Do you need hormonal medications for atopic dermatitis?
The reasons for exacerbation of atopic dermatitis can be many, both allergic and nonallergic nature. However, in the end we are dealing with inflammation of the skin, which involves special types of cells that emit substances that provoke redness of the skin, swelling, itching.
In addition, on the body of any person lives a lot of microorganisms, which in the normal functioning of the protective barrier of the skin does not cause any discomfort. However on inflamed areas of a skin the protective barrier is always broken, therefore bacteria aspire to get to a hotbed of inflammation where begin active reproduction that leads to even more swelling and joining of secondary infection.
Thus, at the slightest hint of inflammation of the skin should be applied anti-inflammatory therapy, in order to avoid deterioration of the skin and secondary infection. If the inflammation is not strong, it is usually possible to do without hormonal drugs (glucocorticosteroids). However, when you need to act quickly or if the case is running-without them can not cope.
In the external application hormonal drugs suppress inflammatory and allergic skin reactions, which leads to the reduction of objective symptoms (erythema, swelling, moknutija) and subjective sensations (itching, irritation, pain). After removal of inflammation the restoration of the protective barrier is made by means of Jemolentov.
How safe is it to use hormonal drugs to treat atopic dermatitis in children?
Many parents (and even some doctors) scare the perspective of the use of hormonal drugs, because the list of side effects they are very large. Therefore, the question arises: how safe are hormonal creams and ointments?
In the 1990s, doctors often prescribed ftorirovanye corticosteroids, such as Ftorokort, Sinaflan, to treat skin diseases (including atopic dermatitis). and smeared children, as a rule abundantly and long enough. The uncontrolled use of such strong drugs often resulted in skin atrophy and other side effects. However, at that time, the more "easy" replacement of these drugs simply did not exist, as well as the data on the required frequency, as well as the duration of use.
In comparison with the previous experience at present time the arsenal of doctors has considerably expanded-new, more safe, preparations have appeared. But most importantly-there are clinical studies and accumulated practices that allow the use of hormonal drugs to the maximum benefit, reducing the risk of side effects to a minimum.
And yet to choose a safe hormonal drug baby is not so easy. The skin of children is much thinner and more delicate than the skin of an adult, the epidermis is still very loose, the permeability of vascular endothelium is increased, and small vessels are so close to the surface of the skin that sometimes they can be seen with the naked eye. Thanks to this feature hormones are absorbed into the blood of toddlers faster and in greater concentration, which increases the risk of side effects, and therefore not all that is safe for adults, can be used to treat the skin babies. That is why for children were developed drugs with greater safety, which became a kind of revolution in the treatment of atopic dermatitis.
Hormonal drugs, allowed for use in babies
The number of drugs for use in children is very limited. To date, the drugs of choice for the treatment of atopic dermatitis are Advantan, lokoid, Afloderm, Elokom. Let's take a closer look.
Age allowed: for the smallest (from 4 months of life) only Advantan is allowed. From 6 months you can use Lokoid, afloderm. It is recommended to use Elokom only after reaching 2 years of age.
Active substance in 1 g of the drug: Advantan-methylprednisolone Aceponat 1 mg; Lokoid-hydrocortisone 17-Butyrate 1 mg; Afloderm-Alklometazon Dipropionate 0.5 mg; Elokom-Mometasone Furoate 1 mg.
Form release: This aspect is very important, because the more forms of release in the drug, the more successful it can be applied at different stages of atopic dermatitis. The widest choice was provided by manufacturers of Advantana: cream, ointment, fatty ointment, emulsion. Lokoida has no greasy ointment. Afloderm is presented only in the form of ointments and cream. Elokom-Ointment, cream, lotion.
Pharmacological action: All these drugs have anti-inflammatory, antiallergic, antipruritic action. Their application results in reduction of both objective symptoms (edema, erythema, Lihenifikacija), and subjective sensations (irritation, itching, pain).
Indications for use: superficial inflammatory skin diseases in which effective use of Cortecosteroids Glucocorticosteroids: dermatitis (including atopic, seborrheic, pin), eczema, psoriasis, etc.
Contraindications: Hypersensitivity to the components of the drug; Viral skin lesions in the application of the drug (including chicken pox, herpes simplex, shingles, etc.); Tuberculosis and Sifiliticalkie lesions of the skin in the application of the drug; Adverse skin reactions; Perioral dermatitis; Rosacea; Violations of the integrity of the skin (open wounds, ulcers) in the application of the drug, etc.
Method of application and dose:
Advantan put a thin layer 1 times/day on the affected areas of the skin. In solar burns emulsion used 1-2 times per day. Continuous daily use of advantana in the form of fatty ointments, ointments or cream should not exceed 12 weeks for adults and 4 weeks for children. The course of treatment of advantanom in the form of emulsion is usually not more than 2 weeks.
Lokoid put thin layer on the affected areas of skin 1-3 times/day. With the advent of positive dynamics, the multiplicity of the application decreases to 2-3 times a week. The dose of the drug should not exceed 30-60 G. A week.
Afloderm inflict on the affected areas of skin 2-3 times per day. Evenly with a thin layer. In areas with more dense skin (palms, elbows, feet, etc.), as well as places from which the drug is easily erased, more frequent application is allowed. In children, as well as in the period aftercare possible use of the drug once/day. and less often. The duration of treatment in children should not exceed 3 weeks.
Elokom is applied 1 times per day. Evenly with a thin layer on the affected areas of the skin.
Side effects: When used in accordance with the instructions, drugs are usually carried out well. Sometimes there are local reactions: itching, erythema, burning, formation of bubbles, rarer-allergic reactions to the components of the drug, folliculitis, Perioral Derimatit, hypertrichosis and other skin reactions. With long-term use, as well as application on large surfaces and/or the use of Occluzih bandages can be observed side effects typical of system glucocorticosteroids.
Overdose: With excessively long and/or intensive use of glucocorticosteroids in high doses, the above mentioned side effects, atrophy of the skin may be increased.
Storage conditions: All preparations should be kept out of reach of children at room temperature not above 25 °c (some-not above 30 ° с).
Thus, for the most effective and safe use of glucocorticosteroids in atopic dermatitis in children should choose only drugs intended for use by toddlers of the appropriate age group, do not exceed prescribed in the instructions dosage, to carry out therapy under the supervision of a doctor.
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