Corticosteroid phobia and other confounders in the treatment of childhood atopic dermatitis explored using parent focus groups


  • Saxon D Smith, MBChB. Esther Hong, MBBS. Samantha Fearns, PhD. Alex Blaszczynski, PhD. Gayle Fischer, FACD.

Dr Saxon D Smith, Dermatology Registrar, Skin and Cancer Foundation, 277 Bourke St, Sydney, NSW 2010, Australia. Email:


Background/Objectives:  Anxieties associated with corticosteroid treatment and preference for ‘safer natural therapy’ are common in parents of children with atopic dermatitis. We used focus groups to explore the source of these attitudes.

Methods:  The study involved 16 parents. Parents expressed difficulties with living with and treating atopic dermatitis which were categorized into themes using qualitative data analysis software.

Results:  Themes identified include: emotional impact of atopic dermatitis; difficulty in accepting ‘control’ verses ‘cure’; topical corticosteroid negative perceptions; anxiety and confusion with treatment; preference for ‘natural’ therapy; and attitude-changing positive experiences.

Conclusions:  Our findings illustrate the emotional impact of atopic dermatitis and the frustration with the lack of potential cure. ‘Corticosteroid phobia’ was universal among parents in our cohort and is a fear generated by doctors, pharmacists, close acquaintances and information from the internet. Participants expressed high levels of parental guilt linked to a desire for an eradicable ‘cause’ for atopic dermatitis, despite intellectually understanding this is a genetically determined condition. Parents were willing to change attitudes with accurate information from perceived reliable sources, positive hospitalization experiences and a relationship with a trusted dermatologist. Parents' suggestions to improve confidence included the provision of readily available information and better access to doctor- and nurse-led paediatric dermatology services.