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What are topical corticosteroids?Topical corticosteroids are medicines that you put directly on your skin. They reduce redness, itching, and rash.

They come in many different forms, including creams, ointments, gels, lotions, shampoos, sprays, and foams. They also come in different strengths. Milder ones can often be bought without a prescription ("over-the-counter") from pharmacies. Stronger ones are available with a doctor's prescription. The right strength and form for you depends on what skin problem you have and which parts of your body are affected.

Steroid medicines are also used as pills, shots, inhalers, and nose sprays for other medical conditions. Those types of corticosteroids are discussed separately.

Topical corticosteroids are not the same as the steroids some athletes take illegally to build muscle.

What are some common topical corticosteroids?Examples of topical corticosteroids include hydrocortisone (sample brand names: Cortaid, Cortizone-10), triamcinolone (sample brand name: Kenalog), and betamethasone (sample brand name: Diprolene). There are many others, too.

What are topical corticosteroids used for?They are used to treat many different skin conditions, including eczema, psoriasis, rash, and minor irritation from insect bites.

How do topical corticosteroids work?Topical corticosteroids work by reducing inflammation in the skin. Inflammation means redness, swelling, and irritation.

What is the correct way to use a corticosteroid cream or ointment?The following are general instructions for using creams and ointments:

First wash the affected skin carefully, rinse away soap, and carefully pat dry. Do not rub the skin dry.

To open the tube the first time, you might need to use the point on the cap to break the seal.

Squeeze out a small amount that is just enough to thinly cover the affected skin. A pea-sized amount is enough for minor skin irritation or an insect bite.

Apply the cream or ointment evenly to the affected skin, in a thin layer.

Gently massage the cream or ointment until it disappears.

If you have large area of affected skin, or several different areas, your doctor or nurse will tell you how much cream or ointment to use.

Using the cream or ointment once a day is usually enough. Do not use more often unless your doctor or nurse tells you to. Do not use topical corticosteroids on your face, genitals, anus, or beneath your breasts unless your doctor or nurse tells you to. Also, do not use them on any raw or broken skin, or on skin that rubs against other skin. Do not cover the area with dressings such as bandages or gauze.

The most important thing to remember is to use a small amount and apply it in a thin layer. This prevents too much of the medicine from being absorbed in your body, and lowers the chance of side effects.

If your doctor prescribes a steroid spray, lotion, shampoo, or foam, he or she will tell you how to use it.

Be sure to carefully follow the instructions your doctor or nurse gives you. You should also read the information that comes with your medicine.

What are the side effects of topical steroids?The most common side effect is a mild burning or stinging feeling when you first apply the medicine. This usually goes away after the first few uses.

Topical corticosteroids do not usually have serious side effects. If you use them for a long time or at high doses, side effects can include thin or red skin or acne in the areas that were treated. Thinning of the skin can make it easier for the skin to break, bruise, or stretch. Older people, young children, babies, and people with fragile skin are more likely to have problems if they use topical corticosteroids.

If you need to use topical corticosteroids for more than a few weeks, your doctor might have you take regular breaks from the medicine. This can help lower the risk of side effects.

What else should I know about topical steroids?Topical steroids are used when a skin problem flares up. As your skin problem gets better, your doctor might have you decrease your topical corticosteroid treatments gradually, instead of stopping all at once. This makes it less likely that your skin problem will come back once you are no longer using the medicine.

Doctors usually recommend treating a flare for 1 to 2 weeks. For some skin problems, they might recommend longer treatment or repeating the treatment. In this case, you might need to see a doctor who is an expert in skin conditions.

If you are pregnant or want to get pregnant, you might be able to use a small amount of topical corticosteroid occasionally. But it's important to talk to your doctor or nurse first, or if you have any questions.

For more detailed information about your medicines, ask your doctor or nurse for information from Lexicomp available through UpToDate. Also, read the information that comes with your medicine. These leaflets explain how to use and store your medicines. They also list more possible side effects and warn you if your medicines should not be taken with certain other medicines or foods.

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