corticosteroids
Table of Contents
corticosteroids
also known as glucocorticosteroids
see also:
topical corticosteroids
- AVOID high potency or super-potent preparations on areas of thin skin such as the face, flexures, scrotum and eyelids
- Take great care when using in occlusive dressings, in children (do not use on nappy region as occluded dressing) and, in the elderly
- Should NOT be used on denuded skin
- AVOID long periods of Rx - no longer than 2 wks on the face and 3-4 wks elsewhere - longer treatments should have steroid-free breaks of a few days to a week to reduce tachphylaxis.
- Should NOT be used for infected skin, acne rosacea, acne vulgaris or perioral dermatitis
- AVOID more than 45g/week of potent or more than 100g/wk of moderately potent steroid to minimise systemic effects in adults.
- AVOID potent steroids in pregnancy as systemic absorption may cause fetal abnormality in animal studies
- Most applications can be daily or bd, but where it is wiped off, may require more frequent applications
general usage guidelines
- lotions are preferred for children (as more permeable skin), on hairy skin and for extensive areas but require shaking
- creams are less greasy than ointments, easy to spread and washable in water
- ointments provide the highest drug penetration and increase the potency
- whole body application requires 30-40g per application!
- one hand application requires 0.3g per application
adverse effects
- skin atrophy with possible scarring and ulceration
- increased skin transparency and brightness
- telangectasia
- striae
- easy bruising
- delayed wound healing
- faster spread of skin infections
- hypopigmentation
- glaucoma if used near the eye
- contact hypersensitivity to preservatives
- tachyphylaxis
- systemic effects if extensive skin areas
classification based upon potency
super-potent - class 1 USA / UK
- 0.05% betamethasone dipropionate as ointment in optimised vehicle
- 0.05% clobetasol propionate
high potency - class 2/3 USA, class II UK
- 0.05% betamethasone dipropionate ointment
- 0.1% betamethasone valerate ointment
- 0.1% mometasone furoate ointment or cream
- the best option for chronic, hyperkeratotic, lichenified or indurated lesions such as:
- palmo-plantar psoriasis
- lichen planus
- lichen simplex chronicus
moderate potency - class 4/5 USA, class III UK
- 0.05% betamethasone dipropionate cream or lotion
- 0.05% betamethasone valerate ointment or cream
- 0.1% triamcinolone acetonide cream
- 0.1% methylprednisolone aceponate ointment, cream or lotion
- 0.05% clobetasone cream
- the best option for:
- psoriasis other than intertriginous
- adult atopic dermatitis
- nummular eczema
low potency
- 0.5% or 1% hydrocortisone or hydrocortisone acetate
- 0.05% desonide
- the best option for areas of thin skin such as:
- children's atopic dermatitis
- seborrheic dermatitis
- intertriginous psoriasis
- other intertrigos
corticosteroids.txt · Last modified: 2019/06/01 14:50 (external edit)
Page Tools
