Eczema Treatment: Oral Corticosteroids

Oral corticosteroids are among the many kinds of eczema treatment medicines aimed at curbing symptoms of an acute eczematous flare-up. Eczema is a chronic skin condition that presents itself in various forms, giving rise to many kinds of symptoms. Typical symptoms of eczema include swelling and cracking of the skin along with scaling, inflammation and itching. Corticosteroids can provide significant relief from such symptoms. However, the use of corticosteroids is among the lesser prescribed of eczema treatment options, recommended under specific scenarios.

Role of Oral Corticosteroids in Eczema Treatment

Corticosteroids are essentially steroidal medications that are aimed at reducing pain and inflammation. They are used across a wide range of medical conditions. This includes painful muscular/bone conditions like rheumatoid arthritis. Corticosteroids are available in two, main forms—topical and oral. The effect of oral corticosteroids is a bit more pronounced since they have a systemic route, i.e. these medications are administered orally and are able to alleviate the symptoms in a more significant manner. Oral corticosteroids are also useful but since they are applied externally, in the form of creams and serums, their overall effect is a bit shorter and less comprehensive.

The most commonly-prescribed oral corticosteroids in eczema treatment include:

  • Prednisone (oral administration)
  • Injected corticosteroids (Kenalog)

Oral Corticosteroid Regimen in Eczema Treatment

Being highly effective anti-inflammatory agents, oral corticosteroids can immediately curb the redness and itching, offering relief to the eczema sufferer. Oral corticosteroid treatments are usually able to arrest the further development of rashes in about two days. Being highly potent medications that are associated with many side-effects, oral corticosteroids are prescribed in the most minimal manner. This includes the lowest possible dosage, use over a limited period and use for emergency-like scenarios only.

For eczema treatment, oral corticosteroids are recommended when all the conventional aids seem to have failed and the symptoms show signs of worsening. Here, a short course of oral corticosteroids is initiated under medical supervision. The most critical aspect of such a regimen is deciding the potency and length of the regimen to ensure that the patient doesn’t suffer from any side-effects and there isn't a relapse of symptoms upon stopping the medications.

Various Ways of Using Oral Corticosteroids in Eczema Treatment

Some dermatologists prefer using oral and topical corticosteroids in combination. This has two advantages. Firstly, the inflamed nature of eczema patches is readily reduced with topical creams. Secondly, this allows creating a low-dosage oral corticosteroid regimen that is the preferred option among most healthcare practitioners. Most oral corticosteroid regimens don’t exceed two weeks but in some cases, three weeks or more might be needed. Sometimes, a short course of oral corticosteroids is used to temporarily curb the eczema symptoms, before starting the patient on an immunosuppressant therapy.

Risks of Oral Corticosteroids

While topical corticosteroids can cause side-effects like irritation and reddening of skin, along with some discoloration, oral corticosteroids are associated with far serious risks. Possible risks with oral corticosteroids include:

  • Gastrointestinal discomfort, including nausea, vomiting, gastroesophageal reflux and bloating
  • Clouding of eyes or cataract
  • Glaucoma (a type of eye disease)
  • Hypertension (high blood pressure) is among the most common side-effect of long-term use of oral corticosteroids
  • Osteoporosis (decrease in bone density, also called bone-thinning)
  • Tachyphylaxis (reduced response to oral corticosteroids)
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