Corticosteroids (topical)

Topical corticosteroids, or topical steroids, are creams, gels or ointments containing corticosteroids.

Corticosteroids are hormones that can reduce inflammation (redness and swelling), suppress the immune system and narrow the blood vessels in the skin. Their main purpose is to reduce skin inflammation and irritation.

Conditions widely treated with topical corticosteroids include:

eczema
seborrhoeic dermatitis – a condition that causes the skin to become flaky, leading to symptoms such as dandruff
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 can't cure these conditions, but can help relieve the symptoms.

See the separate topic on corticosteroids for information about oral (tablets and capsules), inhaled and injected corticosteroids.

Types of topical corticosteroids

Topical corticosteroids are available in different strengths, which are determined by the amount of corticosteroid they contain. They can be:

mild – such as hydrocortisone
moderate – such as clobetasone butyrate
potent – such as betamethasone dipropionate
very potent – such as clobetasol propionate

Mild corticosteroids can often be bought over the counter from pharmacies, while stronger types are only available on prescription. You will usually be prescribed the lowest strength necessary to control your symptoms.

Topical corticosteroids are also available in several different forms, including:

solutions – water- or alcohol-based liquids that are non-greasy and easy to apply, but they can sometimes dry out the skin
lotions – similar to solutions but thicker; they are often recommended to treat larger areas of skin or hairy areas
creams – thicker than lotions and often recommended when the affected skin has become moist or is weeping
ointments – liquids containing high levels of oil, which can make them greasy; they are usually recommended to treat skin that has become dry and scaly
gels – more solidified, jelly-like substances, often used to treat areas of the body that are very hairy, such as the scalp
mousses – foam-like substances that are also often used to treat the scalp

Some topical corticosteroids are available combined with other substances, such as antibiotics or antifungals to treat infected areas of skin.

Using topical corticosteroids

Unless instructed otherwise by your doctor, follow the directions on the patient information leaflet that comes with your medication. This will give details of how much to apply and how often.

Topical corticosteroids usually only need to be used once or twice a day for a few days or weeks at a time and should only be applied directly to the affected areas of skin.

Occasionally, your doctor may suggest using a topical corticosteroid less frequently but over a longer period of time, to help prevent periods where your symptoms worsen.

Read more about how to use topical corticosteroids.

Safety and side effects

If used as directed, topical corticosteroids are a very safe treatment. The most common side effect is a burning or stinging sensation when the medication is applied, but this usually improves as your skin gets used to the treatment.

Serious side effects, such as thinning of the skin and changes in skin colour, usually only occur if too much potent or very potent topical corticosteroids are used for a long period.

Topical corticosteroids are safe for most people to use, but there are some circumstances where they are not recommended. For example, very potent topical corticosteroids should be avoided if you are pregnant or breastfeeding and shouldn't be used to treat young children.