Topical Steroids

Topical steroids are one of the first treatment options for people whose psoriasis covers only a small amount of their body.

What are topical steroids?

The term ‘topical steroids’ refers to steroid medication that is put on the skin. Topical steroids are known as ‘corticosteroids’; an artificial version of hormones that are made inside the body. Their main job when applied to the skin is to reduce skin inflammation and irritation.

Corticosteroids are not the same as steroids you may hear of being used illegally by some athletes and body builders (anabolic steroids), and will have no effect on muscle growth or development.

Topical steroids can come in different formulations, including cream, ointment, foam or gel.

When should topical steroids be used?

Topical steroids are one of the first treatment options for most people with psoriasis. They are most appropriate for people whose psoriasis covers only a small amount of their body, and should not be used on more widespread psoriasis.

Topical steroids may be used separately, or in combination with topical vitamin D treatments. It is recommended that a review appointment is arranged four weeks after starting any new topical treatment (two weeks for children), so that your doctor can assess what the results of the treatment are so far, and to check if you need any help with using the treatment.

Topical steroids can also be used to treat psoriasis in sensitive areas such as the face, genitals and skin folds. Less potent steroids (such as mild or moderately potent) are usually used in the sensitive areas, and for a shorter length of time (ie. two weeks rather than four).

Some mild steroids are available to buy without a prescription, however it is always a good idea to speak to a doctor or pharmacist before using them.

Types of topical steroid

There are lots of different topical steroids available, and some might be combined with other ingredients such as antifungals, antibiotics, or vitamin D. Topical steroids are categorised by their strength, which is referred to as ‘potency’. Below are some examples of topical steroids and there potencies (many more are available):

  • Very Potent topical steroids include; Dermovate, Nerisone Forte, Etrivex.
  • Potent topical steroids include; Betnovate, Dovobet, Elocon, Diprosalic and Fucibet, Bettamousse.
  • Moderately potent topical steroids include; Alphaderm, Eumovate and Trimovate.
  • Mild topical steroids include; Hydrocortisone 0.1-2.5%, Eurax HC cream and Daktacort.

What are the side effects of topical steroids?

If topical steroids are used as instructed in the patient information leaflet, they usually do not cause unwanted side effects. Many of the side effects that you may hear of being associated with corticosteroids are more common to taking them as oral tablets or injections, rather than applying them to the skin.

Topical steroids can sometimes cause burning, stinging, thinning of the skin, and hair growth, but these effects usually disappear after treatment has finished, or can be controlled by using a lower potency steroid. More serious side effects, such as a raise in blood pressure, or drop in calcium levels, are rare and usually only occur if the treatment has not been used properly, or for too long.

Resources

The information on this page is also available in our topical steroids information sheet

December 2017 (Review Date: December 2020)

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