Part 1 of 2: safe use of hydrocortisone on eczema by a student nurse
so I've been struggling with scrotal eczema for the past 4 years, for the first 1-2 years I've been using hydrocortisone wrong, which lead me to TSW back in October 2024. I was prescribed by my dermatologist a bepanthen, a non-steroid topical cream that soothes the itch, but the problem is that my scrotum tends to burn and it has an awful smell due to bepanthen. I was in 1st year nursing school at this point so we haven't studied about pharmacology yet.
fast forward a month later, in November 2024 I was prescribed clobetasol, a more potent topical corticosteroid in which I have to apply in much thinner layers and taper off early on. there were sleepless nights due to intense itching and intense flaking alongside, skin also bleeds and cold water starts to sting, hence the recommendation of my dermatologist to prescribe me a more potent corticosteroid.
luckily I was only able to finish this treatment for just a month, and by January 2025, my flare ups were minimal.
since then, I was educated on how to properly taper off topical corticosteroids, especially when I entered 2nd year nursing.
now here's the tip:
if using for 7 days, always make sure to apply it twice daily (if self medicated always apply 2-3x a day, this is the safest dose, but always ask for the dermatologist's second opinion and recommendations), and on the second day try to increase the dose little by little. and on the 4th to 5th day, make sure than you start to taper off here so you won't end up having TSW.
applying topical corticosteroids on a damp skin and letting it air dry after shower is the best method you can do.
on the post-treatment of topical corticosteroid (8th day), if you still itch, just wash with warm water, make sure it's not hot or else it will make it more worse.
bonus tip: if your eczema has cuts or simply stings to cold water, the best you can do is wash it with warm water and a gentle/sensitive cleanser, washing it as often as you feel the urge to itch is the best way to do it.
wash warm and rinse cold, or wash warm and rinse warm + ice pack, eitherway works best