Best topical steroid for psoriasis

Why are different strengths critical? The appropriate strength depends on many factors. For example, babies absorb topical steroids faster than adults, so they may require a low-potency steroid. Areas of the body where skin touches skin (think: armpits, rectal area, etc), as well as sensitive areas (like the skin on the eyelids), tend to absorb topical steroids more rapidly, so those regions of the body also usually require a low-potency steroid. However, thick, rough skin on the palms of the hands and the soles of the feet usually absorb topical steroids more slowly than other parts of the body, so those areas typically require a more potent steroid. Keep in mind: The greater the potency of the steroid (in other words, the lower its class number), the more likely it is to cause side effects .

Topical steroids have been both extensively used and found to be very effective for the treatment of eczema. Concerns about side effects both on the skin and systemically has increased acceptance of the new steroid free alternative. Worries about long term use of a cortisone cream making the skin less responsive to treatment is a potential risk and is occasionally a concern. This may not occur with the topical immunomodulators but longer term studies will be needed to confirm this.

The new topical immunomodulators (TIMS) provide a significant new choice in the treatment of atopic eczema. They are used as a steroid-sparing medications. There is a discussion whether the immunomodulators should be used alone as monotherapy. Good evidence is available to show that using a potent topical cortisone twice a week only will reduce and may prevent eczema flares. If this was combined with intermittent use the immunomodulators this might further reduce flares. However some TIMs may reduce flares on their own.

For locations such as the face, folds and anterior upper chest the topical immunomodulators seem to be effective, well tolerated and free of significant side effects other than initial and minimal burning.

The following charts simplify some of the anti-inflammatory options:

You can buy some topical corticosteroids "over-the-counter" without a prescription. For example, for dermatitis, you can buy the steroid cream called hydrocortisone 1% from your pharmacy. Do not apply this to your face unless your doctor has told you to do so. This is because it may trigger a skin condition affecting the face ( acne or rosacea. ) Long-term use may also damage the skin. On your face this would be more noticeable than the rest of your body. So usually only weak steroids are used on the face. Those which are suitable are prescription-only.

There is no agreed treatment for topical corticosteroid withdrawal, apart from ceasing the topical corticosteroid. However whether this should be tapered or abrupt has not been determined. Japanese reports suggest there is minimal difference in the outcome, so recommend immediate cessation. A tapering course of oral steroids is helpful, as the addiction appears to relate only to the use of topical corticosteroids. Oral tetracyclines and low-dose isotretinoin have been used in steroid rosacea and perioral /periorificial dermatitis .

The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.

Best topical steroid for psoriasis

best topical steroid for psoriasis

There is no agreed treatment for topical corticosteroid withdrawal, apart from ceasing the topical corticosteroid. However whether this should be tapered or abrupt has not been determined. Japanese reports suggest there is minimal difference in the outcome, so recommend immediate cessation. A tapering course of oral steroids is helpful, as the addiction appears to relate only to the use of topical corticosteroids. Oral tetracyclines and low-dose isotretinoin have been used in steroid rosacea and perioral /periorificial dermatitis .

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