Topical steroid induced acne treatment

Gabriel first started exhibiting small patches of eczema at 10 months old. He was prescribed a “light” steroid cream by the doctor, but the eczema only became worse. The doctor then prescribed Mometasone and Elidel creams. His parents did exactly what they were instructed to do, and they watched Gabriel become more itchy and miserable before their eyes. He was then prescribed, Triamcinolone Acetonide Ointment, Fluocinolone, oral antibiotics, and oral steroids.  They were instructed to apply the topical steroids 3 times a day. This therapy worked temporarily, but when it stopped working, Gabriel’s mother described his skin looking as if it were “attacking itself.”

It seems strange, then, that allergic reactions to corticosteroids actually occur—especially since these medications are used to treat allergic reactions. While severe allergic reactions to corticosteroids are extremely rare, they do in fact occur. Most allergic reactions to corticosteroids are less severe, however, and result from the topical formulations—occurring in up to 6% of people. Allergic reactions to oral or injected formulations are rarer, occurring in less than 1% of people. Causes of allergic reactions to corticosteroids may be due to IgE antibodies , or as a result of delayed-type hypersensitivity reactions caused by T-cells (a type of white blood cell).

Occlusive dressings may be used for the management of psoriasis or other recalcitrant conditions. Apply a thin film of ointment to the lesion, cover with a pliable nonporous film, and seal the edges. If needed, additional moisture may be provided by covering the lesion with a dampened clean cotton cloth before the nonporous film is applied or by briefly wetting the affected area with water immediately prior to applying the medication. The frequency of changing dressings is best determined on an individual basis. It may be convenient to apply triamcinolone acetonide ointment under an occlusive dressing in the evening and to remove the dressing in the morning (., 12-hour occlusion). When utilizing the 12-hour occlusion regimen, additional ointment should be applied, without occlusion, during the day. Reapplication is essential at each dressing change.

Glucocorticoid therapy is associated with an appreciable risk of bone loss, which is most pronounced in the first few months of use. In addition, glucocorticoids increase fracture risk, and fractures occur at higher bone mineral density (BMD) values than occur in postmenopausal osteoporosis. The increased risk of fracture has been reported with doses of prednisone or its equivalent as low as to mg daily [ 1 ]. Thus, glucocorticoid-induced bone loss should be treated aggressively, particularly in those already at high risk for fracture (older, prior fragility fracture). In other individuals, clinical risk factor and bone density assessment may help guide therapy. The prevention and treatment of glucocorticoid-induced bone loss will be reviewed here. The clinical features are reviewed separately. (See "Pathogenesis, clinical features, and evaluation of glucocorticoid-induced osteoporosis" .)

Topical steroid induced acne treatment

topical steroid induced acne treatment

Glucocorticoid therapy is associated with an appreciable risk of bone loss, which is most pronounced in the first few months of use. In addition, glucocorticoids increase fracture risk, and fractures occur at higher bone mineral density (BMD) values than occur in postmenopausal osteoporosis. The increased risk of fracture has been reported with doses of prednisone or its equivalent as low as to mg daily [ 1 ]. Thus, glucocorticoid-induced bone loss should be treated aggressively, particularly in those already at high risk for fracture (older, prior fragility fracture). In other individuals, clinical risk factor and bone density assessment may help guide therapy. The prevention and treatment of glucocorticoid-induced bone loss will be reviewed here. The clinical features are reviewed separately. (See "Pathogenesis, clinical features, and evaluation of glucocorticoid-induced osteoporosis" .)

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