Topical steroids are the topical forms of
corticosteroids. Topical steroids are the most commonly
prescribedtopical medications for the treatment of
rash and
eczema. Topical steroids have
anti-inflammatory properties and are classified based on their skin
vasoconstrictive abilities.[1] There are numerous topical steroid products. All the preparations in each class have the same anti-inflammatory properties but essentially differ in base and price.
To prevent
tachyphylaxis, 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.[3] Long-term use of topical steroids can lead to secondary infection with
fungus or
bacteria (see
tinea incognito), skin atrophy,
telangiectasia (prominent blood vessels), skin bruising and fragility.[4]
The use of the
finger tip unit may be helpful in guiding how much topical steroid is required to cover different areas of the body.
Tachyphylaxis: The acute development of tolerance to the action of a drug after repeated doses.[8] Significant tachyphylaxis can occur by day 4 of therapy. Recovery usually occurs after 3 to 4 days' rest. This has led to therapies such as 3 days on, 4 days off; or one week on therapy, and one week off therapy.
A 2015 meta-analysis of observational studies of pregnancies found no association between mothers' use of topical steroids and type of delivery, APGAR score, birth defects, or prematurity.[10]
The U.S. utilizes 7 classes, which are classified by their ability to constrict
capillaries and cause skin
blanching. Class I is the strongest, or superpotent. Class VII is the weakest and mildest.[11]
Class I
Very potent: up to 600 times stronger than
hydrocortisone
The highlighted steroids are often used in the screening of
allergies to topical steroid and systemic steroids.[13] When one is allergic to one group, one is allergic to all steroids in that group.
^Habif, Thomas P. (1990). Clinical dermatology: a color guide to diagnosis and therapy (2nd ed.). St. Louis: Mosby. p. Inside front cover.
ISBN0-8016-2465-7.