The most frequently used medication to treat the red patches is topical steroids.
Most of the time topical corticosteroids (TCS) are applied only once daily, preferably in the evening.
- There are different strengths of topical steroids (mild, moderate, potent, or super-potent) and different formulations (creams, ointments, lotions, or foams) available. Your clinician will prescribe the most adapted strength and formulation according to your age and location of the patches.
- Another frequently used medication to treat the red patches is topical calcineurin inhibitors (TCI).
- There are only two different TCI available, tacrolimus ointment and pimecrolimus cream.
- It is important to treat the red patches with TCS or TCI, as it is the best way to reduce itch and scratching, which drives the disease process further.
- Antihistamines rarely help the itch in atopic dermatitis, unless they have sedating properties.
- Treating the red patches contributes to reinforcing your skin barrier.
- TCS and TCI must be applied until the itch is gone, the red patches disappear, and the skin becomes smooth again. It is very important to not stop TCS or TCI too early to avoid rapid rebound. An approach of gradual tapering in frequency may be best, and flare prevention treatment 2-3 times per week during the maintenance phase is sometimes used.
Another important thing to bear in mind is to start TCS or TCI as soon as the red patches appear. This is when the skin turns pink and becomes slightly rough. Do not wait for a severe flare-up before starting. If you wait too long before starting the treatment, it will be much more difficult to treat the flare-up.
- Sometimes your clinician will prescribe wet bandages on top of topical steroid applications (see wet wrapping tutorial) in order to boost the efficiency of the treatment.
What about Topical Steroids?