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Steroids and Your Skin: The Benefits and Risks of Topical Steroids

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Topical steroids are often used to reduce inflammation, swelling and redness of the skin. Also known as corticosteroids, drugs that are derived from natural cortisol, a hormone produced by the adrenal glands, these steroids can be effective for treating psoriasis and eczema. However, with the benefits of these often-powerful creams come possible risks and side effects to consider.

A Washington Post article published today, entitled “Steroids can be good or bad,” (as its name suggests) discusses the risks and benefits of using steroids to treat various medical conditions, including psoriasis and eczema.

The article identifies common topical steroids used for skin problems, including psoriasis and eczema: “creams and lotions including over-the-counter hydrocortisone and prescription concentrations of betamethasone (Alphatrex and others), clobetasol (Temovate and others), hydrocortisone (Cortaid and others) and triamcinolone.”

According to the National Psoriasis Foundation, topical steroids are “the most frequently used treatment for psoriasis.” They have been shown to reduce swelling and redness of lesions in psoriasis patients.

Topical steroids have also been shown to be effective in treating eczema. According to the book, Evidence-Based Dematology (Hywel Williams, 2008), “RCTs [‘randomized controlled trials’] of topical steroids versus placebo suggest a large treatment effect in atopic eczema.” Moreover, the book concludes that “[t]here is good RCT evidence that application of twice weekly potent topical steroid to stabilized eczema can reduce the number of flare-ups in adults and children, although further RCTs are needed to confirm the long-term safety profile of this approach on infants.”

While the potential risks associated with using topical steroids are notably less than oral steroids, the existing risks should be considered before use.

According to the National Psoriasis Foundation, potential side effects of topical steroid use include “skin damage, such as skin thinning, changes in pigmentation, easy bruising, stretch marks, redness and dilated surface blood vessels. Steroids can be absorbed through the skin and affect internal organs when applied to widespread areas of skin, used over long periods of time, or used with excessive occlusion.” However, for many, these potential side effects are worth the risk for the decrease in inflammation and redness that can occur as a result of using these steroids.

If you are currently using topical steroids or are considering them, the National Psoriasis Foundation provides some very helpful and important tips:
– When applying steroids, use a small amount on the affected areas only.
– Do not use a topical steroid for longer than three weeks without consulting your doctor.
– Refrain from abruptly discontinuing a topical steroid as it can cause your psoriasis to flare.
– Unless the medication is formulated for the eye area, do not use steroids on, in, or around the eyes, as cataracts and glaucoma can result.
– The more potent the steroid, the more effective it is in clearing psoriasis, but the risk of side effects is greater.
– Low-strength steroids are good for treating the face, groin and breasts, but care must be taken as the risk of side effects is greater in sensitive skin areas.

The Washington Post article also recommends that topical steroids be used sparingly. “The longer the drugs are used and the larger the area of skin covered, the greater the likelihood of side effects.”

If you are considering various topical steroids, the National Psoriasis Foundation also offers a very informative topical steroids potency chart on its website.

Always consult a doctor prior to use.

To read the Washington Post article, click here:

To read more on the National Psoriasis Foundation’s website, click here:

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