Eczema, also known as atopic dermatitis, is a common skin condition characterized by patches of dry, itchy, and irritated skin. Although there are many pathways to healthy skin, if you are experiencing a severe flare-up, a doctor may prescribe anti-inflammatory medicine in the form of topical or oral systemic steroids. 

In this blog, we will explore all you need to know about oral steroids for eczema, including:

• How oral steroids work

• The side effects of oral steroids 

• Alternative steroid-free treatment options

Read on to find out more about what role oral steroids play in treating severe atopic dermatitis flares and why long-term use of systemic steroids is not recommended. 

What are Oral Steroids?

Eczema is caused by the immune system overreacting and creating inflammation when triggered by a substance inside or outside the body. Oral corticosteroids (commonly called steroids) are strong drugs in pill form designed to slow down the immune system and stop the body from producing the chemicals that cause inflammation. 

Oral steroids contain a synthetic substance similar to cortisol, a hormone your adrenal glands naturally produce to help your body respond to stress and reduce inflammation. They work well for treating severe atopic dermatitis, providing quick relief from symptoms like swelling, itchiness, and inflammation. 

Oral steroids are systemic drugs, meaning that when you take a steroid pill by mouth, it affects your entire body. This, alongside the high risk of side effects, is why oral steroids are reserved for severe eczema flare-ups and prescribed sparingly by doctors.

Topical Steroids vs. Oral Steroids

Unlike oral steroids, topical corticosteroids come in various strengths and forms, including gels, creams, ointments, and lotions. Topical steroids work by constricting the blood vessels, which reduces swelling and itching, two common symptoms of atopic dermatitis. 

They should be applied to the specific area experiencing an eczema flare-up and used only for a few weeks, as long-term usage without breaks can lead to other complications, such as topical steroid withdrawal. A doctor will prescribe the appropriate strength topical steroid for a person's needs and advise you on how much to apply, how often, and how long.

Dosage and Usage 

The best dosage for oral steroids is the lowest possible dose that will improve atopic eczema symptoms. Your provider may prescribe a higher dose if symptoms are not improving but should provide a plan to taper off to a lower dose or switch to a milder treatment once your flare-up is under control.

If systemic corticosteroids are taken incorrectly, you may experience a 'rebound effect', where your atopic dermatitis symptoms return straight after coming off the drug. To avoid rebound flares, it is important to take all of the medication as prescribed and not skip any doses even if you feel you are better. Always talk to your doctor before stopping using oral and topical steroids or other treatments you use to control your atopic eczema. 

Who Shouldn't Take Oral Steroids?

Although oral steroids can be useful for treating atopic dermatitis, they can make other medical conditions worse. You should be cautious of taking systemic corticosteroids if you have a history of high blood pressure, osteoporosis, peptic ulcers, or diabetes. 

Oral steroids can also interact with other medications and cause adverse effects. You should avoid oral steroids if you're taking Warfarin, antifungal drugs, nausea medications, or Aspirin. 

Side Effects of Taking Oral Steroids

More than 90% of people taking systemic medications like high-potency steroids for longer than two months will experience some side effects. 

Common Side Effects 

• Skin thinning

• Stretch marks

• Acne

• Weight gain or changes in fat distribution, leading to a rounder' moon face' appearance

• Hair loss 

• Headaches and dizziness

• Irregular periods for women

• Gut issues

• Increased sweating

• Trouble falling or staying asleep 

• Changes in mood, like irritability, depression, and hyperactivity

• Slow healing

• Muscle weakness

• Increased appetite 

• Heartburn

• Nausea and vomiting

Serious Side Effects 

• Oral corticosteroids can make you more susceptible to serious infections because they suppress the immune system.

• By increasing your blood pressure, blood sugar, and cholesterol, oral steroids can increase your risk of heart disease and cause symptoms similar to diabetes. 

• Oral steroids like prednisone can weaken your bones and increase your risk of fractures and osteoporosis, a disease that causes a decrease in bone density. 

• Some oral steroids may suppress growth in children

• Some oral steroids may cause eye issues such as cataracts or glaucoma. 

Managing Side Effects

If you are taking oral steroids to treat a severe atopic dermatitis flare, there are steps you can take to keep yourself healthy and side effects at bay during your treatment. 

To help with stomach problems, it is recommended that you take oral steroids like prednisone with a meal. You should also eat calcium-rich foods, like dairy products and green leafy vegetables, and exercise regularly to avoid complications from weak muscles and bones.

Weight gain can also be combatted by eating a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. If you are experiencing an increased appetite, following a meal plan may also help you avoid overeating.

It is also important to take extra steps to avoid infections, such as wearing a mask in public, keeping any cuts or scrapes clean, and washing your hands regularly.

Alternative Eczema Treatment Options

If you are apprehensive about starting steroid treatment, there are plenty of other natural treatment options available to help treat eczema flare-ups that do not come with the adverse effects that systemic steroids do. 

Natural Balms

Our Grass Fed Tallow Balm is excellent for allergy-prone and sensitive skin. Containing only two ingredients (grass-fed tallow and high-oleic unrefined sunflower oil), this balm creates a very moisturizing and nourishing eczema cream comparable to coconut oil but without the worry of allergies, making it the perfect choice to combat your dry and itchy eczema symptoms. 

Soothing Creams

Our top-selling product, the Organic Manuka Skin Soothing Cream, is a fantastic all-natural, non-greasy treatment option, packed full of antibacterial manuka honey, which is known to promote wound healing and reduce itching, redness, and inflammation associated with atopic dermatitis. 

Your doctor may also prescribe topical calcineurin inhibitors (TCIs) as an alternative to topical steroids. These work by stopping the activity of specific immune cells to relieve symptoms of itching and skin discoloration. They should be used in conjunction with other emollients and natural skin care products as part of your eczema treatment. 

Natural Soaps

If you are looking for an eczema-friendly soap to use in the shower, look no further. Our Coconut and Sunflower Oil Soap Bar is created with wholesome ingredients to provide cleansing without causing further irritation or dryness. 

This soap combines sunflower oil - known to help maintain and enhance the skin barrier - with coconut oil - effective at reducing the presence of bacteria, fungi, and viruses - to make an all-natural, effective eczema treatment for even the most fragile skin. 

Make Informed Decisions About Your Eczema Treatment Today

Follow these tips, guidance, and information to help you decide the best way to treat your eczema and achieve happy, healthy skin today.