Steroid creams are like the supercharged version of household mozzie bite cream - getting rid of your pesky itchy red patches quickly, almost magically! But magic (as always) comes with some things you should take note of!
1. All steroid creams are the same, no?
Topical corticosteroids, or "steroid creams" as they're more commonly called, is a family of products that come in different strengths. They are usually used to relieve inflammation in skin.
For most itching or irritating skin conditions, it's best to start with the lowest strength and work upwards if they don’t work well.
In Singapore, you can purchase lower strength steroid creams (eg. hydrocortisone or betamethasone) with the advice of a pharmacist from a pharmacy, but you'll need a doctor's prescription for more potent ones.
2. It’s hard to apply steroid ointment on my scalp, my hair looks so oily now!
Ointments and creams are greasy preparations and tend to be more suitable for drier and non-hairy skin areas.
If your skin condition requires you to apply topical corticosteroids to your scalp or any hairy area, you should look out for products that come in a solution or gel form for easier application – less oil and less mess!
3. Did you fall and graze your knee? You can put this magic cream on it, I heard it’s super good!
Although tempting, seeing it’s very magical properties of healing, steroid creams CANNOT be used on broken skin (usually meaning when you can see blood).
Steroid creams are meant only for certain skin conditions which can benefit from its anti-inflammatory properties. Using steroid creams on open wounds can slow down the healing process. Some of the steroid can also be absorbed into the body.
FYI: Topical steroids are meant only to cause an effect whereever it's applied on your skin , and not for absorption into your bloodstream.
It WILL NOT heal fungal infections (or bacterial infections), and even worse, can alter the appearance of it, making it harder to diagnose!
4. We must put a thick layer of this steroid cream so that the itch will go away quickly, the thicker the better, like kaya on toast!
NO! Unlike other types of creams (say, non-medicated moisturisers), applying a larger amount or thicker layer of cream does not speed up the healing process!
Parts of the body with thinner skin, such as the eyelids, genitals and at skin creases, tend to absorb the medicine more than other areas. As general rule of thumb, the amount of steroid cream to be applied can be expressed in fingertip units (can you spot the pun though?)
One fingertip unit is when you squeeze a line of cream from the tube going from the tip of an adult’s index finger, to the first crease. This amount is typically enough to cover an area of skin TWICE the size of an adult’s hand.
So you see, only a really thin layer is needed for it to work its magic! Also, this means you don’t waste the cream unnecessarily.
For children, the fingertip unit used is still the adult one, and you can measure the volume needed using your hands over the affected area. Do check with your doctor or pharmacist how much to apply as it may vary with skin condition and age too!
5. This cream works so well that I don’t want to stop using it ever!
Long-term use of steroid creams is not recommended because it might be potentially dangerous. Using these medicines on the same area daily for months on end can cause the skin at the site to thin and tear easily, and you may see stretch marks appear!
If you use a LARGE amount of cream for a LONG time, it's likely that more of the steroid component is absorbed into your body.
Side effects similar to those with long-term oral intake of high-dose steroids can occur, such as Cushing’s syndrome which is due to high levels of a hormone called cortisol – now that's not fun!
I hope this information is useful as steroid creams always seems to be an easy solution to skin itch (but now you know better!)
Don’t hesitate to check how much and how often to use it with your pharmacist or doctor if you're ever in doubt.
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Sarah is a guest writer at DxD, and a fully registered pharmacist with the Singapore Pharmacy Council. She’s currently working towards completing a further degree in public health. Things that excite her include a good book, a good cup of coffee and being able to help people use medicines safely.