SUPPORTING STEROIDAL THERAPY

  M.D. Marek Kot

Dermatology and Venereology clinic of Medical University in Łódź

Topical corticosteroid preparations belong to the most widely used dermatological drugs. They are used to treat chronic dermatoses such as contact dermatitis or atopic dermatitis. Corticosteroids are characterized by their fast action and good tolerance values. What is important in treatment are in particular their anti inflammatory and immunosuppressant qualities. Still, we have to remember that wrongly used corticosteroids can lead to a range of side effects. Chronic and inappropriate use of topical steroids may lead to teleangiectasia, stretch marks or skin atrophy. Regular use of those preparations for longer periods of time may also lead to post-steroid dermatitis, that is the “substance dependence” of skin, which leads to a substantial worsening of skin condition after the local steroids are no longer used. The area that is at special risk of those complication is the facial skin and the skin folds. We should also remember about the possibility of occurrence of contact corticosteroid allergy, with growing frequency, especially among the patients who have used those preparations for years. In order for the corticosteroid therapy to be safe, and the risk of side effects at the lowest possible level, the corticosteroids should be used for the shortest possible time, in time intervals. The interrupted therapy is the administration of active and neutral substance in switching pattern. We may use a one day scheme – steroids on the first day and the neutral substance on the second day, or schemes for several days – e.g. 3 days of topical corticosteroid and the next 3 days of neutral preparation. In the optimal solution this preparation is a hypoallergenic drug, with not only moisturizing, greasing and anti inflammatory action, but also active substances such as zinc oxide (regenerative, anti inflammatory and antibacterial properties), vitamin E (regenerating properties and inhibition of epidermal water loss) and alantoin (soothing and anti inflammatory properties). All those features are found in the Calmapherol crème, which makes it the preferred selection for interrupted corticosteroid therapy.