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For treating atopic dermatitis, newer (second generation) corticosteroids, such as fluticasone propionate and mometasone furoate, are more effective and safer than older ones. They are also generally safe and do not cause skin thinning when used intermittently to treat atopic dermatitis flare-ups.
Prednisone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive properties. [36] [37] Prednisone is a prodrug; it is metabolised in the liver by 11-β-HSD to prednisolone, the active drug. Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone. [38]
Intermittent use of topical steroids for atopic dermatitis is safe and does not cause skin thinning. [6] [7] [8] Skin atrophy can occur with both prescription and over the counter steroids creams. [9] Low doses of prednisone by mouth can also result in skin atrophy.
[38] [39] TSA is characterised by uncontrollable, spreading dermatitis and worsening skin inflammation which requires a stronger topical steroid to get the same result as the first prescription. When topical steroid medication is lost, the skin experiences redness, burning, itching, hot skin, swelling, and/or oozing for a length of time.
Topical steroid withdrawal, also known as red burning skin and steroid dermatitis, has been reported in people who apply topical steroids for 2 weeks or longer and then discontinue use. [ 4 ] [ 5 ] [ 2 ] [ 1 ] Symptoms affect the skin and include redness, a burning sensation, and itchiness, [ 2 ] which may then be followed by peeling.
Prednisone side effects can be very serious, like thin skin, any injuries leading to infections that are difficult to treat, urinary infections, ear infections, and sometimes even aggression.
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