Topical steroid
Encyclopedia
Topical steroids are the topical forms of corticosteroid
s. Topical steroids are the most commonly prescribed
topical medications for the treatment of rash
, eczema
, and dermatitis
. Topical steroids have anti-inflammatory
properties, and are classified based on their vasoconstriction
abilities. There are numerous topical steroid products. All the preparations in each class have the same anti-inflammatory properties, but essentially differ in base and price.
and sensitive areas, especially areas under occlusion, such as the armpit, groin, buttock crease, breast folds. Weaker steroids are used on the face, eyelids, diaper area, perianal skin, and intertrigo
of the groin or body folds. Moderate steroids are used for atopic dermatitis
, nummular eczema, xerotic eczema
, lichen sclerosis et atrophicus of the vulva
, scabies
(after scabiecide) and severe dermatitis
. Strong steroids are used for psoriasis
, lichen planus
, discoid lupus, chapped feet, lichen simplex chronicus
, severe poison ivy
exposure, alopecia areata
, nummular eczema, and severe atopic dermatitis
in adults.
, a topical steroid is often prescribed to be used on a week on, week off routine. Some recommend using the topical steroid for 3 consecutive days on, followed by 4 consecutive days off. Weak topical steroid are reserved for the eyelids, facial skin, body folds, axillae, groin, genitals, and perineal region. Moderate topical steroids are used in wider unoccluded parts of the body like the trunk, arms, and legs. Strong topical steroids are used in limited skin areas to minimize systemic side effects. They are indicated for thick-skinned areas like the palms, soles of feet, and certain dermatitis such as lichen planus
and psoriasis
of the limbs.
Long-term use of topical steroids can lead to secondary infection with fungus
or bacteria
(see tinea incognito
), skin atrophy, telangiectasia
(prominent blood vessels), skin bruising and fragility.
The use of the finger tip unit
may be helpful in guiding how much topical steroid is required to cover different areas of the body.
, hydrocortisone buteprate
, methylprednisolone aceponate
, mometasone furoate
and prednicarbate
.
, Germany
, the Netherlands, New Zealand
, recognize only 4 classes. In New Zealand I is the strongest, while in Continental Europe
, class IV is regarded as the strongest.
, methyprednisolone, and prednisone
, triamcinolone alcohol, amcinonide
, budesonide, desonide
, fluocinonide
, fluocinolone acetonide
, and halcinonide
, dexamethasone sodium phosphate, and fluocortolone
Corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte...
s. Topical steroids are the most commonly prescribed
Medical prescription
A prescription is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. Prescriptions may include orders to be performed by a patient, caretaker, nurse, pharmacist or other therapist....
topical medications for the treatment of rash
Rash
A rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
, eczema
Eczema
Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...
, and dermatitis
Dermatitis
-Etymology:Dermatitis derives from Greek derma "skin" + -itis "inflammation" and genetic disorder.-Terminology:There are several different types of dermatitis. The different kinds usually have in common an allergic reaction to specific allergens. The term may describe eczema, which is also called...
. Topical steroids have anti-inflammatory
Anti-inflammatory
Anti-inflammatory refers to the property of a substance or treatment that reduces inflammation. Anti-inflammatory drugs make up about half of analgesics, remedying pain by reducing inflammation as opposed to opioids, which affect the central nervous system....
properties, and are classified based on their vasoconstriction
Vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, particularly the large arteries, small arterioles and veins. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in...
abilities. There are numerous topical steroid products. All the preparations in each class have the same anti-inflammatory properties, but essentially differ in base and price.
How to choose a steroid
The best result is obtained when the correct strength is matched with a specific diagnosis and anatomic location. Essentially, weaker topical steroids are utilized for thin-skinnedHuman skin
The human skin is the outer covering of the body. In humans, it is the largest organ of the integumentary system. The skin has multiple layers of ectodermal tissue and guards the underlying muscles, bones, ligaments and internal organs. Human skin is similar to that of most other mammals,...
and sensitive areas, especially areas under occlusion, such as the armpit, groin, buttock crease, breast folds. Weaker steroids are used on the face, eyelids, diaper area, perianal skin, and intertrigo
Intertrigo
An intertrigo is an inflammation of the body folds .An intertrigo sometimes refers to a bacterial, fungal, or viral infection that has developed at the site of broken skin due to such inflammation...
of the groin or body folds. Moderate steroids are used for atopic dermatitis
Atopic dermatitis
Atopic dermatitis is an inflammatory, chronically relapsing, non-contagious and pruritic skin disorder...
, nummular eczema, xerotic eczema
Xerotic eczema
Xerotic eczema is a form of eczema that is characterized by changes that occur when skin becomes abnormally dry, itchy, and cracked...
, lichen sclerosis et atrophicus of the vulva
Vulva
The vulva consists of the external genital organs of the female mammal. This article deals with the vulva of the human being, although the structures are similar for other mammals....
, scabies
Scabies
Scabies , known colloquially as the seven-year itch, is a contagious skin infection that occurs among humans and other animals. It is caused by a tiny and usually not directly visible parasite, the mite Sarcoptes scabiei, which burrows under the host's skin, causing intense allergic itching...
(after scabiecide) and severe dermatitis
Dermatitis
-Etymology:Dermatitis derives from Greek derma "skin" + -itis "inflammation" and genetic disorder.-Terminology:There are several different types of dermatitis. The different kinds usually have in common an allergic reaction to specific allergens. The term may describe eczema, which is also called...
. Strong steroids are used for psoriasis
Psoriasis
Psoriasis is an autoimmune disease that appears on the skin. It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. However, psoriasis has been linked to an increased risk of...
, lichen planus
Lichen planus
Lichen planus is a chronic mucocutaneous disease that affects the skin, tongue, and oral mucosa. The disease presents itself in the form of papules, lesions, or rashes. Lichen planus does not involve lichens, the fungus/algae symbionts that often grow on tree trunks; the name refers to the dry and...
, discoid lupus, chapped feet, lichen simplex chronicus
Lichen simplex chronicus
Lichen simplex chronicus is a skin disorder characterized by chronic itching and scratching. The constant scratching causes thick, leathery, brownish skin.- Causes :...
, severe poison ivy
Poison ivy
Toxicodendron radicans, better known as poison ivy , is a poisonous North American plant that is well known for its production of urushiol, a clear liquid compound found within the sap of the plant that causes an itching rash in most people who touch it...
exposure, alopecia areata
Alopecia areata
Alopecia areata is a medical condition in which hair is lost from some or all areas of the body, usually from the scalp. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. In 1–2% of cases, the condition can spread to the entire scalp ...
, nummular eczema, and severe atopic dermatitis
Atopic dermatitis
Atopic dermatitis is an inflammatory, chronically relapsing, non-contagious and pruritic skin disorder...
in adults.
How to use a topical steroid
To prevent tachyphylaxisTachyphylaxis
Tachyphylaxis is a medical term describing a decrease in the response to a drug due to previous exposure to that drug. Increasing the dose of the drug may be able to restore the original response. In this context tachyphylaxis is a synonym for drug tolerance...
, a topical steroid is often prescribed to be used on a week on, week off routine. Some recommend using the topical steroid for 3 consecutive days on, followed by 4 consecutive days off. Weak topical steroid are reserved for the eyelids, facial skin, body folds, axillae, groin, genitals, and perineal region. Moderate topical steroids are used in wider unoccluded parts of the body like the trunk, arms, and legs. Strong topical steroids are used in limited skin areas to minimize systemic side effects. They are indicated for thick-skinned areas like the palms, soles of feet, and certain dermatitis such as lichen planus
Lichen planus
Lichen planus is a chronic mucocutaneous disease that affects the skin, tongue, and oral mucosa. The disease presents itself in the form of papules, lesions, or rashes. Lichen planus does not involve lichens, the fungus/algae symbionts that often grow on tree trunks; the name refers to the dry and...
and psoriasis
Psoriasis
Psoriasis is an autoimmune disease that appears on the skin. It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. However, psoriasis has been linked to an increased risk of...
of the limbs.
Long-term use of topical steroids can lead to secondary infection with fungus
Fungus
A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...
or bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
(see tinea incognito
Tinea incognito
Tinea incognito is a fungal infection of the skin caused by the presence of a topical immunosuppressive agent. The usual agent is a topical corticosteroid . As the skin fungal infection has lost some of the characteristic features due to suppression of inflammation, it may have a poorly defined...
), skin atrophy, telangiectasia
Telangiectasia
Telangiectasias /tɛ.læn.dʒiː'ɛk.teɪ.ʃi:ə/ are small dilated blood vessels near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. They can develop anywhere on the body but are commonly seen on the face around the nose, cheeks, and chin...
(prominent blood vessels), skin bruising and fragility.
The use of the finger tip unit
Finger tip unit
In medicine, a finger tip unit is defined as the amount of ointment, cream or other semi-solid dosage form expressed from a tube with a 5mm diameter nozzle, applied from the distal skin-crease to the tip of the index finger of an adult. One FTU is enough to treat an area of skin twice the size...
may be helpful in guiding how much topical steroid is required to cover different areas of the body.
Side effects of topical steroids
- Diabetes mellitusDiabetes mellitusDiabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
- OsteoporosisOsteoporosisOsteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
- Allergic contact dermatitisContact dermatitisContact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....
(see steroid allergy) - Steroid atrophySteroid atrophySteroid atrophy is a side effect of the use of topical steroids. It can be seen with other changes associated with chronic topical steroid use, including tinea incognito , steroid induced telengiectasia, steroid induced acne or rosacea, and steroid induced skin fragility...
- AddictionAddictionHistorically, addiction has been defined as physical and psychological dependence on psychoactive substances which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.Addiction can also be viewed as a continued involvement with a substance or activity...
- Rebound effectRebound effectThe rebound effect, or rebound phenomenon, is the tendency of some medications, when discontinued suddenly, to cause a return of the symptoms it relieved, and that, to a degree stronger than they were before treatment first began...
: Abrupt withdrawal of these medications can lead to aggressive recurrence of the condition. - Overuse of topical steroid can cause dermatitis. Complete withdrawal of topical steroid use can eliminate dermatitis.
- Perioral dermatitisPerioral dermatitisPerioral dermatitis, a condition related to acne vulgaris, consists of red papules that may appear microvesicular that typically affect the nasolabial folds , perioral area or perioccular area . It usually affects women between the ages of 20 and 45...
: This is a rash that occurs around the mouth and the eye region that has been associated with topical steroids. - Ocular effects: Topical steroid drops are frequently used after eye surgeryEye surgeryEye surgery, also known as orogolomistician surgery or ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist.-Preparation and precautions:...
but can also raise intra-ocular pressure (IOP). - TachyphylaxisTachyphylaxisTachyphylaxis is a medical term describing a decrease in the response to a drug due to previous exposure to that drug. Increasing the dose of the drug may be able to restore the original response. In this context tachyphylaxis is a synonym for drug tolerance...
: The acute development of tolerance to the action of a drug after repeated doses. Significant tachyphylaxis can occur by day 4 of therapy. Recovery usually occurs after 3 to 4 days rest. This has led to therapies such as 3 days on, 4 days off; or one week on therapy, and one week off therapy. - VehicleCream (pharmaceutical)A cream is a topical preparation usually for application to the skin. Creams for application to mucus membranes such as those of the rectum or vagina are also used. Creams may be considered pharmaceutical products as even cosmetic creams are based on techniques developed by pharmacy and...
-related adverse effects - Other local adverse effects: These include facial hypertrichosisHypertrichosisHypertrichosis is an abnormal amount of hair growth on the body; extensive cases of hypertrichosis have informally been called werewolf syndrome. There are two distinct types of hypertrichosis: generalized hypertrichosis, which occurs over the entire body, and localized hypertrichosis, which is...
, folliculitisFolliculitisFolliculitis is the inflammation of one or more hair follicles. The condition may occur anywhere on the skin with the exception of the palms of the hands and soles of the feet.- Causes :...
, miliariaMiliariaMiliaria is a skin disease marked by small and itchy rashes. Miliaria is a common ailment in hot and humid conditions, such as in the tropics and during the summer season...
, genital ulcerGenital ulcerA Genital ulcer is an ulcer located on the genital area, usually caused by a sexually transmitted disease such as genital herpes, syphilis, chancroid, or thrush. Some other signs of having genital ulcers include enlarged lymph nodes in the groin area, or vesicular lesions, which are small, elevated...
s, and granuloma gluteale infantumGranuloma gluteale infantumGranuloma gluteale infantum is a cutaneous condition that appears in the anogenital region of infants as a complication of diaper dermatitis.According to some, no granulomas are actually found....
. Long term use has resulted in Norwegian scabies, Kaposi's sarcomaKaposi's sarcomaKaposi's sarcoma is a tumor caused by Human herpesvirus 8 , also known as Kaposi's sarcoma-associated herpesvirus . It was originally described by Moritz Kaposi , a Hungarian dermatologist practicing at the University of Vienna in 1872. It became more widely known as one of the AIDS defining...
, and other unusual dermatosis. - Continuous use of topical steroids can can cause addiction and rebound effects when trying to stop use of it. Red Skin Syndrome is the result of the addiction and withdrawals from steroids. This syndrome affects adults, toddlers and babies.
Soft steroids
Soft steroids are topical steroids with a low rate of side effects in relation to their anti-inflammatory potency. These include hydrocortisone aceponateHydrocortisone aceponate
Hydrocortisone aceponate is a corticosteroid....
, hydrocortisone buteprate
Hydrocortisone buteprate
Hydrocortisone buteprate is a corticosteroid....
, methylprednisolone aceponate
Methylprednisolone aceponate
Methylprednisolone aceponate is a glucocorticosteroid....
, mometasone furoate
Mometasone furoate
Mometasone furoate is a glucocorticosteroid used topically to reduce inflammation of the skin or in the airways.-Uses, administration, and pharmacodynamics:...
and prednicarbate
Prednicarbate
Prednicarbate is a relatively new topical corticosteroid drug. It is similar in potency to hydrocortisone. Compared to other topical corticosteroids, like betamethasone, repeated prednicarbate use does not cause skin atrophy as quickly...
.
USA system
The USA system utilizes 7 classes, which are classified by their ability to constrict capillaries. Class I is the strongest, or superpotent. Class VII is the weakest and mildest.Group I
Very potent: up to 600 times stronger than hydrocortisone- Clobetasol propionateClobetasol propionateClobetasol propionate is a corticosteroid used to treat various skin disorders including eczema and psoriasis. It is also highly effective for contact dermatitis caused by exposure to poison ivy/oak. Clobetasol belongs to US Class I of the corticosteroids, making it one of the most potent...
0.05% (Dermovate) - Betamethasone dipropionateBetamethasone dipropionateBetamethasone dipropionate is a glucocorticoid steroid with anti-inflammatory and immunosuppressive abilities. It is applied as a topical cream, ointment, lotion or gel to treat itching and other minor skin conditions such as eczema....
0.25% (Diprolene) - Halobetasol proprionate 0.05% (Ultravate, Halox)
- Diflorasone diacetate 0.05% (Psorcon)
Group II
- FluocinonideFluocinonideFluocinonide is a potent glucocorticoid steroid used topically as anti-inflammatory agent for the treatment of skin disorders such as eczema and seborrhoeic dermatitis...
0.05% (Lidex) - HalcinonideHalcinonideHalcinonide is a corticosteroid. It is used topically in the treatment of certain skin conditions....
0.05% (Halog) - AmcinonideAmcinonideAmcinonide is a topical glucocorticoid steroid used to treat itching, redness and swelling associated with several dermatologic conditions such as atopic dermatitis and allergic contact dermatitis.See also fluocinonide....
0.05% (Cyclocort) - Desoximetasone 0.25% (Topicort)
Group III
- Triamcinolone acetonideTriamcinolone acetonideTriamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions and to relieve the discomfort of mouth sores. It is a more potent type of triamcinolone, being about 8 times as effective as prednisone.-Medical use:...
0.5% (Kenalog, Aristocort cream) - Mometasone furoateMometasone furoateMometasone furoate is a glucocorticosteroid used topically to reduce inflammation of the skin or in the airways.-Uses, administration, and pharmacodynamics:...
0.1% (Elocon ointment) - Fluticasone propionateFluticasone propionateFluticasone propionate is a synthetic corticosteroid derived from fluticasone used to treat asthma and allergic rhinitis . It is also used to treat eosinophilic esophagitis....
0.005% (Cutivate) - Betamethasone dipropionateBetamethasone dipropionateBetamethasone dipropionate is a glucocorticoid steroid with anti-inflammatory and immunosuppressive abilities. It is applied as a topical cream, ointment, lotion or gel to treat itching and other minor skin conditions such as eczema....
0.05% (Diprosone)
Group IV
- Fluocinolone acetonideFluocinolone acetonideFluocinolone acetonide is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. The fluorine substitution at position 9 in the steroid nucleus greatly enhances its activity. A typical dosage strength used in...
0.01-0.2% (Synalar, Synemol, Fluonid) - Hydrocortisone valerate 0.2% (Westcort)
- Hydrocortisone butyrateHydrocortisone butyrateHydrocortisone butyrate is a corticosteroid that comes in one of the following forms:* hydrocortisone-17-butyrate - * hydrocortisone-21-butyrate -...
0.1% (Locoid) - Flurandrenolide 0.05% (Cordran)
- Triamcinolone acetonideTriamcinolone acetonideTriamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions and to relieve the discomfort of mouth sores. It is a more potent type of triamcinolone, being about 8 times as effective as prednisone.-Medical use:...
0.1% (Kenalog, Aristocort A ointment) - Mometasone furoateMometasone furoateMometasone furoate is a glucocorticosteroid used topically to reduce inflammation of the skin or in the airways.-Uses, administration, and pharmacodynamics:...
0.1% (Elocon cream, lotion)
Group V
- Triamcinolone acetonideTriamcinolone acetonideTriamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions and to relieve the discomfort of mouth sores. It is a more potent type of triamcinolone, being about 8 times as effective as prednisone.-Medical use:...
0.1% (Kenalog, Aristocort cream, lotion) - Fluticasone propionateFluticasone propionateFluticasone propionate is a synthetic corticosteroid derived from fluticasone used to treat asthma and allergic rhinitis . It is also used to treat eosinophilic esophagitis....
0.05% (Cutivate cream) - DesonideDesonideDesonide is the generic name of a low potency topical corticosteroid that has been available since the 1970s. It is primarily used to treat atopic dermatitis , seborrheic dermatitis, psoriasis and contact dermatitis in both adults and children. It has a fairly good safety profile and is available...
0.05% (Tridesilon, DesOwen ointment) - Fluocinolone acetonideFluocinolone acetonideFluocinolone acetonide is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. The fluorine substitution at position 9 in the steroid nucleus greatly enhances its activity. A typical dosage strength used in...
0.025% (Synalar, Synemol cream) - Hydrocortisone valerate 0.2% (Westcort cream)
Group VI
- Alclometasone dipropionate 0.05% (Aclovate cream, ointment)
- Triamcinolone acetonideTriamcinolone acetonideTriamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions and to relieve the discomfort of mouth sores. It is a more potent type of triamcinolone, being about 8 times as effective as prednisone.-Medical use:...
0.025% (Aristocort A cream, Kenalog lotion) - Fluocinolone acetonideFluocinolone acetonideFluocinolone acetonide is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. The fluorine substitution at position 9 in the steroid nucleus greatly enhances its activity. A typical dosage strength used in...
0.01% (Capex shampoo, Dermasmooth) - DesonideDesonideDesonide is the generic name of a low potency topical corticosteroid that has been available since the 1970s. It is primarily used to treat atopic dermatitis , seborrheic dermatitis, psoriasis and contact dermatitis in both adults and children. It has a fairly good safety profile and is available...
0.05% (DesOwen cream, lotion)
Group VII
The weakest class of topical steroids. Has poor lipid permeability, and can not penetrate mucous membranes well.- Hydrocortisone 2.5% (Hytone cream, lotion, ointment)
- Hydrocortisone 1% (Many over-the-counter brands)
Other countries
Most other countries, such as the United KingdomUnited Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
, the Netherlands, New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
, recognize only 4 classes. In New Zealand I is the strongest, while in Continental Europe
Continental Europe
Continental Europe, also referred to as mainland Europe or simply the Continent, is the continent of Europe, explicitly excluding European islands....
, class IV is regarded as the strongest.
Class IV
Very potent (up to 600 times as potent as hydrocortisone)- Clobetasol propionateClobetasol propionateClobetasol propionate is a corticosteroid used to treat various skin disorders including eczema and psoriasis. It is also highly effective for contact dermatitis caused by exposure to poison ivy/oak. Clobetasol belongs to US Class I of the corticosteroids, making it one of the most potent...
(Dermovate Cream/Ointment, Exel Cream) - Betamethasone dipropionateBetamethasone dipropionateBetamethasone dipropionate is a glucocorticoid steroid with anti-inflammatory and immunosuppressive abilities. It is applied as a topical cream, ointment, lotion or gel to treat itching and other minor skin conditions such as eczema....
(Diprosone OV Cream/Ointment, Diprovate Cream)
Class III
Potent (50-100 times as potent as hydrocortisone)- Betamethasone valerate (Beta Cream/Ointment/Scalp Application, Betnovate Lotion/C Cream/C Ointment, Daivobet 50/500 Ointment, Fucicort)
- Betamethasone dipropionateBetamethasone dipropionateBetamethasone dipropionate is a glucocorticoid steroid with anti-inflammatory and immunosuppressive abilities. It is applied as a topical cream, ointment, lotion or gel to treat itching and other minor skin conditions such as eczema....
(Diprosone Cream/Ointment, Diprovate Cream) - Diflucortolone valerateDiflucortolone valerateDiflucortolone valerate Diflucortolone valerate Diflucortolone valerate (also Nerisone cream/oily cream/ointment, Neriderm ointment, Japanese is a corticosteroid rated Class 2 "potent" (100-150 times) in New Zealand topical steroid system. Chemically, it is a corticosteroid esterified with valeric...
(Nerisone C/Cream/Fatty Ointment/Ointment) - Hydrocortisone 17-butyrate (Locoid C/Cream/Crelo Topical Emulsion/Lipocream/Ointment/Scalp Lotion)
- Mometasone furoateMometasone furoateMometasone furoate is a glucocorticosteroid used topically to reduce inflammation of the skin or in the airways.-Uses, administration, and pharmacodynamics:...
(Elocon Cream/Lotion/Ointment) - Methylprednisolone aceponateMethylprednisolone aceponateMethylprednisolone aceponate is a glucocorticosteroid....
(Advantan Cream/Ointment)
Class II
Moderate (2-25 times as potent as hydrocortisone)- Clobetasone butyrate (Eumovate Cream)
- Triamcinolone acetonide (Aristocort Cream/Ointment, Viaderm KC Cream/Ointment, Kenacomb Ointment)
Class I
Mild- Hydrocortisone 0.5-2.5% (DermAid Cream/Soft Cream, DP Lotion-HC 1%, Skincalm, Lemnis Fatty Cream HC, Pimafucort Cream/Ointment)
Allergy associations
The highlighted steroids are often used in the screening of allergies to topical steroid and systemic steroids. When one is allergic to one group, one is allergic to all steroids in that group.Group A
Hydrocortisone, hydrocortisone acetate, cortisone acetate, tixocortol pivalate, prednisolonePrednisolone
Prednisolone is the active metabolite of prednisone, which is also used as a drug.-Uses:Prednisolone is a corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions such as...
, methyprednisolone, and prednisone
Prednisone
Prednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug. It is used to treat certain inflammatory diseases and some types of cancer, but has significant adverse effects...
Group B
Triamcinolone acetonideTriamcinolone acetonide
Triamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions and to relieve the discomfort of mouth sores. It is a more potent type of triamcinolone, being about 8 times as effective as prednisone.-Medical use:...
, triamcinolone alcohol, amcinonide
Amcinonide
Amcinonide is a topical glucocorticoid steroid used to treat itching, redness and swelling associated with several dermatologic conditions such as atopic dermatitis and allergic contact dermatitis.See also fluocinonide....
, budesonide, desonide
Desonide
Desonide is the generic name of a low potency topical corticosteroid that has been available since the 1970s. It is primarily used to treat atopic dermatitis , seborrheic dermatitis, psoriasis and contact dermatitis in both adults and children. It has a fairly good safety profile and is available...
, fluocinonide
Fluocinonide
Fluocinonide is a potent glucocorticoid steroid used topically as anti-inflammatory agent for the treatment of skin disorders such as eczema and seborrhoeic dermatitis...
, fluocinolone acetonide
Fluocinolone acetonide
Fluocinolone acetonide is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. The fluorine substitution at position 9 in the steroid nucleus greatly enhances its activity. A typical dosage strength used in...
, and halcinonide
Halcinonide
Halcinonide is a corticosteroid. It is used topically in the treatment of certain skin conditions....
Group C
Betamethasone, betamethasone sodium phosphate, dexamethasoneDexamethasone
Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid drugs. It acts as an anti-inflammatory and immunosuppressant...
, dexamethasone sodium phosphate, and fluocortolone
Fluocortolone
Fluocortolone is a glucocorticoid used in the treatment of several conditions, including hemorrhoids.It is similar to fluocortin, but with one less keto group....