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Corticosteroids - topical (skin), nose, and eyes - Management
How do I minimize the risks of adverse effects in people using topical corticosteroids?
- To minimize the adverse effects of topical corticosteroids:
- Prescribe the least potent formulation which is fully effective (advise the person to apply it thinly to affected areas, no more than twice daily).
- Consider prescribing an appropriate quantity of an emollient for use alongside the topical corticosteroid (for moisturizing purposes).
- Avoid prescribing potent corticosteroids for use on the face.
- Unless under specialist supervision, the use of potent (such as betamethasone valerate 0.1%) and very potent (such as clobetasol propionate 0.1%) topical corticosteroids, should be limited to:
- Avoid using occlusive dressings with topical corticosteroids (especially on large areas of the body).
- If a topical corticosteroid is needed for maintenance therapy, consider incorporating regular periods when they are withdrawn (for as long as possible) and emollients are used on their own.
- If the person is using large amounts of topical corticosteroid regularly, monitor them for signs of systemic adverse effects (such as adrenal suppression) and local adverse effects (such as areas of thin skin or striae).
- Monitor the height of children who are using large amounts of topical corticosteroid.
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