Adrenal cortical steroid, or hormone, cream has long been the cornerstone of eczema treatment.
Adrenal cortical steroid cream is extremely effective in treating eczema; often, it can bring an eczema flare-up under control in just a few days. However, in most cases, treatment should continue for several weeks, and when the eczema has healed, use of the cream should be slowly reduced to avoid having any early relapses.
For example, if you have used the cream twice a day for a week, it is usual to reduce this to once a day for a week, eventually cutting down treatment to every other day. Long-term maintenance treatment spanning months should be discussed with your doctor – this is particularly relevant if you have hand eczema.
Various strengths
Adrenal cortical steroid, or hormone, cream comes in four strengths (group 1-4).
Group 1 is a mild steroid cream that can be bought without a doctor’s prescription. This cream is used mostly for children and for adults wanting a mild cream for the face. In most cases it is not effective enough to treat hand eczema in adults.
At the other end of the spectrum is the Group 4 cream, which although particularly effective, can quickly cause side effects.
Which group of adrenal cortical steroid cream a person should use depends partly on the person’s age, inasmuch as children should usually be treated with a milder cream than adults, and partly on which area of the body needs treatment.
Eczema on the face requires a milder cream than eczema on other areas of the body. Similarly, different creams might be used for the hands, as the skin on the backs of the hands is more sensitive than that on the palms.Treatment with a strong steroid cream is often well tolerated on the palms of the hands, but if the same cream is used on the backs of the hands, side effects develop quickly.
Side effects
The main side effect from treatment with adrenal cortical steroid cream is that the skin becomes thin and transparent.
The change can be seen immediately but will gradually disappear when treatment stops.
If only small areas are treated (e.g. eczema on the face, hands or feet) the amount of adrenal cortical hormone absorbed by the body is negligible and side effects are unlikely to occur. If large areas of the body are treated, the hormone can be absorbed through the skin; however, large amounts must be used before side effects develop.
Despite the possible side effects, adrenal cortical steroid cream or salve is still an important and effective treatment for eczema. It is sometimes necessary to continue this treatment for long periods; if this is the case, a treatment plan should be discussed with a doctor or dermatologist.
The cream has been on the market since the mid-1960s, and this means that both its effects and side effects are well known.
