After the first 2 or 3 applications, there is no additional benefit from applying a topical steroid more than once daily. Absorption also depends on the vehicle in which the topical steroid is delivered and is greatly enhanced by occlusion.
Several formulations are available for topical steroids, intended to suit the type of skin lesion and its location. Creams and lotions are general purpose and are the most popular formulations. Gel or solution. As a general rule, use the weakest possible steroid that will do the job. It is often appropriate to use a potent preparation for a short time to ensure the skin condition clears completely.
Topical steroid is sometimes combined with another active ingredient, including antibacterial, antifungal agent or calcipotriol. Topical steroids are medicines regulated by Health Authorities. They are classified according to their strength. The products listed here are those available in New Zealand in November Side effects are uncommon or rare when topical steroids are used appropriately under medical supervision.
Topical steroid may be falsely blamed for a sign when underlying disease or another condition is responsible for example, postinflammatory hypopigmentation or undertreated atopic eczema. Cases of Cushing syndrome due to topical corticosteroids most often occur because of inappropriate prescribing or over the counter sales of corticosteroids in countries where that is permitted.
Local side effects may arise when a potent topical steroid is applied daily for long periods of time months. Most reports of side effects describe prolonged use of an unnecessarily potent topical steroid for inappropriate indications. A topical steroid can cause, aggravate or mask skin infections such as impetigo , tinea , herpes simplex , malassezia folliculitis and molluscum contagiosum.
Note: topical steroid remains the first-line treatment for infected eczema. Stinging frequently occurs when a topical steroid is first applied, due to underlying inflammation and broken skin. Contact allergy to steroid molecule, preservative or vehicle is uncommon but may occur after the first application of the product or after many years of its use. Adverse effects of topical steroids Bruising. A topical steroid should be used cautiously on eyelid skin, where it commonly results in periocular dermatitis.
Potentially, excessive use over weeks to months might lead to glaucoma or cataracts. Mild and moderate-potency topical steroids can be safely used in pregnancy. Caution should be used for potent and ultrapotent topical steroids used over large areas or under occlusion, of which a proportion will be absorbed systemically. Reports of low birth-weight infants exposed to high-dose topical steroid are not thought to be due to the medication.
Topical steroid is applied once daily usually at night to inflamed skin for a course of 5 days to several weeks. After that, it is usually stopped, or the strength or frequency of application is reduced. Emollients can be applied before or after the application of topical steroid, to relieve irritation and dryness or as a barrier preparation. Infection may need additional treatment.
The fingertip unit guides the amount of topical steroid to be applied to a body site. One unit describes the amount of cream squeezed out of its tube onto the volar aspect of the terminal phalanx of the index finger. Fingertip unit Fingertip unit. The quantity of cream in a fingertip unit varies with sex , age and body part.
If the daily dosage is less than 7. Between 7. Over 30 mg of cortisone administered per day is considered a high dosage. Please note: these definitions are somewhat arbitrary. They are meant to give you an idea of how steroids are prescribed by most medical professionals. These medications vary in their anti-inflammatory activity. The table below lists each drug with a number that corresponds with its degree of anti-inflammatory activity in comparison to that of natural cortisol which is 1.
These figures are commonly accepted in the medical world but remain somewhat theoretical nonetheless. General Information. Corticosteroids therapies There are several forms of corticosteroid therapies defined according to their route of administration, the duration of the prescription and the dosage recommended. The main routes of administration of corticosteroids are : — Oral by ingestion through the mouth e.