Olux-E Foam and Nizoral Shampoo

[Annwest83]

I had posted about the Luxiq for itchy scalp. I just went to my dermatologist again and she determined that it wasn't enough. She stated that I need to up the steroid amount.
She has recommended that I use the Olux-E Foam 2 times per day (If I remember correctly, I think she said it was 4%) and Loprox shampoo 3 times per week together for 2 weeks and then as needed after that.
Do I need to worry about a build up of the steroids in my system or long term use of these topical steroids? What about the amount I am absorbing when using these 2 medications together? What would be the threshold for the time frame of using these?
The inital 2 weeks is to get it under control and hopefully after that, I won't need it as often and for as long of a duration.
I am nervous to be using steroids like this. Can they be harmful to the baby? I have been using the Luxiq about 3 times per week for about 1 month.
Can you help me with the risks to breastfeeding?

[cpride]

Dear Annwest83,

Clobetasol propionate (Olux-E) is a very high potency topical corticosteroid and should not be used on the nipple or areola of a breastfeeding mother. In small doses, most steroids are certainly not contraindicated in nursing mothers. Whenever possible use low-potency alternatives. Brief applications of high dose steroids are probably not contraindicated as the overall exposure is low. With prolonged high dose therapy, the infant should be closely monitored for growth and development. You may want to talk with your pediatrician about monitoring your infant if you have to be on these medications long term.Ciclopirox (Loprox) is a broad-spectrum antifungal and is active in numerous species including tinea, candida albicans, and trichophyton rubrum. Topical application produces minimal systemic absorption; it is unlikely that topical use would expose the nursing infant to significant risks. Hope this information is helpful.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

[Annwest83]

Thank you for your response!
For the higher dose corticosteroid, is using that 2 times a day for 2 weeks considered long term? After that, it sounds like it would be on an "as needed" basis. Maybe I would use it for a week at a time every month or 2 (maybe even three). Is this okay?
For now, I think I will stick to the shampoo with the lower dose steroid (luxiq). Does that sound reasonable?

[Annwest83]

Still wondering about what is considered "long term" for these medications?

[admin]

Annwest83:

weeks to months of continuous use. Just observe infant height which would be most sensitive to continued exposure to steroids.

Tom Hale Ph.D.