Topical corticosteroid phobia in patients with atopic eczema

Topical corticosteroids are widely prescribed by dermatologists caring for patients with atopic eczema. Patients' fears about using topical corticoste roids may have important implications for compliance with treatment. We car ried out a questionnaire-based study of 200 dermatology outpatients with at opic eczema (age range 4 months-67.8 years) to assess the prevalence and so urce of topical corticosteroid phobia, We also questioned patients on their knowledge of the potencies of different topical corticosteroids. Overall, 72.5% of people worried about using topical corticosteroids on their own or their child's skin. Twenty-four per cent of people admitted to having been non-compliant with topical corticosteroid treatment because of these worri es, The most frequent cause for concern was the perceived risk of skin thin ning (34.5%), In addition, 9.5% of patients worried about systemic absorpti on leading to effects on growth and development. The most commonly used top ical corticosteroid was hydrocortisone, yet 31% of patients who used this p reparation classified it as either strong, very strong or did not know the potency Only 62.5% of the 48 patients who had used both Dermovate(R) (Glaxo ) and hydrocortisone in the past were able to correctly grade Dermovate(R) as being more potent than hydrocortisone. The most common source of patient information regarding topical corticosteroid safety was the general practi tioner. Although skin thinning and systemic effects can develop very occasi onally in people using topical corticosteroids, the concern expressed by pe ople using them seems out of proportion in relation to the evidence of harm . This study highlights the need for provision of better information and ed ucation to patients and possibly general practitioners regarding the safety , potency and appropriate use of topical corticosteroids.