Topical corticosteroids

1. Corticosteroid ointments maintain skin hydration and maximize penetration. Corticosteroid creams may sting when applied to acute lesions.

2. Mid- and low-potency topical corticosteroids are used twice-daily for chronic, atopic dermatitis. High-potency steroids may be used for flare-ups, but the potency should be tapered after the dermatitis is controlled.

3. Use of higher potency agents on the face, genitalia and skin-folds may cause epidermal atrophy ("stretch marks"), rebound erythema, and susceptibility to bruising. Only hydrocortisone or low-potency, non-fluorinated steroids should be used in these areas.

Preparation

Size

Low Potincy Agints

Hydrocortisone ointment, cream, 1, 2.5% (Hytone)

30 g

Mild Potincy Agints

Alclometasone dipropionate cream, ointment, 0.05% (Aclovate)

60 g

Triamcinolone acetonide cream, 0.1% (Aristocort)

60 g

Desonide ointment, 0.05% (DesOwen)

60 g

Fluocinolone acetonide cream, 0.01% (Synalar)

60 g

Midium Potincy Agints

Triamcinolone acetonide ointment (Aristocort A), 0.1%

60 g

Betamethasone dipropionate cream (Diprosone), 0.05%

45 g

Triamcinolone acetonide cream, ointment, 0.1% (Kenalog)

60 g

Mometasone cream 0.1% (Elocon)

45 g

Fluocinolone acetonide ointment, 0.025% (Synalar)

60 g

Hydrocortisone butyrate 0.1% cream, ointment (Locoid)

45 g

Betamethasone valerate cream, 0.1% (Valisone)

45 g

Hydrocortisone valerate cream, ointment, 0.2% (Westcort)

60 g

Preparation

Size

High Potency Agents

Amcinonide ointment, 0.1% (Cyclocort)

60 g

Betamethasone dipropionate ointment (Diprosone) 0.05%

45 g

Fluocinonide cream, ointment, 0.05% (Lidex)

60 g

4. Allergic reactions to topical corticosteroids may sometime occur. Allergic reactions to mometasone (Elocon) are rare.

D. Antihistamines, such as diphenhydramine or hydroxyzine (Atarax), are somewhat useful for pruritus and are sedating. Nonsedating antihistamines, such as loratadine (Claritin) and fexofenadine (Allegra), are helpful.

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