Are topical steroids safe for the skin?

Are topical steroids safe for the skin?

Topical steroids, good or bad?

Topical corticosteroids have been used for many years and their introduction is a remarkable achievement in Dermatology. Topical corticosteroids refer to any sort of gel, cream, an ointment containing corticosteroids, which is a synthetic drug used to treat inflammatory skin diseases like psoriasis, atopic eczema, contact dermatitis, seborrheic dermatitis and skin irritation caused by insect bites or stings. They cannot cure the disease but are used to provide temporary relief to the symptoms.

Due to the potential side effects that come with the improper or chronic use of high dose steroids, they have developed a bad reputation in society. People often hesitate to use corticosteroids for their skin conditions. Topical steroids if used correctly, are safe and well-tolerated and people who are facing side effects usually are not sticking to the prescription or not applying correctly. 

 How do they work? 

 Topical steroids can reduce inflammation and skin irritation by

  1. Constrict or narrow the blood vessels on the affected skin. So, the inflammatory mediators cannot reach the site easily.
  2. Block the inflammatory pathway.
  3. Regulate the production of new skin cells. 

hand applying steroid cream

 Different potencies of corticosteroids

Topical corticosteroids are available in 4 different strengths (potencies):

  1. Mild topical corticosteroids like hydrocortisone are used to treat mild skin inflammation caused by insect bites and atopic dermatitis. 
  2. Moderate topicalcorticosteroids like clobetasone butyrate are used to treat nappy rash and atopic eczema.
  3. Potent topicalcorticosteroids like betamethasone dipropionate are used to treat skin diseases like psoriasis or seborrhoeic dermatitis that do not respond to other treatments.
  4. Very Potent topicalcorticosteroids like clobetasol propionate are only used for a shorter duration to treat severe symptoms that do not respond to other treatments.

 Guidelines to use topical steroids

 Always consult your dermatologist before using any topical corticosteroid. Your doctor will prescribe the least potency corticosteroids first and then go on to increase the potency if the condition worsens.

 As a general rule, low potency corticosteroids are preferable to use for longer duration and high potency corticosteroids for a shorter duration.

 Condition in which steroids are not recommended

  1. You cannot use steroid on the skin infected with bacteria or other pathogens unless advised by a doctor
  2. If you are suffering from skin conditions like rosacea, acne, and skin ulcers (open sores). 

Can we use steroids in pregnancy and breastfeeding?

Topical corticosteroids are safe to use in pregnancy and breastfeeding. However, remove any topical steroid from your breast if applied before feeding your baby. 

What are the side effects of steroids?

Always rush to your dermatologist if you suffer any of the side effects mentioned below. 

Local side effects occur on the skin and will disappear after finishing the treatment. They include:

Burning of the skin, worsening of the skin condition, thinning of the skin, stretch marks, excessive hair growths, and any kind of allergic reaction. 

Systemic side effects are rare and occur when steroids are absorbed in the bloodstream and affect other parts of the body. They include, 

Hypertension, weight gain, hyperglycemia, depression, bone damage, and decreased growth in children. 

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