Topical Steroids are categorized into seven groups with last group being least potent.
Points to remember about topical steroids are:
1. Always start with the least potent product that can do the job as skin penetration varies in different ares of the body.
2. Ointments are more potent than creams except for the super potency group.
3. Use for the shortest duration of time.
4. Use very high potency steroids for severe cases only especially where there is poor absorption such as palms and soles for no more than 2-3 weeks.
5. Use low potency steroids for genitals and eyelids because of high absorption and limit to 1-2 weeks.
6. Use lower potency products if you are applying to large areas.
7. There is less penetration when skin is dry than when skin is moist.
8. Once controlled, intermittent therapy is better than daily use if possible.
9. Tapering of potency may be needed as skin improves to avoid rebound effect.
10. long terms use of topical steroids may result in dryness, telangiectasia, thinning of the skin, and atrophy.
11. Super high potency products can cause suppression of hypothalamic pituitary axis.
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