Managing Eczema and Acne: When to Resume Acne Treatments After Steroids

Eczema, acne, and comedones?

Hello Doctor, I have been continuously using acne treatments such as Acnex, A-Ret, and Shiseido's acne cream, and I have undergone three sessions of glycolic acid peels.
After each session, I wait for the scabs to fall off before resuming the acne medications.
Last week, I started experiencing itching and redness all over my face, with a rough, bumpy texture.
After seeing a doctor, I was diagnosed with eczema and prescribed a corticosteroid, which has significantly reduced the itching.
Currently, I only have mild itching and some rough, peeling skin left.

I would like to ask when it would be appropriate to resume using my acne medications.
I stopped using them as soon as my skin began to itch, but my acne issue is not resolved, and I've developed a few new closed comedones in the past few days.
I'm concerned that if I wait too long, my acne problem may worsen.
Therefore, I would like to know the recommended intervals and timing for using the corticosteroid for eczema in relation to the acne medications mentioned above.
Thank you, Doctor!

Chen, 20~29 year old female. Ask Date: 2023/01/30

Dr. Wu Yuxin reply Dermatology

In principle, there is no significant conflict between the two, unless the changes in eczema on the face are caused by the application of acne medication.
Otherwise, different lesions can be treated simultaneously with different ointments.
It is advisable to consult your physician about which lesions are suitable for acne medication and which ones are appropriate for eczema ointment.

Reply Date: 2023/01/30

More Info

Managing eczema and acne can be quite challenging, especially when treatments for one condition may exacerbate the other. In your case, it sounds like you have been using topical treatments for acne, such as 藥膏 (medicated creams), and have also undergone chemical peels. Recently, you developed symptoms of eczema, which were treated with steroids. Now, you are concerned about when to resume your acne treatments.

First, it’s important to understand the nature of both conditions. Eczema, or atopic dermatitis, is characterized by dry, itchy, and inflamed skin. It can be triggered by various factors, including allergens, irritants, and stress. On the other hand, acne is primarily caused by clogged pores, bacteria, and excess oil production. The treatments for these conditions often differ, and using them simultaneously requires careful management.

When you apply topical steroids to treat eczema, they can help reduce inflammation and itching. However, steroids can also thin the skin if used excessively or for prolonged periods. This is particularly important to consider when you plan to resume your acne treatments, as some acne medications can be irritating, especially on already sensitive or compromised skin.

Here are some guidelines to help you navigate the timing of resuming your acne treatments after using steroids for eczema:
1. Wait for Skin Recovery: After stopping the steroid treatment, give your skin some time to recover. This means waiting until the redness, itchiness, and rough texture have significantly improved. This could take a few days to a week, depending on the severity of your eczema flare-up.

2. Gradual Reintroduction: Once your skin feels more stable and less reactive, you can start reintroducing your acne treatments gradually. Begin with a small amount of the acne medication on a less affected area to see how your skin reacts. If there is no irritation, you can slowly increase the application to the affected areas.

3. Monitor Your Skin: Pay close attention to how your skin responds after resuming acne treatments. If you notice any signs of irritation, such as increased redness, burning, or itching, it may be best to pause the acne treatment again and consult your dermatologist.

4. Consider Non-Irritating Options: If your skin remains sensitive, consider using non-irritating acne treatments. For example, products containing salicylic acid or benzoyl peroxide may be effective but can be drying. Look for formulations that are labeled as gentle or suitable for sensitive skin.

5. Consult Your Dermatologist: Since you have a history of both eczema and acne, it’s crucial to work closely with your dermatologist. They can provide personalized advice based on your skin's condition and may suggest alternative treatments that can address both issues without causing further irritation.

6. Hydration and Moisturization: Ensure that your skin remains well-hydrated. Use a gentle, non-comedogenic moisturizer to help maintain the skin barrier, especially after using acne treatments. This can help reduce irritation and support overall skin health.

7. Avoid Overlapping Treatments: If you are using multiple treatments, be cautious about overlapping them. For instance, if you are using a steroid cream for eczema, avoid applying acne treatments immediately afterward. Instead, consider using them at different times of the day (e.g., acne treatments in the morning and eczema treatments at night).

In summary, the key to managing both eczema and acne lies in patience and careful monitoring. Allow your skin to recover from the steroid treatment before reintroducing acne medications, and always prioritize gentle, hydrating products to support your skin's health. If you have any doubts or if your skin condition worsens, do not hesitate to reach out to your dermatologist for further guidance.

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