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Dr Sarah Temple
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A family doctor with more than 20 years experience working with children in both General Practice and Mental Health Services. Trained to run Emotion Coaching Parenting Courses. She has a special interest in the link between child and parental wellbeing.
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Child Care & Health

Steroid creams, emollients and eczema

Top tips from St Thomas' hospital, London, on the use of steroid creams for your child with eczema.
In Short

Frequently asked questions are answered, including:

Can I use the same steroid cream for the face and body?

How should I apply my child's topical steroid cream?

Can I use topical steroid creams under wet wrap garments?

Can I use steroid creams for the long term?

Do I need a different treatment for infected eczema?

How many days should I apply the steroid cream for?

Frequently asked questions:
My child has had a flare-up of eczema on the face. Can I use the same steroid cream for the face and the body?

It depends on the potency. Mild steroids are usually used on the face and moderate and potent for the body. Occasionally your specialist may suggest you use moderate potency steroid creams to the face for a few days. If you are unsure, ask your GP, nurse or specialist.

How should I apply my child’s topical steroid cream?

Apply it once a day – unless advised otherwise – to the red, inflamed or itchy areas. Measure out each dose as instructed. Use a clean spoon rather than your fingers to take cream from a jar. Do not use more than instructed.

What are wet wraps?

Wet wraps are special garments or bandages that are designed to help treat conditions such as eczema. One layer is wet and goes directly onto moisturised skin. One dry layer is worn on the top of this. They can be worn throughout the day or night as advised by your doctor.

My child uses wet wrap garments – can I use topical steroid creams under them?

Yes you can as long as the potency is mild or moderate. It might be better to use your topical steroid cream in the morning and the wet wrap at night with an emollient/ advised moisturiser.

Should I worry about using topical steroid creams long-term?

Topical steroid creams are very safe when used correctly. Make sure you use only the lowest potency for the shortest amount of time to control the eczema. Always follow the advice of your doctor or nurse. If you use lots of your child’s emollient throughout the day on a regular basis (even when the skin looks healthy) the need for topical steroids can be reduced.

A normal course of treatment is 7 days. If the skin is still red and sore after this time, continue using it every other day for another 7 days and then use at weekends only. If it is still not better ask your doctor for advice.

I think my child has infected eczema – do I need a different treatment for this?

Firstly – if your child has weepy, yellow crusty areas which are more painful than the other areas, this could indicate infection. If you are not sure, ask your nurse or GP. Small areas of infection can be treated with a combination cream which contains antibiotic and topical steroid. The antibiotic kills the germs and the topical steroid calms the inflammation. You can use these treatments for up to 2 weeks one or two times a day. If the infection covers a larger areas or if your child is unwell, they may need a course of oral antibiotics from the doctor.

What’s the difference between an emollient and a moisturiser?

Nothing! Emollient is the medical name for a moisturiser. Don’t use fragranced cosmetic moisturisers on eczema or children’s skin in general.

How many times a day should I apply emollient to my child’s dry/ eczema prone skin?

At least 3 times a day – more frequently if it looks dry or itchy. This will use up around 500g per week – which is one large tub. You can use cream or ointment depending on which your child’s skin responds best to. Apply all over. Scoop out of the pot using a spoon – not your hand. If your child is at school, you will need to arrange for a member of staff or school nurse to apply the moisturiser throughout the day.

Is it OK to use soaps suitable for babies to clean my child?

No. Soaps and any products that make bubbles can irritate eczema prone skin. Use an emollient to clean the skin instead.

How should I apply the emollient?

Apply in downward strokes in the direction of hair growth. Smooth large quantities on so they look like a snowman before it soaks in.

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DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.