Can my wife use topical steroids while nursing for eczema?

Question

Hello doctor,

My wife, aged 29, delivered a baby four months ago and now has a red, itchy rash on her wrists and behind her knees. She never had skin problems before.

The rash worsens after stress and lack of sleep. So give us your thoughts on the following:

Can hormonal changes after pregnancy suddenly trigger eczema?
Is it safe to use a topical steroid while breastfeeding?
And would cutting out dairy or making other diet changes actually help with the flare?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your situation.

Yes, this can happen after pregnancy. Hormonal and immune system changes after delivery can trigger eczema (also known as atopic dermatitis, a skin condition that causes dry, itchy, inflamed, and sometimes red or cracked skin), even in women who have never had skin problems before. Stress, lack of sleep, sweating, and dry skin can worsen the rash, which is quite common in the post-partum period.

Regarding your question about steroid cream use while breastfeeding, most low- to medium-strength topical corticosteroids, such as Hydrocortisone, are generally safe during breastfeeding when used on small areas, not applied on the breast or nipple area, and used for short periods as advised by a doctor. This is because only a very small amount of the medicine is absorbed into the bloodstream.

Diet changes, such as avoiding dairy, usually do not help eczema unless she clearly notices that a specific food triggers the rash. Routine food restriction is not usually recommended.

She should use frequent moisturizers or emollients, use mild soap or soap-free cleansers, avoid very hot showers, and try to manage stress and get adequate sleep, as these measures help control eczema.

Overall, post-pregnancy hormonal changes and stress can trigger eczema. Mild steroid creams are usually safe during breastfeeding, and regular moisturizing and proper skin care are very important. If the rash spreads, becomes painful, or shows signs of infection, she should consult a doctor in person.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.