There may be instances where customers come back to the pharmacy, even after regularly applying emollients, explaining that their symptoms have flared up or not improved. In this situation, it may be appropriate to recommend a topical corticosteroid such as hydrocortisone 1% cream to soothe any redness, itching or inflammation. However, there are some instances where changing to OTC corticosteriods may not be suitable, such as:

• In children aged under 10 years for hydrocortisone and under 12 years for clobetasone
• On large areas of skin
• On broken or infected skin
• For use on the face
• If treatment is required for longer than seven days.

You should advise that topical steroids should be used sparingly and customers should wash their hands after application unless the hands are being treated. Topical steroids can also be used alongside emollient therapy, but customers should apply the emollient first and wait 30 minutes before applying the steroid.³