Topical Steroids: 

 They are steroids used to treat a range of different skin conditions 

 The body produces steroids similar to those found in topical steroids 

 Topical steroids reduce skin inflammation, redness and itchiness ⬇ 

 They are available in varying strengths – you should apply the steroid strength recommended by your doctor 🏥 

Strengths:

 Adults: stronger steroids usually used on the body, and milder steroids are usually on the face or areas where the skin is delicate (stronger steroids can be used for short periods of time if required) ⏱ 

 Infants/young children: mild steroids usually used unless skin condition is severe, FTUs are measured on an adult finger and the amount required depends on the age of the child 👧 

 Mild: Hydrocortisone (0.5%/1.0%/2.5%) 

 Moderate: Fludroxycortide (0.0125%) Betamethasone valerate (0.025%), Fluocinolone acetonide (0.001%), Clobetasone butyrate (0.05%), Fluocortolone (0.25%) 

 Strong: Diflucortolone valerate (0.1%), Mometasone furoate (0.1%), Fluticasone propionate (0.05%), Betamethasone valerate (0.1%), Hydrocortisone butyrate (0.1%), Fluocinolone acetonide (0.025%) 

 Very strong: Diflucortolone valerate (0.3%), Clobetasol propionate (0.1%) 💪 

Preparations: 

 Creams: preferable when the skin condition is ‘weeping’, and sometimes on the hands/face ✋ 

 Ointments: higher content of oil, and so have a more moisturising effect, suitable for skin conditions which make the skin dry  

 Solutions: water/alcohol based, meaning they are the thinnest preparations, alcohol-based solutions can sting inflamed skin conditions 🔥  

 Tapes: useful for inflammation on hands/feet 👣  

 Lotions: thinner than creams, useful for large areas, or where there is a lot of hair 👩 

Application: 

 Effective application increases the chance of successful treatment ✅ 

 How much: squeezing a line of the topical steroid on your fingertip (from the last crease to the tip) is equivalent to about 0.5g and is sufficient for covering 2 hands (fingers together), this is known as the finger-tip unit (FTU) 👆 

 Application method: apply to the affected area of skin in the direction of hair growth, do NOT rub it in, then wash your hands ✋ 

Steroids and moisturisers: 

 Applying moisturiser when using topical steroids can dilute the strength and so potency ⬆  

 If you must apply both, the moisturiser should be applied half an hour before the topical steroid ⏱  

Length of use: 

 Depends on the type and severity of the skin condition 

 1-2 months of continuous use increases the risk of side effects 📅  

 Longer use should include a break in which you stop using the topical steroid or you should decrease the frequency of use to reduce the risk of side effects ⬇  

 Consult your doctor about when to stop using topical steroids (suddenly stopping can cause the skin condition to flare up) ❌ 

Side effects: 

 Very low risk of side effects if you use them as instructed ⬇ 

 Possible local side effects: 

 Allergic reactions 

 Acne-like rash (strong steroid application to face) 😳  

 Stretch marks (uncommon) 

 Skin thinning (rare, usually resolves when treatment is stopped) 

 Stinging or burning of the skin temporarily (common, but resolves within a few days) 🔥  

 The body absorbs a small proportion of topical steroid on the skin which can potentially cause: 

 Weight gain ⬆  

 Excessive steroid use symptoms (Cushing’s syndrome) 

 The body’s natural hormonal steroids to be affected 

 Pregnancy/Breastfeeding:

 Topical steroids have been used by a lot of pregnant/breastfeeding women with no evidence of harmful effects ❗  

 You should always consult your doctor first though 🏥  

 You should only use mild topical steroids around the nipple/breast when breastfeeding and wash it off before doing so 🤱  

Avoiding topical steroids:

 Topical steroids should be avoided if you have a bacterial/viral/fungal skin infection, unless the infection is being treated with tablet medication, or the topical steroids are applied with an anti-infective agent ❌  

Quick Summary:

1. Topical steroids are used for treating a range of skin conditions
2. Strength and preparation (creams/ointments/solutions/tape/lotions) can vary
3. One fingertip unit is sufficient for covering the surface are equivalent to 2 hands
4. Using moisturiser in conjunction with topical steroids will dilute them
5. Longer use increases risk of side effects
6. Topical steroids are considered safe for pregnant or breastfeeding women, but you doctor's should be consulted
7. Topical steroids should be avoided if you have bacterial/viral/fungal skin infection