Prescriptions written for topical steroids should include explicit instructions about where and how often to apply the preparation, and the body areas where use must be avoided. Pharmacists should ensure these directions are included on the dispensing label. Prescribers should bear in mind that patients may keep unused or leftover corticosteroid skin preparations for some time after they are prescribed and thus forget the original indication or instructions for use. The prescribing of unnecessarily large quantities should be avoided. Patients should be warned not to share their topical steroid preparation with other people as this may result in unsafe application to unsuitable areas such as the face, as well as the potentially inappropriate treatment of undiagnosed skin conditions.
Charman and other researchers in the department of dermatology at Queens Medical Centre asked 200 patients or parents of patients with atopic eczema to fill out a questionnaire about their attitudes toward corticosteroid creams. They found almost three-quarters of the responders worried about using corticosteroid creams on their own or their child's skin . The most common concerns were the risk of skin thinning, which was feared by almost 35% of those surveyed. Twenty-four percent feared long-term effects in general, and almost 10% were afraid of possible effects on a child's growth and development.
Short-term side effects of oral PUVA may include sunburn, nausea and vomiting, itching, abnormal hair growth, and too much repigmentation or darkening of the treated patches or the normal surrounding skin (hyperpigmentation). If received for longer periods of time, this type of treatment may increase your risk of skin cancer. To avoid sunburn and reduce your risk of skin cancer, you'll need to apply sunscreen and avoid direct sunlight for 24 to 48 hours after each treatment. Wear protective UVA sunglasses for 18 to 24 hours after each treatment to avoid eye damage, particularly cataracts.