From the Guidelines
When applying both a steroid and a moisturizer, it's generally better to apply the steroid first, then wait about 10-15 minutes before applying the moisturizer. This sequence allows the medicated steroid cream to penetrate the skin and work effectively without being diluted or blocked by the moisturizer. Topical steroids like hydrocortisone, betamethasone, or triamcinolone are designed to reduce inflammation and need direct contact with the skin to exert their therapeutic effects. After applying the steroid, wait until it has been absorbed before applying your moisturizer (such as CeraVe, Cetaphil, Eucerin, or Vanicream) 1. The moisturizer then creates a protective barrier that helps lock in both the medication and hydration. This approach maximizes the effectiveness of both products while minimizing potential skin irritation. For very dry skin conditions, some dermatologists may recommend the "soak and smear" technique—applying the steroid right after bathing to slightly damp skin, then following with moisturizer to seal in both the medication and moisture.
The use of moisturizers is recommended for adults with atopic dermatitis, as they have a short- and long-term steroid-sparing effect in mild to moderate cases 1. Topical corticosteroids (TCSs) are considered the first-line treatment for flare-ups and are effective in reducing the inflammatory immune response in atopic dermatitis 1. Proactive therapy with twice-weekly application of TCSs or topical calcineurin inhibitors (TCIs) to previously affected skin areas may help to prevent relapses in children with moderate to very severe atopic dermatitis 1.
Some key points to consider when applying both a steroid and a moisturizer include:
- Apply the steroid first to allow it to penetrate the skin effectively
- Wait about 10-15 minutes before applying the moisturizer
- Use a moisturizer that creates a protective barrier to lock in both the medication and hydration
- Consider the "soak and smear" technique for very dry skin conditions
- Regular use of emollients has a short- and long-term steroid-sparing effect in mild to moderate atopic dermatitis 1.
It's essential to follow the recommended guidelines for the management of atopic dermatitis, including the use of topical therapies, to minimize the risk of flare-ups and improve the quality of life for individuals with the condition 1.
From the Research
Application Order of Steroid and Moisturizer
- The provided studies do not directly address the question of whether it is better to apply steroid or moisturizer first 2, 3, 4, 5, 6.
- However, the studies suggest that topical corticosteroids and moisturizers are both essential for treating inflammatory skin conditions such as eczema and atopic dermatitis 2, 3, 4.
- Topical corticosteroids are classified by strength and the risk of adverse effects, and their application should be guided by a healthcare professional 2.
- Moisturizers play a crucial role in maintaining the integrity of the skin barrier by increasing stratum corneum hydration and reducing transepidermal water loss 6.
- One study found that there was no difference in moisturizing effectiveness between immediate and delayed moisturizing in healthy skin 6.
Considerations for Application
- The application of topical corticosteroids and moisturizers should be individualized based on the specific skin condition, skin type, and patient needs 2, 3, 4.
- Patients should be taught correct application techniques, such as using the fingertip unit method for topical corticosteroids 2.
- The use of combined antibiotic/corticosteroid creams may be effective in reducing disease severity and improving quality of life in patients with eczema, but caution is needed due to the risk of antibiotic resistance 3.
- Emollients and moisturizers can help to repair the skin barrier and reduce inflammation, but their effectiveness may vary depending on the specific product and individual skin type 5, 6.