Chapter 13 4- Topical Corticosteroids Somerset Prescribing Formulary

Chapter 13 4- Topical Corticosteroids Somerset Prescribing Formulary

The fingertip unit method (FTU) gives a general estimate of how much should be used. In children the fingertip and two handprints are based on that of an adult also. This is based on the whole area being treated therefore if only a proportion of the area is affected the number of FTU should be adjusted accordingly.

  • Through our work, we help people whose lives are affected by psoriasis and psoriatic arthritis, providing information and raising awareness.
  • It is important that you follow the treatment plan given by your doctor or specialist nurse in order for your skin to avoid a flare of your skin condition.
  • Fludroxycortide Cream contains fludroxycortide, a fluorinated synthetic moderately potent topical corticosteroid.
  • The lowest potency topical corticosteroid for effective treatment should always be used and this may mean using different products for different areas to be treated.
  • Eumovate is available from The Independent Pharmacy as a cream or ointment and helps to relieve symptoms related to conditions like eczema, psoriasis, and insect bites.

Topical corticosteroids should normally only be used under expert supervision. Sometimes, the amount of medicine you’re advised to use will be given in fingertip units (FTUs). Comments submitted to the NIHR Journals Library are electronic letters to the editor. They enable our readers to debate issues raised in research reports published in the Journals Library.


[footnote 1][footnote 2][footnote 3][footnote 4] This is a mixed group of symptoms or conditions, often also referred to by patients as ‘red skin syndrome’ or ‘topical steroid addiction’. Topical corticosteroids rarely pose a large risk of side effects, but this depends on the strength of the use of topical steroids in question. After all, more potent topical corticosteroids are more likely to have adverse effects like burning or stinging on certain areas of the skin. Clobetasol propionate belongs to the most potent class of topical corticosteroids (Group IV) and prolonged use may result in serious undesirable effects (see section 4.4).

  • Betamethasone valerate ready diluted (Betnovate RD) preparations are indicated for maintenance treatment once an acute episode has been treated effectively with a continuous course of betamethasone valerate (Betnovate).
  • When reporting please provide as much information as possible, including information about batch numbers, medical history, any concomitant medication, onset timing, treatment dates, and product brand name.
  • Evidence suggests that fluorometholone is less likely to raise IOP though this may be due to reduced penetration of the cornea.

In fertility studies, subcutaneous administration of clobetasol propionate to rats at doses of 6.25 to 50 micrograms/kg/day produced no effects on mating, and fertility was only decreased at 50 micrograms/kg/day. Long-term animal studies have not been performed to evaluate the carcinogenic potential of clobetasol propionate. Clinical studies have not identified differences in responses between the elderly and younger patients. The greater frequency of decreased hepatic or renal function in the elderly may delay elimination if systemic absorption occurs.

Intravitreal corticosteroids

Both of these medications can help to treat outbreaks of eczema and dermatitis of the scalp, or psoriasis affecting the scalp, and effectively calm redness and irritation. The active ingredient in Eumovate is shop anabolic clobetasone, a moderately potent corticosteroid that reduces redness, itching and swelling. It may also be used as a preventative measure for flare-ups and has very few side effects for adults and children.

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See the MHRA website for the latest information on medicines and vaccines for COVID-19. Steroid eye drops can raise intra-ocular pressure (IOP) and therefore precipitate glaucoma in patients pre-disposed to chronic simple glaucoma. See below for the quantities that should be sufficient for two weeks treatment of once daily application. Unless instructed otherwise by your doctor, follow the directions on the patient information leaflet that comes with the medicine.

During our review we considered data gathered from Yellow Card reports and identified 55 reports indicative of topical steroid withdrawal reactions, most of which were reported by patients. We also considered information available in the literature and from other regulators. However, given the number of patients who use topical corticosteroids, we understand reports of severe withdrawal reactions to be very infrequent. Topical steroid withdrawal reactions have been reported in some long-term users of topical corticosteroids after they stop use.

Through our work, we help people whose lives are affected by psoriasis and psoriatic arthritis, providing information and raising awareness. Some mild steroids are available to buy without a prescription, however it is always a good idea to speak to a doctor or pharmacist before using them. When reporting please provide as much information as possible, including information about batch numbers, medical history, any concomitant medication, onset timing, treatment dates, and product brand name. Please continue to report suspected adverse drug reactions to the Yellow Card scheme.

Topical Steroid Potency Chart

Children are more susceptible to develop atrophic changes with the use of topical corticosteroids. Ultralanum plain cream and ointment both contain the active ingredient fluocortolone, which is a type of medicine known as a topical corticosteroid. Betamethasone is a corticosteroid with topical anti-inflammatory activity.

Topical corticosteroid preparation potencies

If treatment with a local corticosteroid is clinically justified beyond 4 weeks, a less potent corticosteroid preparation should be considered. Repeated but short courses of clobetasol propionate may be used to control exacerbations (see details below). Side effects are most common in the elderly and very young children — or if you use topical steroid creams for long periods. These topical steroids can also spread the infection further from the affected areas of the body.

What are the side effects of topical steroids?

If clobetasol does enter the eye, the affected eye should be bathed in copious amounts of water. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and administration of appropriate antimicrobial therapy. Combination product which includes a topical corticosteroid (moderately potent), antifungal and antibacterial components.

When you’ve got a flare-up, topical steroid creams can be extremely effective in reducing inflammation and irritation, and there are many different types and strengths available — meaning you can find the perfect product for you. It’s worth noting that if you’re using potent topical corticosteroids for a long time or over a large area of skin, you are more likely to experience negative side effects, such as skin thinning (thin skin) or broken skin. This can even result in the corticosteroid being absorbed into your bloodstream and cause internal side effects, particularly in young children.