Steroid based topicals

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Steroid based
topicals

Steroids (corticosteroids) are a frequently prescribed topical treatment for psoriasis. They reduce the redness and dampen down inflammation in the skin.

It is really important to match the strength of the topical steroids to the area of the body being treated and for the correct duration of time. This is because sometimes steroids can cause psoriasis to flare after initially producing good results.

Steering your way around steroids

In general, stronger steroids can be used on thicker parts of the skin such as knees and elbows but only milder ones should be used in thin skin areas such as the face and groin.

A treatment prescribed for one part of the body shouldn't be used on another part unless instructed. You may feel embarrassed to talk about intimate areas of your body but it would be better than making these sensitive areas worse by using a cream that is too strong. There are alternative non-steroid containing topical treatments that may be helpful, please ask your doctor or healthcare provider.

If you think a steroid isn't working, don't stop using it. Check you are using it as instructed and go back to see your doctor or healthcare provider who can change you to a different strength steroid or a different treatment.

Topical steroid strengths

Very potent

Clobetasol propionate 0.05% (Dermovate)
Diflucortolone valerate 0.3% (Nerisone Forte)

Potent

Betamethasone valerate 0.1% (Betnovate)
Mometasone furoate 0.1% (Elocon)
Hydrocortisone butyrate 0.1% (Locoid)
Fluocinolone acetonide 0.025% (Synalar)
Diflucortolone valerate 0.1% (Nerisone)
Fluticasone propionate 0.05% (Cutivate)
Betamethasone dipropionate 0.05% (Diprosone)
Fluocinonide 0.05% (Metosyn)

Moderate

Clobetasone butyrate 0.05% (Eumovate)
Betamethasone valerate 0.025% (Betnovate RD)
Fludroxycortide 0.0125% (Haelan)
Fluocinolone acetonide 0.00625% (Synalar 1 in 4)
Alclometasone dipropionate 0.05%

Mild

Hydrocortisone 1%
Hydrocortisone 0.5%

Doctor’s top-tip

Using a steroid for many years may cause skin thinning but is less common than people think. When skin thinning happens blood vessels may be more noticeable or the skin may look as if it has stretch marks.

Together with your doctor you might decide to change your treatment after a while to lessen the risk of this happening.

Nurse's top-tip

Try to get in a routine for applying your steroid. Depending on how often you have to put it on, try to pair applying your steroid with something else you do routinely.

For example, if it’s applied twice a day, match it up to when you clean your teeth in the morning and evening.

Patient's top-tip

Instructions like 'use sparingly' or 'apply thinly' aren’t always easy to understand. You could ask your doctor or nurse if they can demonstrate the right amount to apply.

Keeping track and checking back

When you first start to use a steroid it is recommended that you have a review within 2 to 4 weeks. Use the review to ask about anything you need to know.

If you were prescribed a steroid some time ago to use when you have a flare, have a review every 3-6 months, or sooner if you have concerns.

Make a list of things you are thinking about
and might want to talk about with your doctor

GOAL 1

If you are using steroids at
the moment:

1. Should I stop using my
steroids at some point?
2. I don't think my steroid is
working, am I using enough?
3.

PLAN 1

If you are not using steroids at
the moment:

1. I don't use a steroid anymore
because I'm worried about sideeffects.
Can I try another one?
2. I've never been given a
steroid. Should I try one?
3.

GOAL 2

PLAN 2

Actions

Make a note in my calendar to book an appointment in

weeks time

For further advice or information please consult your healthcare provider or psoriasis patient association in your region