topical corticosteroids

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What are topical corticosteroids?

Topical corticosteroids are steroid medications that are applied directly to the skin to reduce inflammation and irritation.

Topical corticosteroids come in several different forms, including:

Cream
lotion
gel
moss
ointment
Tapes and bandages
solution

They are available in 4 different potency strengths:

slight
ease
powerful
very effective

Conditions treated with topical corticosteroids

Topical corticosteroid therapy is indicated in conditions characterized by inflammation, hyperproliferation, and immunologic involvement. They can also relieve the symptoms of burning and itching lesions.

Conditions widely treated with topical corticosteroids include:

Eczema – such as atopic eczema
Contact dermatitis - causes things like dandruff and scaly patches on the skin
psoriasis

Topical corticosteroids do not cure these conditions, but they can help relieve symptoms.

Side effects of topical corticosteroids

Topical corticosteroids rarely cause serious side effects if used correctly.

The most common side effect of topical corticosteroids is a burning or stinging sensation when taking the medication. However, this usually improves as your skin adjusts to the treatment.

Less common side effects may include:

You have an existing skin infection that worsens or spreads
Inflammation of hair follicles (folliculitis)
Thinning of the skin, which can make the affected skin more susceptible to damage; for example, you may bruise more easily
Stretch marks, which may be permanent, although they may become less noticeable over time
Contact dermatitis, a skin irritation caused by a mild allergic reaction to substances in certain topical corticosteroids
Acne, or worsening of acne
Rosacea, a condition that causes redness and flushing of the face
Changes in skin color – this is often more noticeable in people with darker skin
Excessive hair growth in the area of skin being treated

You are more likely to experience side effects if you:

Use more potent corticosteroids
Use for long periods of time or large areas

Older adults and young children are more susceptible to side effects.

If strong or very potent topical corticosteroids are used for long periods of time or over large areas, there is a risk that the drug will be absorbed into the bloodstream and cause internal side effects, such as:

Children's growth rate slows down
Cushing's syndrome

This is not a complete list of all possible side effects. For more information about side effects, see the leaflet that comes with the medicine.

Withdrawal side effects

Withdrawal reactions may occur if topical corticosteroids are discontinued after long-term continuous use (usually more than 12 months in adults). These can sometimes be serious. Your doctor may recommend stopping treatment gradually to avoid this.

Withdrawal side effects can include:

Redness or color changes in the skin (may be less noticeable on brown or black skin)
Skin burning, stinging, itching, or peeling, or oozing, open sores
A skin condition you are treating suddenly worsens

If you use topical corticosteroids long-term, it's a good idea to have your treatment reviewed by your doctor.

Preparation

Corticosteroid ointments provide more occlusion and lubrication than other preparations. This preparation increases the absorption of steroids.

Corticosteroid creams contain water suspended in oil. Creams are usually less effective than ointments.

Gels, lotions, and gels are minimally occlusive.

Shampoos, foams and mousses are effective treatments for your scalp.

World Health Organization classification of topical corticosteroids

The effectiveness of topical corticosteroids depends on the formulation, specific molecule type, extent of skin absorption, and amount reaching target cells. Efficacy is also increased when the formulation is used under an occlusive dressing or over an intergrated area. Generally speaking, ointments are more effective than creams or lotions.

Ultra high potency topical corticosteroid

First group