There is a lot of debate about whether steroid creams are safe for babies. When used properly, I feel they are safe. Tips for safe application include:
- Use only on affected skin and avoid normal skin
- Avoid skinfolds (e.g. armpits, groin, thighs) and eyelids as much as possible
- Use no more than two times a day or as per prescription
Steroid cream can be used as a preventative treatment. When the eczema is mild, you may be able to keep it under control by just regularly applying moisturizer, using a humidifier and avoiding irritants. When eczema is more severe, you can try turning on the humidifier more often and applying thicker layers of cream. If you’ve tried all possible measures and your child continuously rashes and itches then a steroid cream on a daily basis can help improve the condition and help stop the itch-scratch-itch cycle. The issue with scratching is that it can cause an infection – and you don’t want that!
Steroid cream can be used as a treatment during flare-ups. Almost all children with eczema will experience a flare-up. An eczema flare-up is when some areas of the skin become more irritated and look raised, red and have slightly oozing patches. It happens when the skin is very dry, it comes in contact with irritating substances or allergic triggers, or when the skin is infected. During a flare-up your child will itch more. Remember you want to avoid an infection at all causes! Use a steroid cream to keep it under control and continue until the rash is less inflamed and more comfortable.
How much should I apply?
I have always found it difficult to judge how much steroid cream to apply. On one hand, I didn’t want to overapply and risk the thinning of my baby’s soft skin. On the other hand, I didn’t want to apply so little that it has no effect on his eczema.
Through research, I’ve learned three methods to determine the right amount to apply:
- Apply enough so that the skin feel tacky immediately after application.
- Apply enough so that the skin glistens.
- A Finger Tip Unit (FTU) - One finger tip unit is the amount of cream that can be gently squeezed in a thin line onto the last joint of an adult index finger. One FTU is enough to cover an area of skin the size of two adult flat palms. Different parts of the body require different amounts of topical steroid.
If you still feel unsure that the amount of cream you applied, bring your bottle of steroid cream to your doctor at the next visit and verify with your doctor. This really helped reassure me that I wasn’t doing anything wrong.
Other application tips:
- Moisturizer should always be applied over the steroid cream
- Wait about 15 minutes before you apply moisturizer on top of the steroid cream to avoid diluting the topical steroid with the emollient and spreading it to areas that don’t need it
- Ask your doctor about an anti-itch cream or adding add an anti-itch component to your steroid cream
- The period of time a steroid may be used depends upon the severity of the eczema and the potency of the topical steroid so don’t be afraid to use it for days or even weeks – your doctor will advise you on this
The biggest side effects of a steroid cream are scarring and thinning of the skin. However, there is no evidence that this is permanent. And for me, the benefits outweigh the risks. Without the steroids, my baby was not able to break the itch-scratch-itch cycle and it obviously impacted his sleep and growth.
Still, I refused to use steroids in the beginning and the constant scratching eventually caused an infection. My poor baby’s eczema was bleeding and a crust was developing over his weeping skin.
We were prescribed an antibiotic cream at first. When that didn’t work, we were prescribed an oral antibiotic. Waking my baby up every 6 hours and hearing him cry when I forced him to take the oral antibiotics was so heartbreaking. I hope other moms don’t have to experience this ever. Good luck on your journey!