Corticosteroids and type 1 diabetes

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

Topical steroids are available as creams, lotions, gels and ointments; selection of an appropriate product can also provide good moisturization of the skin. The wide spectrum of potencies and bases allows these mediations to be used both effectively and safely while under the care of an experienced physician.

During flares, over-the-counter moisturizing preparations that include a topical corticosteroid (such as clobetasone butyrate and hydrocortisone) are helpful to control inflammation and restore the skin barrier. The intensive use of emollient-based products can reduce the need for topical steroids.

Side effects are minimized by taking the lowest doses possible (that still yields positive results) and following doctor's orders. It is important to avoid self-regulation of the dosage, either by adding more or stopping the drug without a schedule. After prolonged use, steroids must be gradually reduced to permit the adrenal glands to resume natural cortisol production. Eliminating doses too quickly can result in glucocorticoid withdrawal symptoms, worsening of underlying inflammatory disease (rebound effect), or rarely, adrenal crisis (a life-threatening state caused by insufficient levels of adrenal steroids).

Long term use of topical corticosteroids can induce tachyphylaxis (tolerance to the vasoconstrictive action of topical corticosteroids). Adverse effects are uncommon when using mild to potent corticosteroids for less than three months, except when used on the face and neck, in intertriginous areas (skin folds), or under occlusion. However, very potent corticosteroids should not be used continuously for longer than three weeks. 2 If longer use of very potent corticosteroids is required, they should be gradually tapered to avoid rebound symptoms and then stopped for a period of at least one week after which treatment can be resumed. 2

Corticosteroids and type 1 diabetes

corticosteroids and type 1 diabetes

Long term use of topical corticosteroids can induce tachyphylaxis (tolerance to the vasoconstrictive action of topical corticosteroids). Adverse effects are uncommon when using mild to potent corticosteroids for less than three months, except when used on the face and neck, in intertriginous areas (skin folds), or under occlusion. However, very potent corticosteroids should not be used continuously for longer than three weeks. 2 If longer use of very potent corticosteroids is required, they should be gradually tapered to avoid rebound symptoms and then stopped for a period of at least one week after which treatment can be resumed. 2

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