Yes, a pregnant woman can use topical steroid cream but should be prescribed the lowest potency possible as there is some evidence that fetal growth is restricted with high potency topical steroids. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.
World Health Organization. Updated October 29, Choosing topical corticosteroids. Am Fam Physician. J Curr Glaucoma Pract. American Academy of Dermatology Association. Atopic dermatitis clinical guideline. Carr WW. Topical calcineurin inhibitors for atopic dermatitis: review and treatment recommendations. Paediatr Drugs. Topical tacrolimus for atopic dermatitis. Cochrane Database Syst Rev.
Tidy C. Topical steroids for eczema. Updated June 26, Alabdulrazzaq F, Koren G. Topical corticosteroid use during pregnancy. Can Fam Physician. Table of Contents View All. Table of Contents. Potency and Absorption. Side Effects. Application Tips. Eye Problems Related to Psoriasis. Frequently Asked Questions How long can you safely use steroid cream on your face? Can you use topical steroid cream when pregnant?
Was this page helpful? Thanks for your feedback! Sign Up. What are your concerns? Article Sources. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Related Articles.
How to Treat and Prevent Eczema. Using Desonide Cream for Eczema. Out of total patients, were females and 34 were males. Maximum patients were in the age group of years 65 patients followed by 53 patients in years and 52 patients in years. Topical corticosteroids of various potencies, either alone or in combination with other agents, were used in all the patients.
Betamethasone and clobetasol ointments were used in 75 patients Indication for using steroids ranged from acne, pigmentation, as a general purpose cream to various undiagnosed dermatosis. Various indications are listed in Table 2. Some patients used corticosteroids for more than one indication. Beauticians recommended the use in 22 patients and physicians other than dermatologists recommended the use in 30 patients.
Multiple adverse effects were seen and are listed in Table 3. They ranged from acne including papulopustular and comedonal lesions to hypertrichosis, erythema etc. Few patients had more than one side effects. There were 24 patients who were initially using mid potent steroids but gradually there was decrease in response and they had to switch to higher potent steroids.
The discovery of glucocorticosteroids opened new doors for discovery of similar molecules and revolutionised the treatment of various dermatosis. Since then their misuse and abuse has been rampant adding to the burden of steroid related adverse effects.
In our study we also reported widespread abuse of corticosteroids over face which was similar to two other studies from China. Another study showed that fairness and skin lighteneting was the main indication of steroid abuse which was also the most common reason in our study. In our study 24 patients had to switch over to more potent steroids as there was decrease in response to previously used steroids.
This phenomenon is due to tachphylaxis. This reflects the unethical distribution of topical steroids and gap in our policies. Moreover stringent policies are required regarding their distribution and prescription. National Center for Biotechnology Information , U. J Dermatol Case Rep. Published online Mar Find articles by Sameer Abrol.
Author information Article notes Copyright and License information Disclaimer. E-mail: ni. Received Jan 23; Accepted Feb This article has been cited by other articles in PMC. Abstract Background Topical corticosteroids have become available as over the counter drugs and are widely misused for various conditions. Objective The aim of this study is to assess the clinical and epidemiological aspects of the unjustified use of topical corticosteroids for facial skin.
Methods A total of patients with facial dermatoses and topical corticosteroid misapplication daily over face for not less than 30 days were included in the study. Results A total of patients were women and 34 were men. Conclusion In most cases the use prolonged use of topical corticosteroids on facial skin was recommended by non-professional persons. Keywords: abuse, adverse effects, contraindications, glucocorticoids, face, steroids, TSDF.
Introduction Since the introduction of the first topical corticosteroid TC's in , multiple agents have come up in the armoury ranging low potency to ultrahigh potency topical corticosteroids. Material and methods A total of patients were taken up for study attending the dermatology outpatient department of Government Medical College of Jammu region for a period of six months from January to June after taking written informed consent.
Results Out of total patients, were females and 34 were males. Table 1 Showing no. Age group No. Open in a separate window. Table 2 Distribution of patients and indication for its use. Reason for application of steroids No. Table 3 Showing no. Adverse effects after using corticosteroids over face No.
Discussion The discovery of glucocorticosteroids opened new doors for discovery of similar molecules and revolutionised the treatment of various dermatosis. References Dey VK. Misuse of topical corticosteroids: A clinical study of adverse effects. Indian Dermatol Online J. Basic and clinical pharmacology of glucocorticosteroids.
Low-potency steroids are the safest agents for long-term use, on large surface areas, on the face or areas of the body with thinner skin, and on children. More potent agents are beneficial for severe diseases and for areas of the body where the skin is thicker, such as the palms and bottoms of the feet. High- and ultra-high-potency steroids should not be used on the face, groin, axilla, or under occlusion, except in rare situations and for short durations. Once-or twice-daily application is recommended for most preparations.
Chronic application of topical steroids can induce tolerance and tachyphylaxis. Ultra-high-potency steroids should not be used for more than three weeks continuously. This intermittent schedule can be repeated chronically or until the condition resolves.
Side effects are rare when low- to high-potency steroids are used for three months or less, except in intertriginous areas, on the face and neck, and under occlusion. The amount of steroid the patient should apply to a particular area can be determined by using the fingertip unit method.
Table 3 describes the number of fingertip units needed to cover specific areas of the body. The amount dispensed and applied should be considered carefully because too little steroid can lead to a poor response, and too much can increase side effects. Prolonged use of topical corticosteroids may cause side effects Table 4 To reduce the risk, the least potent steroid should be used for the shortest time, while still maintaining effectiveness. The most common side effect of topical corticosteroid use is skin atrophy.
All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months.
Concurrent use of topical tretinoin Retin-A 0. Topical steroids can also induce rosacea, which may include the eruption of erythema, papules, and pustules. Steroid-induced rosacea occurs when a facial rash is treated with low-potency topical steroids that produce resolution of the lesions. If the symptoms recur and steroid potency is gradually increased, the rosacea may become refractory to further treatment, making it necessary to discontinue the steroid.
This may then induce a severe rebound erythema and pustule outbreak, which may be treated with a day course of tetracycline mg four times daily or erythromycin mg four times daily. For severe rebound symptoms, the slow tapering of low-potency topical steroids and use of cool, wet compresses on the affected area may also help. The normal presentation of superficial infections can be altered when topical corticosteroids are inappropriately used to treat bacterial or fungal infections.
Steroids interfere with the natural course of inflammation, potentially allowing infections to spread more rapidly. The application of high-potency steroids can induce a deep-tissue tinea infection known as a Majocchi granuloma. Easy bruising. Increased fragility.
Stellate pseudoscars. Steroid atrophy. Aggravation of cutaneous infection. Granuloma gluteale infantum. Masked infection tinea incognito. Secondary infections. Contact dermatitis. Delayed wound healing. Hypertrichosis hirsutism. Perioral dermatitis. Reactivation of Kaposi sarcoma. Rebound flare.
Steroid-induced acne. Steroid-induced rosacea. Ocular hypertension. Cushing disease. Hypothalamic-pituitary-adrenal suppression. Aseptic necrosis of the femoral head. Decreased growth rate. Peripheral edema. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. This tinea folliculitis requires oral antifungal therapy.
Combinations of antifungal agents and corticosteroids should be avoided to reduce the risk of severe, persistent, or recurrent tinea infections. Topical applications of corticosteroids can also result in hypopigmentation. This is more apparent with darker skin tones, but can happen in all skin types. Repigmentation often occurs after discontinuing steroid use.
Steroids can induce a contact dermatitis in a minority of patients, but many cases result from the presence of preservatives, lanolin, or other components of the vehicle. Non-fluorinated steroids e. Topically applied high- and ultra-high-potency corticosteroids can be absorbed well enough to cause systemic side effects.
Hypothalamic-pituitary-adrenal suppression, glaucoma, septic necrosis of the femoral head, hyperglycemia, hypertension, and other systemic side effects have been reported. According to a postmarketing safety review, the most frequently reported side effects were local irritation 66 percent , skin discoloration 15 percent , and striae or skin atrophy 15 percent.
Topical steroids can induce birth defects in animals when used in large amounts, under occlusion, or for long duration. Food and Drug Administration as pregnancy category C. It is unclear whether topical steroids are excreted in breast milk; as a precaution, application of topical steroids to the breasts should be done immediately following nursing to allow as much time as possible before the next feeding. Children often require a shorter duration of treatment and a lower potency steroid.
Already a member or subscriber? Log in. At the time the article was written, Dr. He received his doctorate of pharmacy from the Nesbitt College of Pharmacy and Nursing and completed residency training and a faculty development fellowship at the University of Pittsburgh Pa. Margaret Family Medicine Residency Program.
Address correspondence to Jonathan D. South St. Reprints are not available from the authors. Interventions for chronic palmoplantar pustulosis. Cochrane Database Syst Rev. A double-blind randomized trial of 0. Arch Dermatol. Vitiligo: a retrospective comparative analysis of treatment modalities in patients.
J Dermatol. Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. The treatment of mild pemphigus vulgaris and pemphigus foliaceus with a topical corticosteroid. Br J Dermatol. A comparison of oral and topical corticosteroids in patients with bullous pemphigoid.
N Engl J Med. Efficacy and safety of a new clobetasol propionate 0. J Eur Acad Dermatol Venereol. Randomized double-blind placebo-controlled trial in the treatment of alopecia areata with 0. An open-label study of the safety and efficacy of limited application of fluticasone propionate ointment, 0. Int J Dermatol. Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients. Effect of topical steroid on non-retractile prepubertal foreskin by a prospective, randomized, double-blind study.
Scand J Urol Nephrol. An month follow-up study after randomized treatment of phimosis in boys with topical steroid versus placebo. Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study. Prophylactic beclamethasone spray to the skin during postoperative radiotherapy of carcinoma breast: a prospective randomized study. Indian J Cancer.
Treatment of chronic idiopathic urticaria with topical steroids. An open trial. Acta Derm Venereol. Infantile acropustulosis revisited: history of scabies and response to topical corticosteroids. Pediatr Dermatol. Betamethasone cream for the treatment of pre-pubertal labial adhesions. J Pediatr Adolesc Gynecol. Use of topical corticosteroid pretreatment to reduce the incidence and severity of skin reactions associated with testosterone transdermal therapy.
Clin Ther. Pariser DM. Topical steroids: a guide for use in the elderly patient. Guidelines of care for the use of topical glucocorticosteroids. Goa KL. Clinical pharmacology and pharmacokinetic properties of topically applied corticosteroids. A review. McKenzie AW. Comparison of steroids by vasoconstriction. Facts and Comparisons 4. Accessed February 10, Olsen EA. A double-blind controlled comparison of generic and trade-name topical steroids using the vasoconstriction assay.
Topical steroids: dosing forms and general considerations. To most dermatologists, steroids and skincare go together like peanut butter and jelly. Steroids are the go-to treatment for sudden irritations and allergic reactions — so I didn't hesitate to try them when my dermatologist prescribed topical steroids to treat a small patch of red, flaky skin near my right eye three years ago.
But for some, they actually make the condition worse over time. In short, steroid skin creams can ruin your skin if they aren't monitored properly. They almost ruined mine. Under normal circumstances, I probably wouldn't have agreed to steroid treatment — something about the aggressive, extra-strength implication of the word just scares me — but I did. Because of a boy. My first flare up of dermatitis a skin irritation with no known cause happened on my second date with a new guy in We spent the day together, and what was an innocuous patch of redness under my lash line at brunch gradually worsened, until the irritation covered my entire eyelid.
It kind of looked like pink eyeshadow? By the time I glanced in the mirror at the bar that night, though, my right eye was nearly swollen shut and decidedly not cute, and I ended up crying in the bathroom. Over the next few weeks, I tried everything to look like myself again: ice to soothe the swelling; Eucerin and over-the-counter psoriasis treatments to moisturize the dry, red bumps; hydrocortisone creams, chamomile tea bags, and coconut oil , too.
Nothing helped, so I finally booked an appointment with a dermatologist. After diagnosing my dermatitis, he prescribed a mid-level steroid to be applied twice daily. While he did say that consistent application around the eyes could lead to glaucoma, he didn't mention any of the other long-term side effects for steroids , and he sent me home with little sample bottles of steroid creams and a prescription for a full-size tube.
This stuff was magic. In a few short hours, my eye looked completely normal. But I noticed that if I skipped even a single night of treatment, the dermatitis would crop up again. In the throes of a new relationship and certifiably obsessed with having pretty, perfect skin , I kinda sorta became addicted to steroids.
A thin, even application became the last step in my nightly skincare routine — one I relied on for two years straight. My dermatologist refilled my 45 gram fix which is a lot, by the way every time I visited, without hesitation. He upped my concentration of steroids twice as well, since my skin was becoming resistant to the original dosage. But in normal cases, "Treating the face twice a day would require 30 grams for 30 days," Dr.
Eventually, my skin became completely immune to the medication, and my dermatitis presented in two big circles over my eyes known as periorbital dermatitis , and a circle over my mouth known as perioral dermatitis. Both of these conditions are triggered by excessive use of topical steroids.
I got a second opinion from a new dermatologist, who was shocked that my doctor had allowed me to indefinitely refill a steroid script.