Topical Corticosteroids

Topical corticosteroids (often abbreviated to steroids) include creams, aerosols, lotions, gels, tapes, and solutions. They are applied externally to the skin or scalp, depending on the condition being treated.

Indications

Topical corticosteroid treatment is indicated for conditions characterized by inflammation, hyperproliferation, and immunologic involvement. They also can alleviate symptoms of burning and pruritic lesions. ^[1]  

Preparations

Compared with other preparations, corticosteroid ointments provide more occlusion and lubrication. This preparation increases steroid absorption.

Corticosteroid creams contain water suspended in oil. Creams generally are less potent than ointments.

Gels and lotions and gels offer the least occlusion.

Shampoos, foams, and mousses are effective for treating the scalp. ^[1]

World Health Organization Classification of Topical Corticosteroids

The potency of a topical corticosteroid depends on the formulation, the specific molecule type, level of skin absorption, and amount that reaches the target cell. Potency is also increased when a formulation is used under occlusive dressing or in intertriginous areas. In general, ointments are more potent than creams or lotions. ^[2]

Ultra high potency topical corticosteroids

Group I

• Clobetasol propionate cream (0.05%)

• Diflorasone diacetate ointment (0.05%)

High potency topical corticosteroids

Group II

• Amcinonide ointment (0.1%)

• Betamethasone dipropionate ointment (0.05%)

• Desoximetasone (cream or ointment) (0.025%)

• Fluocinonide (cream, ointment, or gel) (0.05%)

• Halcinonide cream (0.1%)

Group III

• Betamethasone dipropionate cream (0.05%)

• Betamethasone valerate ointment (0.1%)

• Diflorasone diacetate cream (0.05%)

• Triamcinolone acetonide ointment (0.1%)

Moderate potency topical corticosteroids

Group IV

• Desoximetasone cream (0.05%)

• Fluocinonide acetonide ointment (0.025%)

• Hydrocortisone valerate ointment (0.2%)

• Triamcinolone acetonide cream (0.1%)

Group V

• Betamethasone dipropionate lotion (0.02%)

• Betamethasone valerate cream (0.1%)

• Fluocinonide acetonide cream (0.025%)

• Hydrocortisone butyrate cream (0.1%)

• Hydrocortisone valerate cream (0.2%)

• Triamcinolone acetonide lotion (0.1%)

Low potency topical corticosteroids

Group VI

• Betamethasone valerate lotion (0.05%)

• Desonide cream (0.05%)

• Fluocinolone acetonide solution (0.01%)

Group VII

• Dexamethasone sodium phosphate cream (0.1%)

• Hydrocortisone acetate cream (1%)

• Methylprednisolone acetate cream (0.25%)