Pharmacists contributing to ‘steroid phobia’

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Pharmacists often give misinformation about steroid use in eczema, say dermatologists

The Australasian College of Dermatologists has released a position statement on the use of topical corticosteroids for childhood eczema, saying health professionals including pharmacists contribute to negative messaging about the medicines.

President of the ACD, Associate Professor Chris Baker said today that there is “significant misinformation” about the use of steroid creams to treat eczema in children.

“The ACD position statement provides needed recommendations to general practitioners, nurses and pharmacists on the safe and effective use of steroids.”

Dermatologist Associate Professor Gayle Fischer says: “The advice given by dermatologists to parents of children with eczema on the use of steroids is unfortunately frequently undermined by misinformation among the general community, pharmacists and general practitioners.

“It is easy to find negative messages about steroids on the internet, but hard to find positive ones.

“The resulting ‘steroid phobia’ can lead to the poor treatment of eczema in children, further frustration to parents and continued discomfort for the affected child.

“There is a pressing need for the re-education of the community to not be afraid to use steroids and let them know that concerns on long-term adverse effects associated with steroid use are unfounded.”

Last year an AJP poll found, however, that advice to use topical corticosteroids “sparingly” was increasingly unusual among pharmacists.

More than half of respondents – 197 readers, or 55% – said they remove “sparingly” from labels and offer advice using fingertip units.

Another 15% (52 readers) said they remove “sparingly” from labels and advise customers to use topical corticosteroids more liberally.

Nearly one in five (18%) still advised patients to use the products sparingly. Another 5% remove “sparingly” from labels but don’t explain further.

The ACD guidelines state to follow product information and apply steroids once or twice a day to all the inflamed skin until eczema is cleared. Enough cream should be used so that the entire affected area is covered. The steroid cream should be used for as long as it takes for the eczema to clear and whenever it flares up again.

A/Prof Fischer says steroids should be the first-line treatment for eczema and that parents of children with eczema who have concerns should visit their dermatologist for up to date information.

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