Abstract Number: 22

Adverse effects of topical corticosteroids in paediatriceczema: Australasian Consensus Statement

E. Mooney, M. Rademaker, D. Orchard

Meeting: 2015 Dermcoll

Session Information

Date: -

Session Title: Paediatric Dermatology Symposium

Session Time: -

Atopic eczema is a chronic inflammatory disease affecting
about 30% of Australian/New Zealand children. Severe
eczema costs over AUD $6,000/year per child in direct
medical, hospital and treatment costs as well as time off
work for caregivers and untold distress for the family unit.
In addition, it has a negative impact on a child’s sleep,
education, development and self-esteem. The treatment of
atopic eczema is complex and multifaceted but a core component
of therapy is to manage the inflammation with
topical corticosteroids (TCS). Despite this, TCS are often
under-utilised by many parents due to corticosteroid phobia
and inaccurate concerns regarding adverse effects. This has
lead to extended and unnecessary eczema exacerbations for
children.
Contrary to popular perception, topical corticosteroid use in
paediatric eczema does not cause atrophy, hypopigmentation,
hypertrichosis, osteoporosis, purpura or telangiectasia
when used appropriately as per guidelines. In rare cases,
prolonged and excessive use of potent TCS has contributed
to striae, short-term HPA axis alteration and ophthalmological
disease. TCS use can also exacerbate perioroficial
rosacea.
Topical corticosteroids are very effective treatments for
eczema. When they are used to treat active eczema and
stopped once the active inflammation has resolved, adverse
effects are minimal. TCS should be the cornerstone treatment
of atopic eczema in children.