Corticosteroids
Topical corticosteroids (TCS) are used to suppress inflammation and this often reduces itching considerably. Treatment should start as soon as a flare-up is recognised and continue until 48 hours after the inflammation has subsided (skin may not be back to normal but has stopped looking angry and sore).
Usually a moderate or potent TCS is needed to bring a flare-up under control. It is better to use a higher potency agent for a short time than a lower potency agent for a long period.
Some parents are reluctant to use TCS on their child’s skin because of:
- ’Steroid phobia’. However, if TCS are used for a short period then stepped down, there is no risk of skin thinning
- The warning on the information leaflet that says ‘Not to be used on broken skin&rsquo. Most patches of eczema have small breaks in the skin with visible blood flecks. It is safe to apply TCS to such skin but not to large raw areas.
‘Weekend treatment’ with TCS
Once an initial episode of eczema has been controlled in children who experience frequent flares, the affected areas can be treated with potent topical corticosteroids on two consecutive days per week – to prevent flares instead of treating flares when they arise. Such treatment is sometimes known as ‘weekend’ or pulse treatment.4