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Corticosteroids - topical (skin), nose, and eyes - Management
Basis for recommendation
- The likelihood of adverse effects is based on published expert opinion [Coulson, 1996] and the British National Formulary [BNF 59, 2010].
- Children (especially babies) are more susceptible to the adverse effects of topical corticosteroids as they tend to have a thinner epidermis [Coulson, 1996]. However, these concerns should not lead to undertreatment [BNF 59, 2010].
- Local adverse effects are based on the British National Formulary [BNF 59, 2010] and a drug reference database [Sweetman, 2009].
- Serious adverse effects are rare, and this is reflected in the available safety data. For example, the Summary of Product Characteristics for Betnovate® (betamethasone valerate) states that both features of Cushing's syndrome and skin disorders (such as thinning, striae, and dilatation) are 'very rare', meaning they affect less than one in 10,000 people (based on case reports rather than controlled trials) [ABPI Medicines Compendium, 2007].
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