“Black-hearted baby cream” is trending on the Internet. Do you know the truth about hormone ointments?

I believe many parents have experienced eczema or dermatitis in their children. This is especially true for infants and young children with low immunity and impaired skin barrier function. Eczema and atopic dermatitis are inflammatory skin diseases caused by a variety of internal and external factors, often accompanied by itching, and prone to recurrence, which seriously affects the quality of life, often causing irritability and crying in children, and arousing the nerves of parents.

Recently, a well-known evaluation blogger exposed the phenomenon of a 5-month-old baby with a "big head" due to the use of a baby cream containing a large dose of hormones: developmental delay, excessive hair, facial edema, etc. "Hormone baby cream" quickly became a hot search, exacerbating the panic of the majority of mothers about hormones. In fact, we often encounter such inquiries from parents: Does the topical ointment prescribed by the doctor contain hormones? Are the side effects of using hormone ointments on children particularly large? Are there other alternative treatments? I have also seen some parents who resolutely refuse to use hormone-containing ointments on their children, which leads to further aggravation of eczema and dermatitis, and even causes skin damage and infection. Then let's take a deeper look today, is hormone ointment a devil or an angel?

¨ What should I do if my baby has skin problems?

With the development of modern technology, parents are used to searching the Internet for answers when their babies have skin problems. Some parents may choose to buy some herbal ointments online or some ointments purchased from abroad for their children to use. These methods are not recommended for parents. The quality of answers on the Internet is uneven and the credibility is not high. The ointments purchased online are not regular medicines. It is not ruled out that excessive hormones are added or the quality of the ointment products cannot be guaranteed. The "big-headed baby" incident caused by the baby cream that has been on the hot search recently is a good proof. According to the test report of a third-party agency, the content of clobetasol propionate (a glucocorticoid) in the manufacturer's baby cream is more than 70 times higher than that of clobetasol propionate cream containing the same ingredient. Therefore, when a child has skin problems, he must go to a regular hospital for treatment, because dermatologists need to observe the baby's rash to identify and diagnose.

¨ Can hormone-containing ointments be used?

The "hormones" we often talk about actually refer to glucocorticoids. Glucocorticoids have a strong anti-inflammatory effect and can reduce early inflammatory reactions such as exudation, edema, and capillary dilation. Glucocorticoids can be applied systemically and topically. When applied topically, hormone-containing topical products can reduce the inflammatory response of the skin with very little systemic absorption, so the adverse reactions will be much smaller than systemic application. According to the "Guidelines for the Diagnosis and Treatment of Eczema in China (2011)" and the "Guidelines for the Diagnosis and Treatment of Atopic Dermatitis in China (2020 Edition)", hormone ointments are the first-line medication for eczema and atopic dermatitis. The reasonable and correct use of hormone-containing ointments is safe and effective, and there is no need to worry too much about side effects. Timely application of hormone ointments can quickly relieve skin discomfort, accelerate the repair of the skin barrier, and prevent more serious skin problems.

¨ What are the differences between different hormone ointments? Which ones are suitable for children?

Hormone ointments are generally divided into 4 levels according to their intensity:

(1) Super strong: 0.1% fluocinolone cream, 0.05% clobetasol cream;

(2) Strong effects: 0.05% halometasone cream, 0.05% betamethasone dipropionate cream, 0.1% betamethasone valerate cream, 0.25% desoxymethasone ointment and cream;

(3) Medium-acting: 0.05% fluticasone propionate cream, 0.1% mometasone furoate cream, 0.1% hydrocortisone butyrate cream, 0.1% triamcinolone acetonide cream;

(4) Weak effect: hydrocortisone cream, 0.05% desonide cream.

Children are a special group of people who need to take medication. Due to the high moisture content of their skin, topical medications are absorbed quickly and completely. Therefore, the use of weak and medium-potency hormone ointments usually has a good therapeutic effect. Weak and medium-potency hormone ointments are safer and more suitable for children.

¨ What should you pay attention to when using hormone ointments?

▲It cannot be applied over a large area for a long time, nor should it be used less blindly. It is recommended to use fingertip units as the basis for quantitative measurement. One fingertip unit is defined as the amount of ointment squeezed out from a 5mm diameter external ointment tube that can cover the length of the most distal knuckle of an adult's index finger. Fingertip units can help patients better follow the doctor's dosage. For example, a single surface of the hand is usually dosed with 0.5 fingertip units of ointment.

▲After applying hormone ointment to your baby, do not cover the skin surface with diapers or other airtight objects, which may cause excessive and rapid absorption of the drug.

▲When applying, avoid eyes, mucous membranes (such as oral cavity, nasal cavity, etc.) and broken skin.

The correct and reasonable use of hormone ointments is the premise of drug safety and effectiveness. Hormone ointments are not the devil, and it is not advisable to avoid medical treatment. The correct way to use them is to use them when necessary!!!

References

1. Chinese Eczema Diagnosis and Treatment Guidelines (2011)

2. Chinese Guidelines for the Diagnosis and Treatment of Atopic Dermatitis (2020 Edition)