What Are Topical Steroids? A Comprehensive Guide

Here’s a table listing popular topical steroids, their brand names, common uses, benefits, and potential side effects:

Generic Name	Brand Names	Common Uses	Benefits	Potential Side Effects
Hydrocortisone	Cortaid, Hydrocort	Mild skin irritations, itching, insect bites	Reduces inflammation and relieves itching	Skin thinning, burning, stinging
Triamcinolone	Kenalog, Aristocort	Eczema, psoriasis, dermatitis, skin allergies	Reduces inflammation and itching	Skin thinning, rash, burning, itching
Betamethasone	Diprolene, Celestene	Skin conditions, including eczema and psoriasis	Potent anti-inflammatory and anti-itching effects	Skin thinning, stinging, burning
Clobetasol	Temovate, Clobex	Severe skin conditions, psoriasis, lichen planus	Highly potent anti-inflammatory properties	Skin thinning, skin discoloration, itching
Mometasone	Elocon	Eczema, dermatitis, psoriasis	Effective for reducing skin inflammation	Skin thinning, burning, itching, rash
Fluticasone	Cutivate, Flonase	Eczema, psoriasis, allergic reactions	Anti-inflammatory and soothing for skin	Skin thinning, burning, itching, redness
Desonide	Desonate, DesOwen	Atopic dermatitis, itching, rashes	Mild potency with anti-inflammatory effects	Burning, itching, dryness, redness
Fluocinonide	Lidex, Vanos	Various skin conditions, eczema, psoriasis	Potent anti-inflammatory and anti-itching properties	Skin thinning, rash, burning, itching
Halobetasol	Ultravate	Severe inflammatory skin conditions	Very potent and fast-acting	Skin thinning, burning, stinging, rash
Flurandrenolide	Cordran	Skin conditions, including dermatitis	Medium potency for inflammation reduction	Burning, itching, dryness, skin peeling

Please note that side effects can vary in severity and may not affect everyone using these medications. It’s important to use topical steroids as directed by a healthcare professional or a seasoned user and report any adverse reactions or concerns to your healthcare provider.

How to Apply Topical Corticosteroids

When using topical corticosteroids, it’s important to follow the provided instructions unless directed otherwise by your doctor. Here are some general guidelines:

1. Read the Patient Information Leaflet: Refer to the patient information leaflet that accompanies the medication for specific instructions on how much to apply and how often to use it.
2. Frequency of Use: In most cases, applying the medicine once or twice a day for a duration of 3 to 7 days is sufficient. However, there may be instances where a doctor recommends less frequent application over a longer period.
3. Target Affected Areas: Apply the medication exclusively to the affected areas of your skin. Avoid applying it to unaffected areas.
4. Application Technique: Gently spread a thin layer of the medication onto your skin in the direction of hair growth. Be cautious not to use excessive amounts.
5. Hand Hygiene: Prior to and after applying the medicine, ensure you wash your hands thoroughly unless you are treating an area on your hands.
6. Combining with Emollients: If you are using both topical corticosteroids and emollients (moisturizers), it’s advisable to wait 20 to 30 minutes between applying each product. This allows for the effective absorption of both treatments.

Always adhere to the specific instructions provided with your medication and consult your healthcare provider if you have any questions or concerns about its usage.

Using Fingertip Units (FTUs)

At times, your prescribed medication dosage may be measured in fingertip units (FTUs).

An FTU, equivalent to approximately 500 milligrams, represents the amount required to squeeze a line of medication from the tip of an adult finger to the first crease of that finger. This quantity should be adequate to treat an area of skin double the size of the flat of your hand when your fingers are together.

The recommended dosage varies depending on the area of the body being treated. This variation arises from differences in skin thickness and sensitivity to corticosteroids in different body regions.

For adults, the suggested FTUs for a single application are as follows:

• 0.5 FTU for genital areas
• 1 FTU for hands, elbows, or knees
• 1.5 FTUs for the feet, including the soles
• 2.5 FTUs for the face and neck
• 3 FTUs for the scalp
• 4 FTUs for a hand and arm together or the buttocks
• 8 FTUs for one leg and foot, the chest, or the back

In the case of children, the recommended FTUs will depend on their age, and it is advisable to consult a general practitioner (GP) for guidance in this regard.

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Side Effects of Topical Corticosteroids

When used correctly, topical corticosteroids rarely lead to severe side effects. The most common side effect is a temporary burning or stinging sensation upon application, which typically improves as your skin adapts to the treatment.

Less frequent side effects may include:

1. Worsening or Spreading of Existing Skin Infections: In some cases, topical corticosteroids can exacerbate or spread an existing skin infection.
2. Inflamed Hair Follicles (Folliculitis): This condition may occur as a result of corticosteroid use.
3. Skin Thinning: Prolonged use of topical corticosteroids can lead to skin thinning, making the treated area more susceptible to damage or bruising.
4. Stretch Marks: Stretch marks may develop, which are generally permanent but tend to become less noticeable over time.
5. Contact Dermatitis: Some individuals may experience skin irritation or contact dermatitis, which results from a mild allergic reaction to the components of a particular topical corticosteroid.
6. Acne: In some cases, the use of topical corticosteroids can lead to acne or exacerbate existing acne.
7. Rosacea: Another potential side effect is the development or worsening of rosacea, a condition characterized by facial redness and flushing.
8. Changes in Skin Color: Changes in skin colour may occur, which is more noticeable in individuals with darker skin.
9. Excessive Hair Growth: Unwanted hair growth in the treated area is possible.

The likelihood of experiencing side effects is higher if you are using a more potent corticosteroid, using it for an extended period, or applying it over a large skin area. Vulnerable populations, such as the elderly and very young, are also at a higher risk of side effects.

In cases where potent or very potent topical corticosteroids are used extensively over an extended period, there is a risk of the medication being absorbed into the bloodstream, potentially leading to internal side effects. These can include:

• Decreased growth in children
• Cushing’s syndrome

This list does not encompass all possible side effects. For comprehensive information on side effects, refer to the leaflet accompanying the medication.

If you find yourself using potent or very potent topical corticosteroids for several weeks or more, you may receive a steroid treatment card that provides guidance on minimizing the risk of side effects. It is essential to present this card to healthcare professionals when seeking medical or dental treatment to ensure they are aware of your corticosteroid use.

Withdrawal side effects

If you stop using topical corticosteroids after using them continuously for a long time (usually over 12 months in adults), you may have a withdrawal reaction. These can sometimes be severe. Your doctor may advise stopping the treatment gradually to avoid this.

Withdrawal side effects can include:

• redness or changes in skin colour (this may not be as noticeable on brown or black skin)
• burning, stinging, itching or peeling of the skin, or oozing, open sores
• a flare-up of the skin condition you were treating

If you’ve been using topical corticosteroids for a long time, it’s a good idea to ask your doctor to review your treatment.

What is Topical Steroid Withdrawal?

Topical steroid withdrawal (TSW) is a condition that occurs when individuals who have been using topical corticosteroids (commonly known as topical steroids) for an extended period stop using them. TSW is characterized by a range of withdrawal symptoms, which can include redness, burning, itching, dryness, flaking, and increased sensitivity of the skin. These symptoms typically occur in the areas where the topical steroids were previously applied.

TSW is believed to be a result of the body’s adaptation to the presence of steroids on the skin. Prolonged use of topical steroids can lead to a phenomenon where the skin becomes dependent on these medications. When the steroids are discontinued, the skin may react with a rebound effect, leading to withdrawal symptoms.

It’s essential for individuals experiencing TSW to seek guidance from a healthcare professional, typically a dermatologist, for proper diagnosis and management. Treatment may involve discontinuing the use of topical steroids, implementing a skincare regimen, and addressing symptoms as they arise. The duration and severity of TSW can vary widely among individuals.

How long does topical steroid withdrawal last

The duration of topical steroid withdrawal (TSW) can vary significantly from person to person. TSW occurs when an individual who has been using topical steroids for an extended period stops using them. The withdrawal symptoms can include redness, burning, itching, and flaking of the skin.

The duration of TSW can depend on several factors, including:

1. The severity of Previous Steroid Use: The more potent the topical steroids used and the longer they were used, the more likely it is that TSW symptoms will be severe and last longer.
2. Individual Response: Some individuals may experience shorter TSW periods, while others may endure symptoms for an extended time.
3. Skin Sensitivity: Skin sensitivity and resilience can vary from person to person, affecting how the skin reacts during TSW.
4. Proper Management: Appropriate management, such as avoiding triggers, moisturizing, and consulting a healthcare professional, can help mitigate the duration and severity of TSW symptoms.

In general, mild TSW symptoms may last a few weeks to a few months, while more severe cases can persist for several months to a year or more. It’s essential to consult a dermatologist or healthcare provider if you suspect TSW or experience prolonged and distressing symptoms, as they can provide guidance and treatment options to manage the condition effectively. Additionally, they can help determine when it is safe to reintroduce topical steroids if necessary.

How to treat topical steroid withdrawal naturally in two sentences

To treat topical steroid withdrawal naturally, focus on gentle skincare practices, including regular moisturization with natural, fragrance-free products and the use of soothing, anti-inflammatory ingredients like aloe vera or chamomile. Stay hydrated, maintain a healthy diet rich in antioxidants, and consult a healthcare professional for guidance on natural remedies that may help alleviate symptoms during the withdrawal process.