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.
A common mistake is to be too cautious about topical steroids. Some parents undertreat their children's eczema because of an unfounded fear of topical steroids. They may not apply the steroid as often as prescribed, or at the strength needed to clear the flare-up. This may actually lead to using more steroid in the long term, as the inflamed skin may never completely clear. So, you may end up applying a topical steroid on and off (perhaps every few days) for quite some time. The child may be distressed or uncomfortable for this period if the inflammation does not clear properly. A flare-up is more likely to clear fully if topical steroids are used correctly.
I wanted to comment on the Dr. Aron’s approach. I have recently been reading all I can on his treatment plan. If I had learned of this before TSW then I believe this is the way I would have gone knowing what I know now. I went through TSW unknowingly 9 years ago after giving birth to my 3rd child – I had to stop breastfeeding at 3 months due to the severity of my skin. I went to multiple dermatologists who said I had the worst eczema they ever saw. They all wanted to give me steroid creams but I remember telling them that they didn’t work at all. I then remember my sister sending me some nystatin cream (for fungal infections) – I kept thinking my raw painful skin was infected. I mixed nystatin, bactroban, and 1% hydrocortisone cream together. That worked so much better – I still had bad skin but I was not in so much pain and I could take care of my kids. I did this for a few years and around the 3 year mark is when I changed our standard American diet to the all natural nourishing diet and my skin cleared dramatically! The only reason I went back to straight hydrocortisone is because I returned to work and kept getting my hands infected – so I used more and more cream. I have been in withdrawal now for 27 months and feel that I would have been better off if I weaned off the steroids like I did before and focused more on diet and keeping my hands from getting infected.