Introduction

• Topical steroids or also known as corticosteroids are medications commonly used for the treatment of eczema, rash, dermatitis and psoriasis, skin swelling, redness, itching and discomfort caused by insect bites and skin rashes.

• Topical steroids have anti-inflammatory properties where it suppresses inflammation on the skin and help to relieve itching and redness.

• It may come in different forms such as ointments, or creams or lotions.

• Ointments are usually prescribed to patients with dry, scaly skin where as creams and lotion are usually prescribed to patients with moist or weepy skin.

How it acts

• When skin is irritated by allergens or irritations, the skin reacts by producing various inflammation-causing chemicals.

• These chemicals in turn will cause blood vessels to widen and the affected area will then become red, swollen and itchy.

• Topical steroids are used in such condition and when applied to the skin, it is absorbed into the skin cells.

• Topical steroids work by preventing the inflammatory causing chemicals to be released into the skin, thus reducing the inflammation and relieve the itchiness.

Classification

• Topical steroids are available in different strengths and its used depends on the severity and location of the skin condition.

• They are classified into seven (7) potency classes where class 1 is the strongest or superpotent and class VII as the weakest and mildest.

How to choose a steroid

• Topical steroids are absorbed at different rates from different parts of the body depending on the skin thickness.

• Weaker topical steroids are usually used on body parts where the skin is very thin and sensitive such as groin area, face, eyelid and diaper area.

• Moderate topical steroids are usually used at on body parts such as arms and legs.

• Strong steroids are usually prescribed for patients with psoriasis, discoid lupus or severe types of eczema.

• Always get a doctor or pharmacist advice before purchasing any topical steroids.

How to use this medicine

• Apply a thin layer to the affected area and rub it gently.

• This medicine is used on the skin only. Do not get it in the eyes, nose or mouth. If it does get on these areas, rinse it off right away.

Side effects

1. Local skin effects:

   • Burning, itching or peeling skin

   • Red or swollen skin

   • Thinning of skin known as atrophy

   • Stretch marks known as striae

   • Enlarged blood vessel which is prominent under the skin surface known as telangiectasia

   • Easy bruising

   • Development of tolerance after repeated used

   • Temporary loss of pigment in the skin known as hypopigmentation

   • Increase risk to infection

   • Increase hair growth

   • Allergic to topical steroids

2. Systemic side effects are generally rare but it does occur when used on large areas of skin for prolonged periods of time. Infants and children as more susceptible to systemic side effects compared to adults.

   • Growth suppression

   • Adrenal suppression

Ways to minimise side effects of topical steroids

• Avoid using topical steroids for a long period of time

• Avoid using on large areas of skin

• Only apply on affected area and as directed by doctor

• If possible, use the least potent steroid to control inflammation

• Use plenty of moisturisers to control flare-ups