Making a Tough Decision

Over a year ago, I was being interviewed by a student for a project about eczema. One of the questions she asked me really got me thinking. She asked if, having gone through the hell of TSW, I would ever use steroid creams on my kids. I can't actually remember my exact answer, although I think it was along the lines that I would consider it if I'd tried everything else first.

Like I've said before, I'm not steroid phobic. I'm quite clear about the sequence of events that got me to this point. I was prescribed steroids for eczema and neither my doctor or I were aware of the risks of long term use. He happily filled prescriptions and I happily smeared myself with stronger and stronger creams for over a decade until they finally stopped working and I ended up in TSW.

I'm also a strong believer that steroids only mask symptoms. They don't get to the root cause of eczema. I think it is a better strategy to look for triggers in environment and even diet before embarking on the steroid route.

OK, after having said that, I was faced with a dilemma recently. It's winter here in the UK and my kids all have seasonal eczema in varying severity. My youngest only has patches on his hands and they aren't bothering him at all. My daughter has quite a lot and my oldest, teenage son has it on his neck where it is very visible. The eczema patch is uncomfortable and is also knocking his self confidence. He was surprised when I suggested a steroid cream.

I explained the dangers and the risks. Heck, he can SEE what steroids are capable of when he looks at me! I also explained that if he were to use steroid cream, it must be the weakest OTC, used twice a day or less and  for less than a week. Then stop. No matter how your skin responds, stop nefore the week is done. I've read of people getting addicted in as little as two weeks, so I'm guessing one week is probably OK.

He's been using 1% hydrocortisone for 2 days now and as predicted, the rash is going away. I might actually ask him to stop tomorrow. I worry that if there is a genetic predisposition to TSA that he might be more likely to get addicted to the creams than the average person. That said, we have been extremely careful and weighed the risks. He is old enough to understand the possible consequences of his decision and was happy to try it out. My daughter refuses to use the cream. She says her eczema will go away by itself. Funnily enough, hers looks a lot better today too.

Use of steroids requires balance, knowledge and an understanding of risk. Personally, I know I have no intention of using them on myself, but I don't feel the need to prevent my family from using them in a sensible and controlled way. I hope we have made the right decision.