Topical Corticosteroids

Corticosteroid hormones are naturally occurring hormones produced by the adrenal glands within the body. Topical corticosteroids are synthetic (man-made) corticosteroid medications used for treating skin conditions such as rash, dermatitis, itching, eczema, and psoriasis. Topical corticosteroids have potent anti-inflammatory actions and also suppress the immune response. Topical corticosteroids are used based on their potency, the area of the body to which they will be applied, and type of skin condition being treated.

Topical corticosteroids are grouped according to their potency:

1. Very high potency: betamethasone dipropionate (Diprolene), clobetasol propionate (Clobex, Temovate, Olux), diflorasone diacetate, fluocinonide (Vanos), and halobetasol propionate (Ultravate).
2. High potency: amcinonide (Cylocort), desoximetasone (Topicort, Topicort LP), halcinonide (Halog), and triamcinolone acetonide (Kenalog).
3. Medium potency: betamethasone valerate (Luxiq), clocortolone pivalate (Cloderm), fluocinolone acetonide (Synalar), flurandrenolide (Cordran), fluocinonide (Lidex), fluticasone propionate (Cutivate), hydrocortisone butyrate (Locoid), hydrocortisone valerate (Westcort), mometasone furoate (Elocon), and prednicarbate (Dermatop).
4. Low potency: alclometasone dipropionate (Aclovate), desonide (Desowen, Verdeso), and hydrocortisone (Hytone).

Common side effects of topical corticosteroids are:

• itching,
• burning,
• irritation,
• redness, and
• dryness.

Long-term use can lead to loss of skin tone, deterioration of skin cells, and risk of infections.

Topical corticosteroids are available in:

• cream,
• ointment,
• gel,
• lotion,
• solution,
• foam,
• spray,
• shampoo,
• oil, and
• pads.

The risk of topical corticosteroids interacting with other drugs is low, and they do not have significant interactions with other drugs. Administration of other topical medications should be separated from administration of topical corticosteroid to avoid any potential interaction and diminished effect.

There is no evidence of safe and effective use of topical corticosteroids in pregnant mothers. Therefore, they should be used only if clearly needed. Long term use and large applications of topical corticosteroids may cause birth defects in the unborn. It is not known whether topical corticosteroids enter breast milk. Therefore, caution must be exercised before using it in nursing mothers. Topical corticosteroids should not be applied to the breasts of nursing mothers unless the mothers instructed to do so by the physician.