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Choosing a topical steroid

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Choosing a topical steroid

The choice of appropriate topical corticosteroids depends on the following:

  • condition being treated
    • highly responsive conditions (atopic dermatitis) requires mild corticosteroid preparations
    • less responsive or refractory conditions (palmoplantar or nail psoriasis, lupus erythematosus) needs more potent agents (1)
  • anatomic area of application
    • areas with thin skin (scrotum, parts of the face) or areas of occlusion (groin, axillae, other intertrigenous areas) - moderate to low potent preparations. However in conditions such as lichen sclerosus or discoid lupus erythematosus and conditions which are resistant to lower potent preparations - high potent preperations (1,2)
    • areas with thick skin (palms and soles) and for thick, chronic plaques - requires a more potent preparation (1,3)
    • for large surface area - low-to-moderate potent preparations are preferred due to increased risk of systemic absorption (1)
  • age of the patient
    • in geriatric patients use of high potent agents should be avoided due to the increased risk of adverse effects (1)
    • more potent preparations and halogenated moderate potent preparations are not used in infants and children (3)

Reference:

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