Whether or not babies can become addicted to topical corticosteroids is a bit of a complicated question, but it’s worth looking at the factors involved, so you can make informed decisions about your child’s eczema treatment.
First, we’d take issue with the term ‘addicted’, as the implications are that the steroids were misused or that the people using them are in some way to blame for the condition. Babies, of course, are not in control of what is put on their skin!
The term ‘addicted’ is describing the phenomenon of the skin being affected by the regular use of steroid creams, so that the body’s immune system response is altered, and the skin becomes inflamed.
Many parents notice that prescribed steroid creams get less and less effective against their child’s eczema flare-ups, so that a dose that acted quickly to calm inflamed skin when first prescribed doesn’t work a few months down the line. Often doctors will then have to prescribe a higher potency, and parents will have to apply more frequently.
In some cases, steroid creams stop having any effect at all, but the skin flares up badly when the parents stop using them. This is the ‘topical steroid withdrawal’ effect, also known as a rebound flare.
There’s nothing controversial about saying that topical steroids affect the skin and should be used very sparingly, if at all: the side-effects of topical steroids are well known to dermatologists and doctors. Current advice is to be very cautious about using steroids to manage eczema flare-ups, especially on the delicate skin of babies and children, and to use them for very limited periods and in low potencies.
So can babies’ skin become resistant to or damaged by topical steroid creams? The answer is clearly yes, it can! We wouldn’t use the word ‘addicted’, but certainly babies and little children can be affected by the quantity, frequency and strength of steroid creams put on their skin.
The controversy around topical steroid withdrawal syndrome comes from the fact that many parents report that they’ve ended up using strong steroids for long periods of time on their babies and children; instead of a short-term emergency management tool, steroid creams become daily medication, and if stopped, cause rebound flare-ups that are worse than the original eczema they were prescribed to treat.
At Balmonds, we believe that the culture around childhood eczema needs to be changed! A holistic management plan involving gentle but effective emollients, an appropriate diet, and the detailed identification and avoidance of triggers is preferable and more sustainable than prescribing steroids as a long-term strategy.
Balmonds offer information and support, whether you’re going through topical steroid withdrawal, looking for safe long-term management strategies or wondering whether your symptoms match the condition.
Check out our TSW Info Hub for more information about Topical Steroid Withdrawal/RSS.
Hashtags to follow for peer-to-peer support: #thisisnoteczema #tsw #TSWFab5
Current medical advice is not to use daily topical steroids continuously for more than two to four weeks; then the frequency should be tapered to twice weekly use.
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Skin Salvation is a safe, effective, non-steroidal, intensively hydrating emollient that works in four crucial ways to help you manage your TSW or chronic dry skin:
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For more information about TSW, its symptoms and how to manage them, go to the ITSAN website.
If you require medical advice we recommend you always contact your healthcare professional.
If you or someone you are caring for seems very unwell, is getting worse or you think there's something seriously wrong, call for emergency services straight away. For general medical advice, please contact your healthcare professional, this article does not contain or replace medical advice.
Do not delay getting help if you're worried. Trust your instincts.