Topical corticosteroids

Topical corticosteroids (steroids) are medicines put on the skin to reduce inflammation and irritation.

These steroids are different from anabolic steroids.

Anabolic steroids are sometimes prescribed by healthcare professionals. They can also be misused by people to increase muscle mass and improve athletic performance.

Read the patient information leaflet that came with the topical corticosteroids you were prescribed. It will have specific advice about your medicine.

Types of corticosteroids

Topical corticosteroids are available in different forms including:

  • creams
  • lotions
  • gels
  • mousses
  • ointments

They're available in different strengths from mild to very potent (strong).

Mild corticosteroids such as hydrocortisone are available over-the-counter from pharmacies.

Stronger types are only available on prescription.

Uses of topical corticosteroids

Topical corticosteroids are used to treat conditions such as:

Topical corticosteroids cannot cure these conditions but can help relieve the symptoms.

Check if you can take topical corticosteroids

Most adults and children aged 12 or older can use mild topical corticosteroids safely.

Do not use a topical corticosteroid if you have:

  • broken skin
  • widespread psoriasis and dermatitis around the mouth or nose (perioral dermatitis)
  • infected skin
  • rosacea
  • acne
  • skin ulcers (open sores)

Children

Children aged 12 or older can also use mild topical corticosteroids, such as hydrocortisone.

Only use more potent or stronger topical corticosteroids in children if your GP advises it.

Continuous use of a topical corticosteroid in children may affect the child's growth.

Information:

Always give your child the correct dose and only for the length of time recommended by the GP

Pregnant and breastfeeding

Talk to your GP or pharmacist before using a topical corticosteroid if you are pregnant, breastfeeding or trying to get pregnant.

Most mild topical corticosteroids are safe to use during pregnancy or breastfeeding.

If you are told to put steroid cream on your breasts, wash it off before feeding your baby. This is to make sure the baby does not get the medicine in their mouth.

How and when to use it

Follow the directions your GP gives you or the advice on the information leaflet.

This will give details of how much to use and how often.

Most people need to use a topical corticosteroid 1 or 2 times a day for 1 or 2 weeks. Your GP may suggest using it less often over a longer period of time.

Only put the medicine on the affected areas of skin. Gently smooth it into your skin, in the direction the hair grows.

If you use both topical corticosteroids and emollients, put on the emollient first. Wait about 30 minutes before you put on the topical corticosteroid.

Using a dressing or nappy

Your GP may recommend using the topical corticosteroid under a dressing or a nappy. This can make it easier for the medicine to pass through the skin. This may cause side effects more easily.

Clean your skin before you put on a fresh dressing or nappy. Only use the dose prescribed and only for the recommended length of time.

Fingertip units

Sometimes, the amount of medicine you're advised to use will be given in fingertip units (FTUs).

A FTU (about 500mg) is the amount needed to squeeze a line from the tip of an adult finger to the first crease of the finger.

The recommended dosage depends on what part of the body is being treated. This is because the skin is thinner in certain parts of the body and more sensitive to the effects of corticosteroids.

Your GP or the information leaflet will advise you on how much you should use.

Side effects of topical corticosteroids

People with more delicate or thinner skin, such as children or the elderly, are more vulnerable to the side effects of topical corticosteroids.

Urgent advice: Phone your GP if your:

  • skin condition gets worse
  • skin becomes swollen during treatment

Stop using the topical corticosteroid.

You may be allergic to the medicine or have an infection that requires other treatment.

The most common side effects from taking topical corticosteroids are

  • a burning or stinging sensation
  • itchy skin

This happens when you put on the medicine and usually improves as your skin gets used to the treatment.

Less common side effects include:

  • worsening of a pre-existing skin infection
  • contact dermatitis – skin irritation from a topical corticosteroid
  • an allergic reaction on the area where you use the corticosteroid

Long-term use

If you use topical corticosteroids for a long time, at high doses or over a large area, there's a risk of the medicine being absorbed into the bloodstream.

This can cause:

  • internal side effects such as decreased growth in children
  • Cushing's syndrome - signs of Cushing's syndrome include moon face and weight gain
  • thinning of the skin – you may bruise easily
  • stretch marks – likely to be permanent but become less noticeable over time
  • changes in skin colour
  • excessive hair growth on the area of skin you are treating

See the patient information leaflet that comes with your medicine for a full list of possible side effects.

You can report any suspected side effects to the Health Products Regulatory Authority (HPRA).

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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