Topical steroid

Source: Wikipedia, the free encyclopedia.

Topical steroids are the topical forms of

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.

Side effects may occur from

long-term topical steroid use.[2]

Medical uses

Weaker topical steroids are utilized for thin-

discoid lupus, chapped feet, lichen simplex chronicus, severe poison ivy exposure, alopecia areata, nummular eczema, and severe atopic dermatitis in adults.[1]

To prevent

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.

Adverse effects

See also:
Topical steroid addiction

Safety in pregnancy

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]

Classification systems

See also: ATC code D07

Seven-class System

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

Class II

Class III

Class IV

Class V

Class VI

Class VII

The weakest class of topical steroids. Has poor lipid permeability, and can not penetrate mucous membranes well.

Five-class System

Japan rates topical steroids from 1 to 5, with 1 being strongest.

Four-class System

Many countries, such as the United Kingdom, Germany, the Netherlands, New Zealand, recognize 4 classes.[12] In the United Kingdom and New Zealand I is the strongest, while in Continental Europe, class IV is regarded as the strongest.

Class IV (UK/NZ: class I)

Very potent (up to 600 times as potent as hydrocortisone)

Class III (UK/NZ: class II)

Potent (50–100 times as potent as hydrocortisone)

Class II (UK/NZ: class III)

Moderate (2–25 times as potent as hydrocortisone)

Class I (UK/NZ: class IV)

Mild

  • Hydrocortisone 0.5–2.5% (DermAid Cream/Soft Cream, DP Lotion-HC 1%, Skincalm, Lemnis Fatty Cream HC, Pimafucort Cream/Ointment)


Allergy associations

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.

Group A

Hydrocortisone, hydrocortisone acetate, cortisone acetate, tixocortol pivalate, prednisolone, methylprednisolone, and prednisone

Group B

Triamcinolone acetonide, triamcinolone alcohol, amcinonide, budesonide, desonide, fluocinonide, fluocinolone acetonide, and halcinonide

Group C

dexamethasone sodium phosphate, and fluocortolone

Group D

mometasone
furoate

History

Corticosteroids were first made available for general use around 1950.[14]

See also

References

  1. ^
    ISBN 0-8016-2465-7
    .
  2. PMID 25396122
    .
  3. ^ Recommendations from New Zealand Dermatological Society Incorporated on corticosteroids Archived 2016-07-08 at the Wayback Machine
  4. ISBN 0-8016-2465-7
    .
  5. PMID 7794369
    .
  6. S2CID 38326748
    .
  7. PMID 21330017
    .
  8. ISBN 0-7216-7728-2
    .
  9. ISBN 0-7216-7728-2
    .
  10. PMID 26497573. Archived
    from the original on 2020-08-15. Retrieved 2018-06-23.
  11. ISBN 0-8016-2465-7
    .
  12. ^ "Topical steroids (corticosteroid creams)". DermNet NZ. Archived from the original on 2016-07-25. Retrieved 2008-12-05.
  13. ISBN 0-7216-7728-2
    .
  14. PMID 13260925
    .
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