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Corticosteroids - topical (skin), nose, and eyes - Management
What should I consider when initiating topical corticosteroids?

  • Topical corticosteroids are effective and have few adverse effects if they are used appropriately.
  • The choice of topical corticosteroid depends on the condition being treated (and its stage), the area of the body that is affected, and the age of the person.
    • Condition being treated and its stage — mild forms of dermatitis may only require a mild topical corticosteroid whereas psoriasis may require a more potent topical corticosteroid.
      • Prescribe the least potent steroid that relieves the symptoms, and an appropriate quantity.
      • If the treatment is for a flare up of disease activity, taper the treatment by using a less potent steroid once the flare up is under control.
    • The person's age — children and elderly people are more susceptible to the adverse effects of topical corticosteroids because they have a thinner epidermis. Elderly people also have decreased dermal collagen (due to age and sun damage).
    • Area of body being treated
      • Areas where the skin is thin or flexural (such as the face, scrotum, groin, axillae, and submammary area) usually require a weak or moderately-potent corticosteroid.
      • Areas where the skin is thick, due to either site (palms of the hands and soles of the feet) or from constant scratching (lichenification), usually require more potent preparations.
  • Consider prescribing an emollient with the topical corticosteroid (to moisturize the skin).

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