From the FDA Drug Label
Dermatologic acne, acneiform eruptions, allergic dermatitis, alopecia, angioedema, angioneurotic edema, atrophy and thinning of skin, dry scaly skin, ecchymoses and petechiae (bruising), erythema, facial edema, hirsutism, impaired wound healing, increased sweating, Karposi’s sarcoma (see PRECAUTIONS: General Precautions), lupus erythematosus-like lesions, perineal irritation, purpura, rash, striae, subcutaneous fat atrophy, suppression of reactions to skin tests, striae, telangiectasis, thin fragile skin, thinning scalp hair, urticaria
The FDA drug label does not answer the question.
From the Research
Prednisone can be used to treat severe eczema that doesn't respond to other treatments, but it's typically reserved for short-term use during serious flares. For adults, a typical regimen might start with 20-40mg daily for 5-7 days, followed by a gradual taper over 1-2 weeks to minimize withdrawal effects, as seen in general clinical practice 1. Children require lower doses based on weight. Prednisone works by suppressing the immune system and reducing inflammation, providing quick relief from itching and redness. However, it should not be used long-term due to significant side effects including weight gain, mood changes, increased blood sugar, bone loss, and increased infection risk.
Key Considerations
- It's essential to continue using moisturizers and topical treatments while on prednisone, and to follow your doctor's tapering schedule exactly to avoid rebound flares.
- Alternative long-term management options like topical corticosteroids, calcineurin inhibitors, or biologics like dupilumab are preferred for ongoing eczema control, as they have a more favorable safety profile for long-term use 2.
- The choice of topical corticosteroid depends on the severity of the eczema, the location of the affected skin, and the patient's age, with potent and moderate topical corticosteroids being more effective than mild ones for moderate or severe eczema 1.
Safety and Efficacy
- The safety of topical corticosteroids has been evaluated in several studies, with no evidence of harm found when used intermittently or for short periods 2.
- However, long-term use of topical corticosteroids can lead to adverse effects such as skin thinning, especially with very potent corticosteroids 2.
- Prednisone, being a systemic corticosteroid, carries a higher risk of systemic side effects compared to topical corticosteroids, emphasizing the need for cautious use and monitoring 3.
Application and Dosage
- The quantity of topical corticosteroid prescribed depends on the duration of treatment, the frequency of application, the skin location, and the total surface area treated, with the fingertip unit method being a useful guide for patients 3.
- Topical corticosteroids can be applied once or twice per day for up to three weeks for super-high-potency corticosteroids or up to 12 weeks for high- or medium-potency corticosteroids, with no specified time limit for low-potency topical corticosteroid use 3.