They can be prescribed or purchased over the counter (OTC) and come in different strengths and forms, such as creams or ointments.
This article will discuss how topical steroids work, how they are grouped by concentration, and provide drug examples.
How Topical Steroids Work
Topical steroids reduce inflammation of the skin .
Inflammation is a sign of an immune response. Treatment is applied to the affected area of the skin to relieve symptoms such as rashes, scaly patches, itching, pain, redness, or swelling.
For example, eczema , also known as atopic dermatitis, is a group of skin conditions that cause itching and inflammation of the skin with a scaly rash. Eczema is common in children. If you have an eczema flare-up, you can apply a cream to stop scratching the area and allow your skin to heal.
Topical steroids can be used for other skin conditions such as:
The strength of a topical steroid is determined by a test that measures how much it can cause the blood vessels to narrow in the upper dermis.
Narrowing of the blood vessels can reduce swelling and discomfort.
Topical steroids constrict blood vessels to reduce inflammation. They can be prescribed for autoimmune diseases that affect the skin, allergic reactions, and conditions that cause skin rashes.
Topical steroids are usually applied in a thin layer and rubbed into the skin one to four times a day.
They can take many forms, including:
- The most commonly prescribed creams are a mixture of water and oils and generally contain a preservative. They are especially good for hairy and wet areas and apply easily without leaving a greasy feel.
- Ointments are made up of oils and contain almost no water and generally do not contain preservatives. They are ideal for dry and flaky skin or thick skin areas such as the soles of the feet and the palms of the hands.
- The gels are made of water and propylene glycol , a synthetic alcohol. They are easy to apply, just like creams.
- Solutions, foams, and lotions often contain oil, water, and chemicals and are used on the scalp.
Topical steroids are both oily and non-oily. The type of remedy prescribed depends on the area of the skin to which it will be applied.
Topical steroids come in various strengths and are divided into seven classes based on their strength. The strongest steroids are in class I (first class) and the weakest steroids are in class VII (seventh class).
Class I topical steroids are approximately 600 to 1000 times stronger than class VII steroids.
It is important to note that the percentages shown on the product label do not reflect strength. For example, a 0.01% topical class I steroid is much more effective than a 3% class VII steroid.
The appropriate strength or effectiveness of steroids depends on many factors.
For example, babies metabolize topical steroids much faster than adults, so they may need a low-potency steroid.
Areas of the body where the skin comes into contact with the skin, such as the armpits or under the breasts, or sensitive areas of the skin, such as the eyelids, also rapidly absorb topical steroids and only low-potency medications may be required. .
However, the thick, rough skin on the palms and soles of the feet generally absorbs topical steroids more slowly than other parts of the body, so a stronger steroid is generally required for these areas.
The more effective a topical steroid is, the greater the risk of side effects.
Your healthcare professional can help you weigh the risks and benefits of using topical steroids and find the dose that works best for your skin condition.
How long you take the medicine also depends on your condition.
Follow all instructions for use of this medicine and consult your doctor if it does not help with your symptoms or if it causes further irritation. You may need to change the effectiveness or formulation of the medicine, or you may need to stop using it.
Within each class of topical steroids, there are many medications and formulations.
Class I topical steroids
The most effective topical steroids include:
- Temovat (clobetasol propionate) 0.05% ointment
- Ultravate (halobetasol propionate) 0.05% cream, ointment or lotion
- Psorkon (diflorazone diacetate) 0.05% ointment
- Diprolene (betamethasone dipropionate) ointment or gel 0.25%
Class II topical steroids
These topical steroids are considered very powerful:
- Lidex ( fluocinonide ) 0.05% cream, gel, ointment or solution
- 0.1% halogen (galcinonide) cream, ointment or solution
- Cyclocort (Amcinonide) Ointment 0.1%
- Topicort (deoxymethasone) 0.25% cream or ointment
Class III topical steroids
These topical steroids are considered powerful:
- Elocon Ointment (mometasone furoate) 0.1%
- Cutivate ointment (fluticasone propionate) 0.005%
- Bethanate cream (betamethasone dipropionate) 0.05%
- Kenalog (triamcinolone acetonide) 0.5% cream or ointment
Class IV topical steroids
These topical steroids are considered moderately effective:
- Synalar (fluocinolone acetonide) 0.025% cream or ointment
- Cordran (flurandrenolide) 0.05% cream, ointment or lotion
- Triderm (triamcinolone acetonide) 0.1% cream, ointment, or lotion
- Elocon (mometasone furoate) 0.1% cream, lotion or solution
- Cutivate cream (fluticasone propionate) 0.05%
Class V topical steroids
These topical steroids are considered quite powerful:
- Westcourt (hydrocortisone valerate) 0.2% cream or ointment
- Locoid Ointment (Hydrocortisone Butyrate) 0.1%
- Dermatop (prednicarbat) 0.1% cream or ointment
- Pandel (hydrocortisone probutate) 0.1% cream
Class VI topical steroids
These topical steroids are considered mild:
- Desonar gel 0.05%
- Sinalar (fluocinolone acetonide) 0.025% cream, solution or shampoo
- Locoid (hydrocortisone butyrate) cream, lotion or 0.1% solution
Class VII topical steroids
These topical steroids are considered the least effective:
- Giton ( hydrocortisone ) 2.5% cream and lotion
- 1% hydrocortisone (many over-the-counter creams, ointments, and lotions)
- Anusol-HC (hydrocortisone acetate) 0.5% and 1% creams
There are seven classes of topical steroids based on their strength. As class and potency increase, the risk of side effects increases.
Topical steroids are medications that are applied to the skin to reduce inflammation and irritation.
They are available over the counter and by prescription, in various strengths and formulations. Class VII steroids, which include over-the-counter hydrocortisone creams, are the mildest, while class I steroids are the strongest.
Your doctor can help you decide if a topical steroid is appropriate to treat your skin condition and what strength and duration of treatment might be most beneficial for you.