What to Do When Steroid Creams Don't Work for Eczema

If your eczema isn't responding to topical steroid creams, your doctor may recommend other treatments such as prescription topical medications, oral medications, light therapy or immunosuppressants. Learn more about managing eczema.

What to Do When Steroid Creams Don't Work for Eczema

If your eczema doesn't improve after a week of using topical steroid creams, or if it returns soon after you stop treatment, you may need a stronger steroid or additional treatment. Initially, you can try over-the-counter hydrocortisone creams to control itching and reduce redness and swelling. Unfortunately, there is no simple cure for discoid eczema, but medications can help ease symptoms.Dr. Peter Lio, a dermatologist at the Feinberg School of Medicine at Northwestern University in Chicago and a member of the National Eczema Association (NEA) board of directors, takes an alternative approach when deciding when to prescribe topical steroids and at what concentration.

The NEA warns that overusing moderate-to-high-potency topical steroids and then abruptly stopping them can cause “topical steroid withdrawal syndrome”, which can cause burning, stinging, swelling, skin tenderness, black-like bumps and pustules, as well as bright red skin in people with light skin.If your eczema isn't responding to topical steroid creams, your doctor may recommend other treatments. These may include:

  • Prescription topical medications such as calcineurin inhibitors
  • Oral medications such as antibiotics or antihistamines
  • Light therapy
  • Immunosuppressants
Your doctor may also suggest lifestyle changes to help manage your eczema. These may include avoiding triggers such as certain fabrics or soaps, taking lukewarm baths with mild soap, and using moisturizers regularly.If you're concerned about the side effects of topical steroids or if they aren't working for you, talk to your doctor about other treatment options. With the right combination of treatments and lifestyle changes, you can manage your eczema and reduce flare-ups.

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