What is the role of steroids?
There are lots of different hormones that our bodies make, and the topical steroids that we use to treat things like eczema, allergic dermatitis and poison ivy are called general corticosteroids. These are the ones you can even buy over-the-counter such as hydrocortisone, which is actually the same substance that your own body makes. And this reduces inflammation and reduces the immune response locally. There is a small subset of patients who do require oral prednisolone or oral steroids for a short period of time to get control.
There are other steroids, called anabolic steroids, which athletes have used to help pump up their muscles, and those steroids are very different. They have a whole different set of effects and belong to a whole different category and would have no effect here. They are two completely separate things, but a lot of parents with little children worry that when you give them steroids they're going to have those anabolic effects.
What are the pros and cons of using steroid treatments for eczema?
They happen to be excellent for short-term treatment of eczema because they will knock it out for most people. But then there's the problem of maintaining that clearance. Eczema is a chronic condition, and steroidals are never really great for treating chronic conditions because there are a lot of problems with them over time.
While I think that steroids have a huge role to play in the treatment of eczema, you have to use them appropriately and have very close control over the patient and how they're using the steroids.
