Efficient and safe use of topical glucocorticoids therapy in children – facts and controversies

Glucocorticoid adrenocortical hormones (GCSs) are among the most effective treatments for topical inflammatory skin diseases. However, the safety of such therapy causes a lot of emotions, related to the so-called steroidophobia described in about 50-70% of adult patients as well as parents of children with atopic eczema. This causes in patients avoidance of the necessary treatment or its dangerous modifications. This is due to ignorance caused by the lack of proper information from the doctor. That is why appropriate education of medical personnel is so important. The basis for the safe treatment of local GCSs includes three fundamental principles: correctly selected potency of action, the dose, and the method of application. The treatment depends on the nature of the skin lesions, their location, and the age of the patient. The article discusses the above-mentioned principles in the aspect of children’s therapy. Significant differences in the structure of the skin-epidermal barrier in this age group compared to adults are visible. One such difference is increased penetration of hydrophilic GCS particles; however, with proper use, side effects are very rare. On the other hand, the consequences of avoiding local GCS application such as uncontrolled significant pruritus, physiological disorders resulting from negative social impact, insomnia, and family difficulties may cause more damage than the low risk of GCS side effects.