Corticosteroids (topical)

Corticosteroids (topical)

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Uses

* Corticosteroids (topical) are effective anti-inflammatory preparations used to control eczema/dermatitis and many other skin conditions.

Corticosteroids (topical), or topical steroids, are effective anti-inflammatory medications prescribed to treat rashes, eczema, and dermatitis, as well as other skin conditions. They are classified into seven different groups, and whenever possible, the weakest topical steroid that is still effective should be the one that is used.

Group I (Very potent. The strongest class of topical steroids, up to 600 times stronger than hydrocortisone)

Clobetasol propionate 0.05% (Dermovate)
Betamethasone dipropionate 0.25% (Diprolene)
Halobetasol proprionate 0.05% (Ultravate, Halox)
Diflorasone diacetate 0.05% (Psorcon)

Group II

Fluocinonide 0.05% (Lidex)
Halcinonide 0.05% (Halog)
Amcinonide 0.05% (Cyclocort)
Desoximetasone 0.25% (Topicort)

Group III

Triamcinolone acetonide 0.5% (Kenalog, Aristocort cream)
Mometasone furoate 0.1% (Elocon ointment)
Fluticasone propionate 0.005% (Cutivate)
Betamethasone dipropionate 0.05% (Diprosone)

Group IV

Fluocinolone acetonide 0.01-0.2% (Synalar, Synemol, Fluonid)
Hydrocortisone valerate 0.2% (Westcort)
Hydrocortisone butyrate 0.1% (Locoid)
Flurandrenolide 0.05% (Cordran)
Triamcinolone acetonide 0.1% (Kenalog, Aristocort A ointment)
Mometasone furoate 0.1% (Elocon cream, lotion)

Group V

Triamcinolone acetonide 0.1% (Kenalog, Aristocort cream, lotion)
Fluticasone propionate 0.05% (Cutivate cream)
Desonide 0.05% (Tridesilon, DesOwen ointment)
Fluocinolone acetonide 0.025% (Synalar, Synemol cream)
Hydrocortisone valerate 0.2% (Westcort cream)

Group VI

Prednicarbate 0.05% (Aclovate cream, ointment)
Triamcinolone acetonide 0.025% (Aristocort A cream, Kenalog lotion)
Fluocinolone acetonide 0.01% (Capex shampoo, Dermasmooth)
Desonide 0.05% (DesOwen cream, lotion)

Group VII (The weakest class of topical steroids)

Hydrocortisone 2.5% (Hytone cream, lotion, ointment)
Hydrocortisone 1% (Many over-the-counter brands)

The type of topical steroid used is based on the diagnosis and body location. In general, weaker topical steroids are used on thin-skinned and sensitive areas, especially areas like the armpit, groin, buttock crease, breast folds. Weaker steroids are also used on the face, eyelids, diaper area, perianal skin,the groin or body folds. Moderate steroids are used for atopic dermatitis, nummular eczema, asteatotic dermatitis, lichen sclerosis, scabies, severe dermatitis. Stronger steroids are used for psoriasis, lichen planus, discoid lupus, chapped feet, lichen simplex chronicus, severe poison ivy, alopecia areata, nummular eczema, and severe atopic dermatitis in adults.

Dosing

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.

Topical steroids should only be applied to the areas affected by the skin disease, and generally only once or twice daily, or as otherwise as sparing as possible. The fingertip unit -- a standard way to measure the amount of steroid you should be using to treat skin inflammation -- is useful in determining how much lotion cream or other dosage should be used.

Side Effects

If used correctly topical steroids are safe and rarely cause side effects. However the use of Corticosteroids (topical) may cause some side effects which can include raised blood pressure fluid retention diabetes and suppression of the adrenal gland which may result in the patient becoming ill when trying to come off the steroid treatment. Other side effects may include atrophy (irreversible thinning of the skin) tearing bruising stretch marks rash around the mouth glaucoma and telangiectasia (enlarged blood vessels in the skin).

Abrupt withdrawal of these medications can lead to aggressive recurrence of the condition. Moreover overuse may cause dermatitis.

Notes of Precaution

* Use the least potent steroid possible to control the inflammation.

* Only apply the steroid to areas of skin affected by the skin disease.

* Only use the steroid as often as prescribed by your doctor
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