Topical Corticosteroids

For more than 50 years, topical corticosteroids have been doctors' first choice in treating the inflammation, itching and redness associated with atopic dermatitis.

Corticosteroids work by regulating gene expression. They help increase anti-inflammatory proteins and decrease pro-inflammatory cytokines. Usually, a reduction in symptoms is seen within about one or two weeks of twice-daily treatment.

One of the potential drawbacks of topical corticosteroids is rebound flaring (i.e. the skin improves when corticosteroids are used, but then when the treatment is stopped, there is a severe recurrence of symptoms).1 Topical corticosteroids have also been known to break down the skin barrier, which is counterproductive in patients with atopic conditions.2-4

It should be noted that the excessive use of Topical Corticosteroids has been associated with many side effects including burning and stinging of the affected areas as well as an increased risk for viral infections. These side effects have been highlighted by the Food and Drug Administration (FDA) in the US which has issued "Black Box Warnings" as well as Health Canada which has issued prescribing warnings.5

1. Zheng PS, et al. J Invest Dermatol 1984;82:345-352. 2. Sheu HM, et al. Br J Dermatol 1997;136:884-890. 3. Kolbe L, et al. Skin Res Technol 2001;7:73-77. 4. Kao JS, et al. J Invest Dermatol 2003;120:456-464. 5. Sugarman et al. J Drugs in Dermatol 2009:v8:issue12:1106-1111

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