Can topical corticosteroids be used to treat eczema (atopic dermatitis) on the penis?

From the Guidelines

Topical steroids can be used to treat eczema on the penis, but with caution and careful consideration of potential risks and benefits, as highlighted in the most recent guidelines 1. When using topical steroids on the penis for eczema, it is essential to choose mild to moderate potency steroids, such as hydrocortisone 1% or triamcinolone 0.1% cream, to minimize the risk of adverse effects like skin atrophy, striae, and systemic absorption. Some key points to consider when using topical steroids on the penis include:

• Apply a thin layer to affected areas once or twice daily for 7-14 days
• Avoid high-potency steroids, which can cause skin thinning, striae, or systemic absorption
• Wait 15-30 minutes before putting on clothing to allow absorption
• If symptoms don't improve within two weeks, or if they worsen, consult a healthcare provider
• Topical steroids work by reducing inflammation, itching, and redness by suppressing the immune response in the skin
• For maintenance after the initial treatment, consider using moisturizers regularly and only using the steroid cream during flare-ups
• Always wash hands before and after application, and avoid sexual activity immediately after applying the medication, as noted in general guidelines for topical corticosteroid use 1. The potential risks and benefits of topical corticosteroid use, including local skin adverse effects and the importance of careful patient education, are discussed in recent guidelines 1.

From the FDA Drug Label

temporarily relieves external anal and genital itching other uses of this product should only be under the advice and supervision of a doctor for external anal and genital itching, adults: when practical, clean the affected area with mild soap and warm water and rinse thoroughly gently dry by patting or blotting with toilet tissue or a soft cloth before applying apply to affected area not more than 3 to 4 times daily

The hydrocortisone (TOP) cream can be used on the genital area, including the penis, for eczema but only under the advice and supervision of a doctor 2. For external anal and genital itching, the product can be applied to the affected area not more than 3 to 4 times daily 2.

• Key points:
  • Use on genital area is allowed but with medical supervision.
  • Apply not more than 3 to 4 times daily for external anal and genital itching.
  • Children under 12 years of age should ask a doctor before using the product for external anal and genital itching 2.

From the Research

Topical Steroids for Eczema on the Penis

• The use of topical steroids on the penis for eczema is a common treatment approach, but it requires careful consideration due to the sensitive nature of the area 3.
• Topical corticosteroids are classified by strength and the risk of adverse effects, such as atrophy, striae, rosacea, telangiectasias, purpura, and other cutaneous and systemic reactions 3.
• The risk of adverse effects increases with prolonged use, a large area of application, higher potency, occlusion, and application to areas of thinner skin, such as the face and genitals 3.
• When prescribing topical corticosteroids for use on sensitive areas like the penis, lower potencies and shorter durations should be used to minimize the risk of adverse effects 4, 3.

Effectiveness of Topical Steroids for Eczema

• Potent and very potent topical steroids have been ranked among the most effective treatments for improving patient-reported symptoms and clinician-reported signs of eczema 5, 6.
• However, the evidence for the effectiveness of topical steroids on the penis specifically is limited, and more research is needed to determine the optimal treatment approach for this area 5, 4, 6.
• Network meta-analysis has shown that potent topical steroids, Janus kinase inhibitors, and tacrolimus 0.1% are consistently ranked as among the most effective topical anti-inflammatory treatments for eczema 5, 6.

Safety Considerations

• Local application site reactions, such as burning sensations and increased pruritus, are common adverse events associated with topical corticosteroids, particularly with higher potencies 5, 7, 6.
• Skin thinning is a potential risk with long-term use of topical corticosteroids, particularly with higher potencies, but the evidence for this risk is limited and more research is needed 5, 4, 6.
• Patients should be carefully monitored for adverse effects and instructed on proper application techniques to minimize the risk of adverse effects 3.