Topical Corticosteroids Potency Selector
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Background
Corticosteroid strength has been classified according to the
vasoconstrictor assay, which is based on the extent to which the
compound induces cutaneous vasoconstriction ("blanching effect") in
normal human subjects |
Product Potency:
* Relative potency of a product depends on the characteristics and
concentration of the drug and the vehicle.
* Generally, ointments and gels are more potent than creams or lotions;
however, some products have been formulated to yield comparable potency.
Product Selection:
* Selection of a specific corticosteroid, strength, and vehicle depends
on the nature, location, and extent of the skin condition, patient’s
age, and anticipated duration of treatment.
* Use the least potent corticosteroid that would be effective.
* Low potency agents are preferred for the face, intertriginous areas
(e.g., groin, axilla), large areas, and children, to reduce the
potential for side effects.
* Reserve higher potency agents for areas and conditions resistant to
treatment with milder agents.
Adverse Reactions:
* Systemic absorption of topical corticosteroids has produced reversible
HPA axis suppression, Cushing’s syndrome, hyperglycemia, and glycosuria.
* Conditions that augment systemic absorption include application of
more potent steroids, use over large surface areas, prolonged use,
addition of occlusive dressings, and patient’s age.
* Perform appropriate clinical and laboratory tests if a topical
corticosteroid is used for long periods or over large areas of the body.
With chronic conditions, gradual discontinuation of therapy may reduce
the chance of rebound. |
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References |
1] Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby, Inc.
2004.
2] Hengge et al. Adverse effects of topical glucocorticosteroids. J Am
Acad Dermatol. 2006 Jan;54(1):1-15.
3] Jacob SE, Steele T. Corticosteroid classes: a quick reference guide
including patch test substances and cross-reactivity. J Am Acad Dermatol.
2006 Apr;54(4):723-7.
4] Klaus Wolff, Lowell A. Goldsmith, Stephen I. Katz, Barbara A.
Gilchrest et al. Editors, Fitzpatrick’s Dermatology in General Medicine,
7th Edition, New York: McGraw-Hill; 2007.
5] Ong PY, Boguniewicz M. Atopic Dermatitis. Prim Care Clin Office Pract.
2008 Mar;35(1):105–117.
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