The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.
Phototherapy or light treatment is an effective treatment for eczema. With phototherapy, various wavelengths of sunlight (UVB, UVA, combined UVA/UVB, UVA1, or narrow-band) are administered in a unit that is similar to a telephone booth but which is lined by fluorescent appearing light bulbs. The type of phototherapy that you will receive will be determined by your dermatologist. It is usually administered twice weekly. Possible side effects of phototherapy are redness, sunburn, or dryness. Long-term side effects, which are more likely with white skin, are possible skin cancers and enhanced aging.
Dry, chapped, and itchy skin on the hands that doesn’t improve with moisturizer may be a sign of hand eczema. Symptoms can include red, itchy, inflamed skin with blistering that can lead to oozing, crusting, and cracking. People who have their hands in water all day or work closely with irritants such as detergents or solvents are more likely to develop this type of eczema. If you had atopic dermatitis as a child, you may also have a higher risk of developing hand eczema. Applying a cream after washing hands or wearing gloves may help protect hands from future flare-ups.