If your child has ever experienced any skin problems, their doctor may have prescribed them a steroid cream.
When used properly, steroid creams can ease inflammation, reduce pain and even alleviate irritation.
They are very useful for localised conditions that cannot be directly targeted with oral pain medication.
But you may have also read that topical creams can be dangerous. Especially for kids. So let us explore whether there’s any truth to these claims.
We had a chat with Nazatul Amira Hamzah from Primabumi Sdn Bhd, qualified pharmacist with 10 years of pharmaceutical experience, to learn more about this.
Q1: What are topical corticosteroids and how do they work?
Topical steroids are a type of medication that can applied to the skin to reduce inflammation, irritation, redness and itchiness.
Available in the form of cream, ointment, gel, solution, and shampoo, topical steroids help treat a variety of skin conditions such as skin allergies, eczema, and psoriasis.
They are generally categorised into 7 classes based on how strong they are. The mildest is hydrocortisone and the strongest is clobetasol propionate.
Commercial topical steroid products contain a specific drug called a corticosteroid as the main active ingredient.
However they are often combined with other anti-inflammatory drugs, antibiotics, or antifungals for enhanced efficacy or for treating multiple skin issues simultaneously.
Q2: Are topical steroids safe for babies and children?
You should not administer topical steroids to children under the age of 2 years old unless directed by your healthcare provider.
Q3: What are the side effects of a topical steroid, and how can I prevent them from occurring?
Using steroids for long periods of time (months), can result in several unpleasant side effects. Some of them include:
- Skin thinning (atrophy)
- Stretch marks (striae) in the armpits or groin
- Easy bruising (senile/solar purpura) and tearing of the skin
- Enlarged blood vessels (telangiectasia)
- Localised increased hair thickness and length (hypertrichosis)
Corticosteroids work by suppressing the immune system to bring down the skin’s hypersensitivity to irritants. So, excessive or prolonged use may cause the skin to become more vulnerable to infections.
Topical steroids are helpful for controlling the intense redness and/or itchiness associated with skin allergies or eczema flare-ups.
However, you are strongly advised to limit the use of any topical steroids as instructed by your doctor/pharmacist and reduce the frequency of application as your child’s condition improves.
If continuous use of a topical steroid is required, restrict its use to a maximum of 4 weeks, pause the treatment for several days, and then resume its application if necessary as advised by your healthcare professional.
Q4: My pharmacist told me that topical steroids are available in the form of cream, ointment, gel, and lotion. What are the differences, and which one is most effective?
Ointments are like greasy creams because they have a lot of oil in them. They stick around on your skin for a long time and are really good at keeping your skin moisturised. They work better than creams, gels, and lotions.
Creams are the most popular choice because they’re not greasy, soak into your skin easily, and look nice on your skin. But they’re not as good at moisturising as ointments.
Both creams and ointments work best on parts of your body that don’t have much hair.
Ointments are the best for skin that’s thick and scaly.
Gels don’t have any oil in them. They soak into your skin really quickly and don’t create a barrier on your skin. So, they might not be great for really dry skin.
Lotions are light and spread easily because they have a lot of water in them. They’re the cheapest option if you need to cover a big part of your body.
Both lotions and gels are good for skin that has hair, like your arms, legs, chest, or scalp.
Q5: Certain topical steroids are combined with antibiotics and/or antifungals. How do I know which one is the most suitable for my child’s condition?
To figure out if your skin irritation might also be caused by bacteria, fungi, or both, you need to see a doctor for a proper checkup.
Please talk to your healthcare provider to get the right advice on which cream or ointment is best for your child’s skin.
Q6: What is the recommended method for applying a topical steroid?
First, wash the area of your body where you want to put the cream with a gentle soap and make sure it’s completely dry.
Then, put a very thin layer of the cream on the part of your skin that’s bothering you.
You can also use a moisturising lotion before or after you use the cream. Just wait for a little while (about 5-10 minutes) to let one of them soak in before you put on the other one.
This helps the cream work better. But, be extra careful if the cream is really strong, like clobetasol propionate or betamethasone dipropionate.
You might need to use the cream once, twice, or three times a day, depending on what your doctor says.
You might use it for 5 days or even a few weeks. It depends on how old you are, why your skin is irritated, and how bad it is.
After a while, you’ll stop using the cream or use it less often, as your doctor tells you to.
Q7: A doctor prescribed my child a steroid cream for his/her skin allergy. I’m reluctant to use the cream since I heard steroid-based products come with nasty side effects. What should I do?
It’s important to understand that any medicine, no matter what kind or why it’s used, can have side effects.
These side effects can range from not so bad to more serious.
But don’t worry! Your doctor or pharmacist knows a lot about these medicines, and they can recommend the one that works best for your child and has the lowest chance of causing problems.
If you have any worries or questions about the medicine your child is taking, don’t hesitate to talk to your healthcare provider.
They’re there to help you and your child feel better.
Q8: Someone recommended I use a steroid cream for treating rashes on my child’s skin. Is it okay to do so?
While steroid cream can often help with red and irritated skin, like rashes, it’s a good idea to talk to your healthcare provider first to make sure it’s the right choice for your child.
If your child’s rashes aren’t too serious and aren’t caused by an infection, your doctor or pharmacist might suggest other products that don’t have steroids but can still work well and be safer for your child.
Q9: I still have some of the steroid creams I used on my 10-year-old son. Can I apply the same cream to his 1-year-old sister?
If your child is under 2 years old, it’s important not to use any creams with steroids on their skin unless your doctor tells you to do so.
This is because their skin is delicate and can be more sensitive to the possible side effects of these creams.
Additionally, using a steroid cream might not be necessary for your 1-year-old daughter.
To make sure you’re using the right product for your child’s symptoms, it’s best to talk to your healthcare provider and follow their advice.
Q10: What options do I have to treat my child’s skin problem apart from topical steroids?
The way we treat skin problems depends on how bad they are.
For simple issues like itchy skin from mosquito bites, you can often use non-prescription products that have anti-itch stuff like crotamiton, calamine, or ichthammol.
Sometimes, irritated skin can be dry. If that’s the case, it’s important to keep the skin hydrated. You can start by using a gentle cleanser with a pH level of 5.0–5.5 to clean and moisturise your child’s skin.
After that, use a good moisturiser to help the skin stay healthy, keep it moist, and protect it from things that can cause allergies or diseases like bacteria, fungi, and viruses.
It’s a good idea to look for products that don’t have harmful stuff like parabens, alcohol, SLS/SLES, phthalates, mineral oils, and fragrances.
Also, try to avoid things that could make your child’s skin problems worse, like certain foods, medicines, chemicals, dust, pollen, and pet hair.
Source: Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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