Choosing Corticosteroids for Topical Use

Topical steroids come in a variety of strengths and formulations. To safely and effectively treat steroid-responsive skin diseases, physicians should get familiar with one or two drugs in each potency group. When prescribing topical steroids, the diagnosis, as well as the steroid potency, delivery medium, frequency of administration, duration of treatment, and side effects, should all be taken into account. The anti-inflammatory qualities of topical steroids are directly responsible for their utility and side effects, while no single drug has been proved to have the optimal benefit-to-risk ratio.

Topical corticosteroids are one of the most well-known and effective therapies for dermatological problems. There are numerous topical steroids on the market, each with its own potency and composition. A correct diagnosis, as well as assessment of the steroid’s delivery method, potency, frequency of administration, duration of treatment, and side effects, are all necessary for successful treatment. Psoriasis, vitiligo, eczema, atopic dermatitis, phimosis, acute radiation dermatitis, and lichen sclerosus are among the disorders for which topical steroids have been shown to be beneficial. For usage in melasma, chronic idiopathic urticaria, and alopecia areata, there is limited evidence.

Anabolic steroids such as Wachstumshormone may cause you to develop a psychological dependence on them. If this happens, you may develop a strong desire for steroids and find it difficult to stop using them, despite the fact that you are aware of their negative effects on your health. Anabolic steroids can just be physically ‘hooked’ to the same extent that alcohol or heroin can. Users of anabolic steroids frequently report feelings of exhilaration (highness) or increased self-esteem (feeling better about themselves). Others claim they experience mood swings, violent or aggressive behavior (‘roid rages,’) or become paranoid or sad as a result of the medication. Because there has been so little study done in this area, it is difficult to say whether a particular anabolic steroid user will have any or all of these negative effects. If you think you’re experiencing any of these adverse effects, talk to your doctor about it.

Topical steroids are used to treat a variety of skin diseases (Table 1), but only a small number of them have been proven to be effective. Topical steroids of high or ultra-high potency, alone or in conjunction with other topical treatments, are the mainstay of psoriasis treatment. They can also be used to treat vitiligo that affects only a small area of the skin, lichen sclerosus, bullous pemphigoid, and pemphigus foliaceus. Although alopecia areata is normally self-limited, it may respond to ultra-high-potency topical corticosteroids, randomized controlled trials have had mixed outcomes.

The vasoconstrictor assay, which classifies steroids based on the extent to which they elicit cutaneous vasoconstriction (“blanching effect”) in normal, healthy people, is the recommended method for determining topical steroid potency. This is a good but flawed strategy for forecasting steroid clinical effectiveness. Some steroids’ anti-inflammatory efficacy varies from patient to patient, depending on how often they’re given, how long they’re given for, and where they’re given. A rating system that compares clinical results or an effectiveness-to-safety ratio would be more useful, but one does not exist at the moment.