Topical Corticosteroids for Skin Conditions

What Are Corticosteroids?

Corticosteroids are naturally-occurring or synthetic compounds with cyclopentanoperhydrophenanthrene ring. The major naturally occurring corticosteroid is cortisol, which is synthesized by the adrenal cortex. The synthetic corticosteroids are of different types and are used to treat various problematic skin conditions.

How Do They Act?

Once applied to the skin, they are absorbed into the skin surface and thereby reduce the swelling, suppress immunity, and constrict the blood vessels of the skin.

Potency of Corticosteroids

Depending on the severity of the inflammation, following corticosteroids of different potencies can be used.

1. Mild: Hydrocortisone 0.1 to 1 %.
2. Moderate: Fluocinolone acetonide 0.1 %, Betamethasone valerate.
3. Potent: Betamethasone dipropionate 0.05 %, Beclomethasone 0.025 %, Betamethasone 17 valerate 0.1 %.
4. Very potent: Beclomethasone dipropionate 0.5 %, Clobetasol 0.5 %.

Uses

Topical corticosteroids are primarily used in the treatment of:

• Dermatitis.
• Eczema.
• Itching.
• Rashes.
• Psoriasis.
• Insect bites.
• Lichen Planus.

Topical corticosteroids are not recommended for use if there is a skin infection, acne, ulcers and open wounds. Abstain from using potent and very potent topical corticosteroids like Clobetasol, Halobetasol, and Betamethasone in children, on the face and neck, in body folds, for prolonged periods or over a large area.

Some Important Points to Remember When Using Them

• Avoid application on the unaffected skin.

• Use the weakest corticosteroid possible that will produce the desired therapeutic effect.

• Tail down the strength of the corticosteroid once the skin lesions improve (like if you are using super potent steroid then switch over to mid potent then to low potent).

• Use the corticosteroid for as short a duration as possible.

• Apply the topical immediately after a bath or when the skin is slightly damp to allow better spreading of the cream thus minimizing side effects.

• After application of a steroid, follow up with a moisturizer.

• Use sparingly and as prescribed by the physician.

• Do not use for too long a period.

• Observe and report any changes in the skin lesions and any side effects.

Side Effects of Corticosteroids

Side effects are more commonly seen in the area of application. They may also be seen systemically (in the body).

Topical side effects:

1. Itching, burning or stinging sensation.
2. Stretch marks (striae).
3. Thinning of skin (atrophy) and dryness.
4. Localised increased hair thickness and length (hypertrichosis).

Systemic side effects:

1. Growth failure in children.
2. Osteoporosis.
3. Avascular necrosis.
4. Atherosclerosis.
5. Suppression of hypothalamic-pituitary axis.
6. Cushing's syndrome.
7. Hypertension.
8. Hyperglycemia.
9. Peptic ulceration.
10. Glaucoma and cataracts.

For more information consult a skin disorders specialist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist/skin-disorders