Eczema is characterized by red, itchy, and flaky skin. The cause is increased activity in the immune system of the skin and impaired skin barrier function. Corticosteroid creams address both of these causes, while moisturizing creams strengthen the skin barrier. There are several types of eczema, and you can read more about them here: atopic eczema, seborrheic eczema, contact eczema, and hand eczema.
Moisturizing creams provide the skin with lipids, helping it retain moisture. Regardless of the type of eczema, it is beneficial to use a moisturizing cream. It is recommended to use moisturizing cream on both eczema-affected skin and on the skin after the eczema has healed. Moisturizing creams can also help prevent the recurrence of eczema.
Side effects are extremely rare, but it is possible for long-term use to reduce the skin's natural lipid production, and like with any cream, it is possible to develop allergies to certain ingredients.
Corticosteroids are hormones produced in the body. Corticosteroid creams are used on skin affected by eczema, which is red, dry, and itchy.
Corticosteroid creams come in various strengths, and it is the name of the cream that indicates its potency, not the percentage (for example, Hydrocortisone cream 1% is much weaker than Elocon cream 0.1%).
Corticosteroid creams are categorized into four different strengths, with group 1 being the mildest.
Hydrocortisone and Mildison
Locoid and Apolar are medium-strength corticosteroid creams suitable for use on most areas of the skin.
Betnovate, Synalar, Elocon, Ovixan, and others are potent corticosteroid creams and are generally not used on the face.
Dermovate is an extra potent corticosteroid cream mainly used on the body, hands, and feet, and are rarely used on the face or in skin folds such as armpits, groin, and inner thighs.
The main principle for using corticosteroid creams is to apply them in periods on the same area of skin. A typical regimen for the hands would be once or twice daily for 2 weeks, then every other day for 2 weeks, and finally twice a week for 2-4 weeks.
As a guideline, the same area of skin should not be treated with corticosteroid cream for more than 14 days per month. If the skin has a break from corticosteroid treatment, it is unlikely to develop severe side effects. Side effects of corticosteroid creams in the face are particularly acne or perioral dermatitis.
Other than corticosteroid creams, there are corticosteroid-free alternatives for treating eczema, such as calcineurin inhibitors like Elidel and Protopic. These creams/ointments work best on the thin skin of the face. Calcineurin inihibitors creams/ointsments can be used daily for longer periods than corticosteroid creams. A common side effect is a burning or stinging sensation, especially at the beginning of the treatment.
