(Reuters Health) – Many people with eczema, a common skin disease, may avoid creams and ointments that can help ease symptoms like itching and inflammation because they’re afraid to try topical corticosteroids, a recent study suggests.

Eczema, also known as atopic dermatitis, usually develops in early childhood and often runs in families. Scaly, itchy rashes are the main symptoms. The condition can be treated using moisturizers, avoiding certain soaps and other irritants and with prescription creams and ointments containing corticosteroids to relieve itching.

For the study, researchers examined results from 16 previously published studies and found as many as four in five people were afraid to use corticosteroids for eczema. Between one third and one half of people who were prescribed steroid creams but also expressed concerns about them did not adhere to the treatment – meaning they didn’t use the creams and missed out on their benefits.

“Steroids have developed a bad reputation because of the potential side effects that come with improper or chronic use of high-potency steroids,” said senior study author Dr. Richard Antaya, director of pediatric dermatology at Yale School of Medicine in New Haven, Connecticut.

Common side effects of corticosteroids can include stretch marks as well as thinning, thickening or darkening of the skin. Less often, these steroids can cause acne or infected hair follicles or more serious side effects in the eyes like glaucoma and cataracts.

“The resistance to using topical corticosteroids is definitely partly driven by the confusion over the adverse effects of long term use of high potency steroids versus those of short term use of low potency steroids,” Antaya said by email. “The risks from using short-term low potency steroids are vastly lower.”

For the study, Antaya and colleagues examined studies published from 1946 to 2016 that surveyed patients and caregivers about their opinions of topical corticosteroids. The studies included in the analysis were done in Australia, Canada, Croatia, France, Germany, Hong Kong, Japan, Korea, Mexico, the Netherlands, Poland, Singapore and the U.S.

Two studies compared how often patients used these medicines based on whether or not they had phobias.