Friday Facts #19 A topical steroid is like a fire extinguisher

Topical steroid creams are called anti-inflammatories because they work like fire extinguishers. Inflammation needs "putting out" - otherwise it can smoulder on, spread, and flare up again. Steroid medication is the specific remedy, just like the fire brigade is for a house fire. But the fire brigade does not stop pouring in water when the flames are extinguished. Unless the firemen continue to "damp down" with even more water, the flames can easily re-ignite.  Using a topical steroid on eczema requires the same process: first, put out the flames, then deal with the embers - otherwise there can be an early relapse on stopping the steroid.

"Obvious healing" is followed by the important "hidden healing". Both need topical steroid. For acute flare-ups the two phases together involve a few days treatment, together with more frequent use of moisturiser.

For chronic atopic eczema the treatment takes a few weeks, combined with the correct use of moisturisers, and habit reversal to deal with the scratching.

But in both cases, the golden rule is:  do not forget the "hidden healing" ...

                                                        - with topical steroids, do not stop too soon!