Monday, March 30, 2015

Steroid cream will get into body for adults and children (inevitably)

I have received plenty of reassurance that topical cream with steroid will not cause any problem because the steroid will not get into the body (or at least at a predetermined rate of skin absorption), i.e. steroid will stay on the skin longer while absorption rate is controlled.
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I asked, "what about accidentally ingesting it from fingers or hands"? The same reassurance of negligible amount.
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I asked "what about scratching and breaking the skin"? The same negligible amount.
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However, steroid such as hydrocortisone will be absorbed by the body. It is important to know how much is considered hazardous (or detriment). I hope the clinical or toxicological studies on steroid cream toxicity considered the above accidental means of introducing steroid into the body (e.g. increased "absorption" due to skin tear made by scratching or ingestion by toddlers).
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Our 3 yo toddler got prescribed the following medicines:
  • Elosone 0.1% (w/w) mometasone furoate which is a synthetic corticosteroid with anti-inflammatory, anti-pruritic and vasoconstrictive properties used on face. Precaution includes adrenal suppression more prone in infant and children (I had a look at a similar disorder adrenal insufficiency in children). In children, other complications are Cushing syndrome and probable stunted growth (no study on it thus far).
  • celestroderm/diprocel (aka Betamethasone dipropionate) 5g is a body topical steroid cream.
  • Prelone syrup taken orally. Synthetic steroid with anti-inflammatory and anti-itch effect.
  • Polaramine (aka DEXCHLORPHENIRAMINE MALEATE) taken orally. It is an antihistamine.
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We never felt confortable giving steroid cream but had to give in after seeing how unbearable the itch was. Unfortunately, the steroid cream is not as effective as Calamine solution with menthol (soothing and cooling effect). We are using these two medication alternately and prefer the Calamine over steroid cream.
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As for the oral medication, we are hoping that the anti-histamine will neutralize the histamine produced by the body.
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It's been three weeks now and any sign of recovery would be a relief.
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I hope there is no "urbanized eczema" caused by exposing children to overly clean and sterile environment. After this, we are planning to bring our kids to more outdoor activities with lots of earth, soil, and sand. Physical interaction with leaves, grass, and crawlies will be good. Some gardening will be super.
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References

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