Topical corticosteroids (steroids) are medicines you put on your skin to reduce inflammation and irritation.
These steroids are different from anabolic steroids.
Types of topical corticosteroids
Topical corticosteroids are available as:
- creams
- lotions
- gels
- mousses
- ointments
They're available in different strengths from mild to very potent (strong).
You can get mild corticosteroids, such as hydrocortisone for piles and itchy bottom, without a perscription. Ask your pharmacist for one that best suits your needs.
You can only get strong corticosteroids on perscription.
Uses of topical corticosteroids
Topical corticosteroids are used to treat conditions such as:
- eczema - such as atopic eczema
- seborrhoeic dermatitis
- psoriasis
- nappy rash
- lichen planus - a condition that causes an itchy, non-infectious rash
- discoid lupus erythematosus - a type of lupus that usually only affects the skin
- skin irritation caused by insect bites or stings
Topical corticosteroids cannot cure these conditions but can help relieve the symptoms.
Check if you can take topical corticosteroids
Most adults and children age 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 age 10 or older can also use mild topical corticosteroids, such as hydrocortisone. But some products may only be suitable for older children. Ask your pharmacist for advice.
Only use stronger topical corticosteroids on children if your GP advises it.
If you use a topical corticosteroid on your child for a long time, it may affect their growth.
Always give your child the correct dose and only for the length of time recommended by the GP or pharmacist.
Pregnant and breastfeeding
Talk to your GP 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 up to 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 a thin layer onto your skin, in the direction the hair grows.
If you use both topical corticosteroids and emollients, put the emollient on 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. But you may get side effects.
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 the part of your body 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.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Side effects of topical corticosteroids
People with more delicate or thinner skin, such as children or older people, are more vulnerable to the side effects of topical corticosteroids.
Urgent advice: Stop using the topical corticosteroid and contact your GP straight away if your:
- skin condition gets worse
- skin becomes swollen during treatment
You may be allergic to the medicine or have an infection. You may need different treatment.
The most common side effects from topical corticosteroids are:
- a burning or stinging sensation
- itchy skin
These can happen when you first 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 condition
- 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.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
Fact check
This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).
