The doctor said that steroid ointment for external use should be used according to the doctor's instructions, and must not be purchased by oneself; the picture shows the situation.

(picture taken from shutterstock)

[Health Channel/Comprehensive Report] The man dared not go to the toilet after applying the topical steroid ointment, worried that the "stem" would be different when touching important parts.

Lin Yunxuan, a dermatologist at Lin Zhengxian Dermatology Clinic in Kaohsiung, said that steroid use will shrink the skin, not the size, and it will take a long time to use it for a long time. It will return to normal after a few months of stopping the drug.

In addition, you should follow the doctor's instructions to use the medicine, and never buy it yourself, and children, the elderly, or the lesions are on the face, perineum and other parts, use weak ointment to reduce the occurrence of side effects.

Lin Yunxuan posted an article on the Facebook fan page "Naughty Female Doctor Skin Specialist Dr. Lin Yunxuan", pointing out that the strength of topical steroid ointment is divided into 7 levels according to the degree of vasoconstriction, the first level is the most powerful, and the seventh level is the weakest.

However, steroid ointments with the same concentration have different strengths if they are in different dosage forms (such as ointment, gel, etc.).

The doctor will give the most suitable ointment according to the thickness of the lesion, its location, dryness or wetness, and the age of the patient.

Please read on...

Lin Yunxuan gave an example, the absorption rate of the ointment on the face and perineum is 13 times and 24 times that of the arm respectively; moist places such as the armpits and groin will also increase the absorption of the ointment by about 4-5 times; Seal it up for 10x more absorption.

Therefore, weak ointment should be used in these places, which can not only achieve curative effect, but also reduce side effects.

She reminded that children's skin is thin, the skin barrier is not fully developed, and the drug absorption rate is high, so weak topical steroids should be used.

The skin of the elderly is also thin, so it is suitable to use weak ointment, and avoid long-term use to prevent the skin from becoming thinner and senile purple scars.

Common local side effects of topical steroid creams

Lin Yunxuan said that the following are common side effects of topical steroid ointments:

●Skin thinning and atrophy:

the most common side effect is related to continuous rubbing of medicine on the same part.

Not only the epidermis of the skin is thinned, but also the connective tissue in the dermis is lost, resulting in erythema, vasodilation and purpura.

Skin folds are most likely to occur. Because the skin is thin and the folds have a sealing effect, increasing drug absorption will easily cause side effects.

However, the condition is reversible and the skin returns to normal within a few months as long as the steroid cream is stopped.

●Skin stretch marks:

Inflammation and edema of the dermis, resulting in the deposition of collagen in places where the skin is stressed.

The stretched skin is a kind of scar tissue, which is permanent, and there is no way to return to normal after stopping the drug.

Some people may appear after a few weeks of applying the medicine, while others may take several months, and the time of appearance is not necessarily certain.

Acne-like rash:

topical steroid ointment will degrade the epidermis of hair follicles, increase free fatty acids on the skin surface, and make it easier for acne bacillus to multiply and grow, thus producing acne.

If you accidentally rub your face with a strong steroid, erythema, dilated blood vessels, and a pimple-like rash may appear within 1-2 weeks.

●Others:

steroid distiller's grains, perioral dermatitis, etc.

●Uncommon local side effects:

skin color change, hirsutism, infection, poor wound healing.

Systemic side effects:

Although topical steroids are only rubbed locally, if strong steroids are applied to the face or inflammatory lesions for a long time, systemic side effects may occur, such as cataracts, glaucoma, Cushing's syndrome (moon face, buffalo shoulder, body obesity) Thin limbs, high blood pressure, high blood sugar, etc.).

Lin Yunxuan emphasized that as long as you follow the doctor's instructions and don't buy it yourself, you can reduce the chance of side effects, and stop taking the medicine as soon as possible.

However, if some patients stop taking the medicine suddenly after using it for a period of time, withdrawal dermatitis will occur, especially in the first week after stopping the medicine, the original skin condition will deteriorate, become more red, scaling, and even pimples and small pustules appear. Patients also experience significant itching, stinging, burning, or swelling.

She reminded that if you can't stand the discomfort of stopping the medicine and then go back to use steroids, you will only fall into a vicious circle and make the side effects more serious.

You should cooperate with the doctor for treatment, use oral medicine with moisturizing lotion or Vaseline, and reapply every 3-4 hours, so as to help repair the skin barrier and restore health as soon as possible.

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keywords

• Steroid

• skin disease

• stretched skin

• drug side effects

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