Topical steroids (steroids that are applied directly to the skin) are anti-inflammatory treatments to bring eczema under control quickly, to reduce the risk of infection. They should only be used under the supervision of a doctor and it is essential to use the appropriate strength and quantity.
Only one topical steroid can be bought from a pharmacist without a prescription. This is hydrocortisone and is sold as a cream or ointment. It can be used to treat mild eczema but it should not be used on the eyes, face or other sensitive areas of the body.
Risks:From time to time steroids receive adverse publicity and are branded as potentially dangerous medications. It is important not to confuse topical steroids with those used illegally for body building or those used in the contraceptive pill; they are completely different. If they are correctly used under the supervision of a GP, topical steroids are a safe and effective treatment for eczema. The likelihood of side effects (thinning of the skin, increase of fine hair growth) is related to the potency of the preparation, where it is being used and the condition of the skin. There is also a risk that topical steroids could be absorbed into the blood through the skin. This could slow growth in children by suppressing the adrenal gland. It is for this reason that strong steroids will only be prescribed for short periods of time for young children. Fear of side effects can mean that parents under-treat children with eczema by stopping treatment too soon or not using the preparation at all. This can make the condition worse and mean that a stronger preparation will be needed to bring the eczema under control. It is important to bear in the mind that steroids are only used to control flare ups of eczema. Emollients are the crucial part of daily care to keep the skin moisturised and protected.

Antihistamines

These are sometimes prescribed to aid sleep and relieve itching. A doctor should always be consulting before giving antihistamines to children.
Risks:Very occasionally, antihistamines can cause children to become over-active.

Evening Primrose Oil

A number of studies have looked at the effect of evening primrose oil in treating eczema. Unfortunately, the results have not been conclusive - some trials have seen an overall improvement in the eczema of those patients studied, while others have not. Evening primrose oil is available on prescription for the treatment of atopic eczema under the brand name EPOGAM™.
Risks: This form of treatment is not suitable for children with epilepsy.

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Eczema in childhood