Tweet
I was just given three topical steriods to treat guttate psoriasis that is covering my entire body. I was directed to apply twice a day to my face with hydrocortisone, my scalp with fluocinonide and my body with triamcinolone acetonide. All of the information I can find says to limit dose and frequency, but I'm unsure what I should limit them to. Since the psoriasis is over my entire body, in the ideal situation I would be covering my whole body, but I don't think I should do that while breastfeeding a young baby (5 weeks). Do you have suggestions? Thanks.
-
-
Hi, thanks for your post.
Dr. Hale and I have discussed this question. In broad terms, topical steroids are not well absorbed into the bloodstream and it is believed that very little goes from the blood to the milk, although there are not many studies addressing this topic. We suggest the following:
1. Use the medications as prescribed until your psoriasis is under control. Then, you can cut back on your usage to a maintenance level. It will take some trial and error to figure out how much steroid it takes to keep the symptoms suppressed, but it should be less than you started out using.
2. Make sure to clean your breast and nipple area thoroughly before breastfeeding. You do not want to get any residual steroid in the baby's mouth.
3. Potential side effects of high-dose steroids include hypothyroidism and Cushing Syndrome. These can harm your baby, but only if you are severely affected. You should have plenty of warning before that happens. If you begin to notice symptoms of these disorders, your doctor may choose to draw hormone levels or to adjust your steroid dose. Also, the first sign of trouble with your baby would be substantial deviation from his or her growth curve. Your pediatrician checks for this every time you bring the baby in for a checkup. Again, not likely to be a problem, but keep an eye on it.
Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519
-James Abbey, MD
Comment