […] some related posts I’ve written on above topics, here on moisturizing tips by Dr Bridgett, here on steroid potency, here on finger tip units, here on wet-wrap and here on bleach […]

  7. […] There’s a question on whether it’s possible to over-moisturize using wet wrap, and the doctor on the support group’s advisory panel suggested not to wet-wrap if the wound is infected and to be mindful of use of topical steroid cream on flexural areas where the skin is thinner (as wet wrap increases the absorbency of steroid to skin). Also not to moisturize on weepy wounds and when the skin is better, wet wrap can be stopped and see your doctor again to assess the next-step skin management steps. There’s also concern on steroid potency, as GP/pediatrician and specialist tend to carry different steroid creams, you can check the table for steroid potency here. […]

  8. […] Steroid-Phobia – Research has showed that steroid cream is safe as long as used as prescribed. In fact, the concern is that parents may end up under-treating the […]

  9. […] started pre-schooling when she could crawl, almost walk and her eczema was much improved after a one-time oral steroid course. I visited a few preschools and selected one which was close to my (and my parents’) home. The […]

  10. Hi Marinah,

    My baby Marcie’s doctor is Prof Hugo Van Bever at the NUH. You can call 67722002 for an appointment, Prof Hugo is from department of Paediatrics.

  11. can u recommend me the doctor…

  12. […] Apply chlorhexidine before applying steroid cream to clean away the bacteria so that the steroid cream will be more […]

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