Choosing Topical CorticosteroidsTopical steroids are available in creams, ointments, solutions and most potent steroid drug vehicles. There is little point in diluting a topical steroid, as their potency does not most potent steroid drug much on concentration and diluting the product does not reduce the risk of adverse effects. After the first 2 or 3 applications, there is no additional benefit from applying racz epidural steroid injection topical steroid more than once daily. Absorption also depends on the vehicle in which the topical steroid is delivered and is greatly enhanced by occlusion. Several formulations are available for topical steroids, intended to suit the type of skin lesion and its location.
Topical steroid potency chart | National Psoriasis Foundation
Topical steroids are available in creams, ointments, solutions and other vehicles. There is little point in diluting a topical steroid, as their potency does not depend much on concentration and diluting the product does not reduce the risk of adverse effects. After the first 2 or 3 applications, there is no additional benefit from applying a topical steroid more than once daily.
Absorption also depends on the vehicle in which the topical steroid is delivered and is greatly enhanced by occlusion. Several formulations are available for topical steroids, intended to suit the type of skin lesion and its location. Creams and lotions are general purpose and are the most popular formulations.
As a general rule, use the weakest possible steroid that will do the job. It is often appropriate to use a potent preparation for a short time to ensure the skin condition clears completely. Topical steroids are medicines regulated by Health Authorities. They are classified according to their strength. The products listed here are those available in New Zealand in November Side effects are uncommon or rare when topical steroids are used appropriately under medical supervision.
Topical steroid may be falsely blamed for a sign when underlying disease or another condition is responsible for example, postinflammatory hypopigmentation or undertreated atopic eczema.
Cases of Cushing syndrome due to topical corticosteroids most often occur because of inappropriate prescribing or over the counter sales of corticosteroids in countries where that is permitted. Local side effects may arise when a potent topical steroid is applied daily for long periods of time months.
Most reports of side effects describe prolonged use of unnecessarily potent topical steroid for inappropriate indications. Stinging frequently occurs when a topical steroid is first applied, due to underlying inflammation and broken skin.
Contact allergy to steroid molecule, preservative or vehicle is uncommon, but may occur after the first application of the product or after many years of its use. Topical steroid should be used cautiously on eyelid skin, where it commonly results in periocular dermatitis.
Potentially, excessive use over weeks to months might lead to glaucoma or cataracts. Mild and moderate-potency topical steroids can be safely used in pregnancy. Caution should be used for potent and ultrapotent topical steroids used over large areas or under occlusion, of which a proportion will be absorbed systemically. Reports of low birthweight infants exposed to high-dose topical steroid are not thought to be due to the medication.
Topical steroid is applied once daily usually at night to inflamed skin for a course of 5 days to several weeks. After that, it is usually stopped, or the strength or frequency of application is reduced.
Emollients can be applied before or after the application of topical steroid, to relieve irritation and dryness or as a barrier preparation. Infection may need additional treatment. One unit describes the amount of cream squeezed out of its tube onto the volar aspect of the terminal phalanx of the index finger.
Topical corticosteroids are regulated. However, potent steroid is illegally present in some cosmetic products purchased over the counter or via the Internet, according to reports from China and several developing countries. This has resulted in many reports of steroid-dependent periorificial dermatitis , rosacea and other adverse effects. DermNet NZ does not provide an online consultation service.
If you have any concerns with your skin or its treatment, see a dermatologist for advice. Updated 4 January New Zealand approved datasheets are the official source of information for these prescription medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website. Adverse effects of topical corticosteroids in paediatric eczema: Bolognia Textbook of Dermatology.
Mosby Elsevier publishing; Topical Steroids in Chinese Cosmetics. Prescriber Update 38 4: See the DermNet NZ bookstore.