Steroids and Calcineurin inhibitors

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Some tips picked up from BGPERT teaching

Steroids

General tips

• Consider two strengths of steroids for "face and flexures" and "body and limbs"
• Ointments preferable as fewer additives
• Steroid or Emollient any order as long as there is a gap.
• Use an appropriately potent steroid.

How to use

• Use daily for 2/52 or until completely switched off (up to one month max)
  • Then alternate days for 2/52
  • Can use maintenance of 2x / week (weekend therapy) for a further few months

If need a lower allergy preparation steroid - Synalar maybe helpful

Calcineurin inhibitors

• Can be used twice daily and weaned down to twice weekly maintenance
• Elidel (Pimecrolimus) cream can be used from age 3/12 - BNF licence from 2 years
• Leave at least 1 hour either side of application before applying moisturiser
• Not generally used in acute therapy as they sting.
• Warn that patient may experience warmth / burn on application - WARN Patient
• Possible alcohol reaction - patchy urticaria reaction
• Useful as maintenance therapy