Weighing the pros and cons of steroid cream use. Do you regard steroid creams as your saviour or something taboo? If you suffer from skin disease, you are likely familiar with this group of medications and probably have heard a lot about it.

With the conflicting views on steroid creams, it is time to review and clear up the myths about it.

What are steroids?

Steroids are chemical compounds that can occur naturally with certain characteristic chemical configurations. Steroids are present in the body and your body can’t function without them.

These include sex hormones (oestrogen, progesterone and testosterone), the “fight-and-flight” hormone (cortisol), the “building” hormone (anabolic hormones), and even cholesterol.

It can also be found in plants, animals and fungus.

What are steroid creams?

Steroid creams are often corticosteroids that are applied onto the skin to exert therapeutic effects. There are many such creams currently in the market, ranging from mild to very potent formulations.

It can also be marketed in many forms, ie lotion, gel, cream, ointment, etc. Sometimes, it is used in combination with other medications, ie antibiotics or antifungal creams.

What do steroid creams do to our skin?

Many types of skin diseases are due to inflammation, and steroid creams work by reducing this inflammation. This is achieved via altering the proteins and skin immune cells involved. This will reduce the redness and the severity of the skin disease.

Why are people afraid of steroid creams?

When used injudiciously, it can be associated with a list of side effects.

Over the applied area, the skin may develop redness due to visible blood vessels, thinning of the skin, or it may be more prone to bacterial infection. Application around the eyes may cause cataract and glaucoma.

With long-term potent steroid cream usage, it can even lead to hormonal imbalance, central obesity, increased blood pressure and blood sugar levels, as well as osteoporosis.

So, should I still use steroid creams for my skin condition?

Yes, you can still use steroid creams for your skin condition, PROVIDED the correct potency and formulation of the cream is used on appropriate skin conditions.

Weak steroid creams should be used on areas with thin skin as absorption tends to be more on these areas, ie face and folded areas like armpits and groins.

Strong steroid creams are only reserved for very thick skin lesions on areas with thick skin, ie soles of the feet, for a limited period of time.

So how do I know which steroid creams are suitable for my condition?

Since steroid creams come with a long list of side effects, it should be used cautiously, especially if used on a long-term basis.

The best people to decide which cream is suitable are dermatologists. They are the experts in steroid creams and skin diseases. They can juggle between its therapeutic properties and its side effects to customise the use according to your condition. If it is a mild cream, a general practitioner can also be consulted on this issue.

If I develop intolerable side effects towards these steroid creams, do I have other alternatives?

Yes, there are other treatments that can replace steroid creams, but these also come with side effects.

Efficacy of the treatment may also differ with different skin conditions. Therefore, it is best to consult your dermatologist or general practitioner should you encounter this problem.

Steroid creams are not the only solution, but at times it might be the best solution. Proper use of steroid creams are safe under good and adequate supervision.

In short, steroid creams can be both your friend and your foe. Make it your friend by consulting a dermatologist or general practitioner when you need them.

Dr Irene Lee Chew Kek is a consultant dermatologist. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.