Corticosteroids and Eczema

New research says most cases of eczema (2/3rds) is from a defective barrier function and from skin that is too thin, but the #1 prescribed thing is hydrocortisone which thins the skin.  

From Croatian Medical Journal, "Conclusion. Previous long-term topical treatment resulted in allergic contact dermatitis in most of the patients, and to a lesser extent in irritative contact dermatitis or a combination with seborrheic dermatitis and rosaceiform dermatitis. The data stress the importance of avoiding long-term topical treatment with corticosteroids, antibiotics and aggressive agents." 

Tapering off should be done slowly or the condition might flare up.  I'll share with you how I tapered off:  First, I started using them only when my skin was soaking wet with water (that diluted it).  Then, I  used less and less of it each time I applied.  Then, I skipped applications.  Then, I skipped days.  Within a short time, I had weaned myself off of the external steroids.  Ask your physician how you should do it.

Please note:  Clearly I am not saying never use corticosteroids, because they can be helpful sometimes.  I would like to emphasize, though, that there are many things you can be doing to lessen your dependence upon them and even come to a point where you don't ever need them.  When using corticosteroids, remember that cortisone creams tend to have a drying effect and for this reason are better for weepy eczema ... ointments are better for dry eczema.

My Personal Feelings on Steroids for Eczema and What Happened to Me

When traditional/western medicine failed me, I didn't get better until I went the naturopathic/ holistic way.  However, after being well for a few years, I was overexposed to harmful chemicals at school for months on end and experienced a breakout.  For one year after that I tried so many natural remedies to get better, but it just seemed like the more I tried and experimented, the worse I got.  My skin was in such a hypersensitive state that everything irritated it:  even water.   I couldn't get better.  I was stuck.*/  (see my footnote below)  Finally, I went back to a dermatologist for testing thinking it was maybe a bacterial infection or something.  I didn't have a staph infection. What happened, though, was that although internal modifications are great and helpful and are what it took to get me well and keep me well the first time around after suffering for a couple of decades, it was the things I was putting on my skin that were irritating it this time around.  My skin was so hypersensitive that it couldn't tolerate anything at all. 

The dermatologist instructed me to use pure mineral oil on top of the skin after a 10 minute lukewarm soak in the bathtub.  Your skin will absorb water only for the first 10 minutes, but too much water will dry out your skin (it'll shrivel up and wash away your natural oils).  Mineral oil is found in the laxatives section at the drugstore.  He said there is only one thing he knew of that would lubricate the skin and not cause an allergic reaction:  mineral oil.  He was right.  It didn't burn me or cause me to itch like all the natural oils did, and God knows I tried everything natural I could.  Every company for eczema out there gave me stuff for free because of my www.eczema.net web site, but I didn't find one single product to help me.  Not one.  That's why I don't have any for sale on my site.  Sure mineral oil is an occlusive barrier (will smother the skin); but, that's exactly what we need when the skin is messed up until it can heal over.  It's a good bandaid.   It was the only skin bandaid I knew of that wouldn't cause a reaction on hypersensitive skin.  Vaseline caused me to break out.  

He also gave me prescriptions that dealt with the inflammation:   a) on the face:  hydrocortisone ointment 2.5%; and, b) on the rest of my body alternate or mix together (however I wanted) but to apply more than generously even up to 100 times a day to keep the skin moist:  Betamethasone Valerate Cream 0.1% and Betamethasone Valerate Ointment 0.1%.  This is important:  applying a lot of this medium strength cortisone on the skin (even “up to 100 times daily,” he said) isn’t at all like taking them internally in terms of the side effects and dangers.  In other words:  putting that medium strength steroid on the skin up to 10 times a day is much, much, much safer than taking them internally.  So there you go … taking dangerous levels of internal steroids didn’t help me at all; but, applying that medium strength steroid onto the skin itself very, very, very generously did the trick.  I wonder why in the world I had never been instructed to do that before in all my years of suffering.  Appling non-prescription steroids topically 3-4 times daily was definitely not enough to stop the cycle of inflammation that I was experiencing from the extreme chemical damage done to my skin; and, applying the medium strength prescription steroid only 3 to 4 times daily as is usually instructed was nowhere near what was needed to end that cycle of inflammation.  I don’t believe in living off of cortisones, but I do believe in using them to stop bad inflammation to calm it down.  Why doctors prescribe the dangerous internal steroids before using the external steroids generously is beyond me. 

The last tricky part came after my skin had calmed down, the rash was gone, and I still needed to lubricate.  Somehow that magical mineral oil that did good for my skin now seemed to make my skin lifeless.  It was great for helping me heal up, but for the long term it was smothering my skin (it does).  Now that the skin is under control, though, I can use other lighter all natural products and not have the allergic reaction because my skin is now in a calmer state. Since adding calcium to my diet, though, it doesn't even really get very dry anymore.

Honey is also a potent anti-inflammatory, antimicrobial, has an acid pH, helps keep the moisture in, causes no tissue damage, significantly increases production of collagen and has no negative side effects when used topically (allergy to honey is rare).  Read this honey link, and you will begin to see why honey worked better for me than even cortisones.  Remember, though, don't give honey internally to infants. 

Hopefully the knowledge in this book will help bring you to a place where you don’t need to live off of steroids like I did my first 15 years of suffering that didn’t even help me because that’s all I knew and trusted in with Western Medicine; and, on the other hand, you won’t be so rigid that you refuse to use the cortisones under any circumstances, although hopefully we'll help bring you to the place where you won't have to use them all.

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*/  Later, I learned that the reason I couldn't clear up the eczema the naturopathic way during that year was because of taking a medicine, so make sure you check out the list of drugs to see if you're taking something that might be causing you to have a rash:  Drugs that Cause Rashes