Treatment ''phobia'' is a major problem in Australia, says a leading dermatologist who is urging doctors to help allay parents' concerns about using cortisone ointments for childhood eczema.
Parents are bombarded with well-meaning but incorrect information that topical treatment with steroids is bad, says Dr Saxon Smith, lead author of an article in the latest issue of the Medical Journal of Australia.
But eczema (atopic dermatitis) can be safely and easily managed with corticosteroids, says Dr Smith, of Sydney's Royal North Shore Hospital. Unlike oral cortisone medicines, they had no serious side effects when used appropriately.
He says doctors should reassure parents there is no danger of topical treatments thinning the skin or causing problems by being absorbed into the body.
Untreated eczema can be disabling and disruptive but it is rarely life-threatening, says the article, which cites the extreme case of Gloria Sam, a nine-month-old who died in 2002 after her homeopath father refused treatment.
Doctors have a duty to intervene to protect a child's right to freedom from physical and psychological pain and disability, says the article. If parents refused treatment, as a last resort doctors should consider making a report to family and children's services.
Despite the genetic nature of eczema, parents often felt guilty and sought an external cause, which often led to a focus on allergies.
''But you can't alleviate all allergens from a child's environment. They cannot live in a bubble,'' the article says. ''Eczema is a chronic condition that waxes and wanes.
''But it can be managed and it generally improves over time as most children grow out of it.'' AAP