激素排行表,方便打不开上面链接的mm。
Brand name Generic name
CLASS 1—Superpotent
Clobex Lotion/Spray/Shampoo, 0.05% Clobetasol propionate
Cormax Cream/Solution, 0.05% Clobetasol propionate
Diprolene Ointment, 0.05% Betamethasone dipropionate
Olux E Foam, 0.05% Clobetasol propionate
Olux Foam, 0.05% Clobetasol propionate
Temovate Cream/Ointment/Solution, 0.05% Clobetasol propionate
Ultravate Cream/Ointment, 0.05% Halobetasol propionate
Vanos Cream, 0.1% Fluocinonide
Psorcon Ointment, 0.05% Diflorasone diacetate
Psorcon E Ointment, 0.05% Diflorasone diacetate
CLASS 2—Potent
Diprolene Cream AF, 0.05% Betamethasone dipropionate
Elocon Ointment, 0.1% Mometasone furoate
Florone Ointment, 0.05% Diflorasone diacetate
Halog Ointment/Cream, 0.1% Halcinonide
Lidex Cream/Gel/Ointment, 0.05% Fluocinonide
Psorcon Cream, 0.05% Diflorasone diacetate
Topicort Cream/Ointment, 0.25% Desoximetasone
Topicort Gel, 0.05% Desoximetasone
CLASS 3—Upper Mid-Strength
Cutivate Ointment, 0.005% Fluticasone propionate
Lidex-E Cream, 0.05% Fluocinonide
Luxiq Foam, 0.12% Betamethasone valerate
Topicort LP Cream, 0.05% Desoximetasone
CLASS 4—Mid-Strength
Cordran Ointment, 0.05% Flurandrenolide
Elocon Cream, 0.1% Mometasone furoate
Kenalog Cream/Spray, 0.1% Triamcinolone acetonide
Synalar Ointment, 0.03% Fluocinolone acetonide
Westcort Ointment, 0.2% Hydrocortisone valerate
CLASS 5—Lower Mid-Strength
Capex Shampoo, 0.01% Fluocinolone acetonide
Cordran Cream/Lotion/Tape, 0.05% Flurandrenolide
Cutivate Cream/Lotion, 0.05% Fluticasone propionate
DermAtop Cream, 0.1% Prednicarbate
DesOwen Lotion, 0.05% Desonide
Locoid Cream/Lotion/Ointment/Solution, 0.1% Hydrocortisone
Pandel Cream, 0.1% Hydrocortisone
Synalar Cream, 0.03%/0.01% Fluocinolone acetonide
Westcort Cream, 0.2% Hydrocortisone valerate
CLASS 6—Mild
Aclovate Cream/Ointment, 0.05% Alclometasone dipropionate
Derma-Smoothe/FS Oil, 0.01% Fluocinolone acetonide
Desonate Gel, 0.05% Desonide
Synalar Cream/Solution, 0.01% Fluocinolone acetonide
Verdeso Foam, 0.05% Desonide
CLASS 7—Least Potent
Cetacort Lotion, 0.5%/1% Hydrocortisone
Cortaid Cream/Spray/Ointment Hydrocortisone
Hytone Cream/Lotion, 1%/2.5% Hydrocortisone
Micort-HC Cream, 2%/2.5% Hydrocortisone
Nutracort Lotion, 1%/2.5% Hydrocortisone
Synacort Cream, 1%/2.5% Hydrocortisone
3. 外用激素的副作用
激素对婴儿的副作用主要有两点:
1)大面积长时间使用,身体吸收激素过多,对HPA生长轴产生抑制,影响骨骼发育,暂时出现身高增长缓慢现象,虽然以后还会partial catch up。
2)对局部皮肤的影响。长时间使用,皮肤变薄,出现色素不均或皮下毛细血管显露。但多数在停药数周或者数月后会恢复。
我感觉,一般医生担心的是第一种副作用。我和医生讨论过这个大面积、长时间怎么定量。我的医生回答是身体面积90%以上,连续使用中强度激素3个月以上,可能会出现影响。
让这里妈妈纠结最多的第二种副作用。最容易受影响的是皮肤最薄,最影响美观的面部。我的儿医认为,小婴儿皮肤本来就薄,随着年龄增长,皮肤会变厚,不是大问题。我曾经追问,
- What if the uneven color or blood vessel won’t disappear?
儿医答:
- Honey, take him here. I still have a way. You’ve more important things to worry about now.
我家宝宝在5个月时,因为湿疹大爆发,面部连续使用过5周Desonide强度的激素。现在湿疹基本退去,我没有发现明显异常。回头来看这个激素使用,我现在不主张连续使用。因为我发现,激素有立竿见影的效果,但连续使用两周后,效力明显变弱。如果停用两周再用,效果又立现。所以,我认为,最好是连续用不超过7天,停一周再用。但我知道湿疹发得严重的时候,停药这一周是很艰难的,也有risk。
4. 外用激素的用法及用量
医生一般会告诉,薄薄一层在affected area, 一天1-2 次。尽量避免眼睛周围。因为如果把激素揉进眼里,会造成日后青光眼和其他眼科疾病。
如果宝宝全身大面积都是affected area,妈妈常常不知道如何用药。这里有一个用量单位FTU。