Applying topical corticosteroids

Topical corticosteroids are medicines which have been used since the 1950s to treat various local dermatological conditions. They come in various textures--such as creams, ointments or lotions--all of which contain cortisone. 

Topical corticosteroids are cortisone creams used for their anti-inflammatory effects on the skin.

Why use topical corticosteroids?

Topical corticosteroids are absolutely essential in that they are the only treatment that gradually reduces inflammation (elimination of acute incidences) and the accompanying symptoms:

  • Reduction in the appearance of red, oozing lesions
  • Reduction in redness and swelling
  • Reduction in thickened plaques

Inflammation

When to use dermocorticoids?

  • Apply once daily, typically in the evening
  • Start reapplying the topical corticosteroid as soon as redness returns

How to apply a topical corticosteroid

As soon as lesions appear, apply the topical corticosteroid to inflamed areas only, as well as some of the skin around the patch

How much to apply

In adults, children and infants aged 3 months and up, the fingertip unit is the best measurement to use when trying to decide how much cream to apply to a certain area.

dosage des dermocorticoides pour traiter l'eczema atopique

A fingertip unit corresponds to the amount of cream dispensed when squeezed out continuously along the entire length of the end of an adult's index finger. This amount is enough to treat a surface area equivalent to two adult-sized hands (or approximately 250 to 300 cm²). A fingertip unit is equal to 0.5 g of product. A single 30 g tube contains 60 fingertip units.

Treatment of large surface areas requires that the number of tubes used be monitored.

It is recommended to apply the product in dabs spaced out along the patch, then to spread the cream by massaging it gently into the skin until it is fully absorbed.

How to use topical corticosteroids properly

  1. Follow your doctor's instructions
  • Depending on where the red patches are on your body, and whether they are dry or oozing, your doctor will prescribe you either a cream, ointment or lotion."
  • Your doctor will prescribe a stronger or weaker potency based on the severity of the patches.
  1. Apply the right dose at the right time
  • Start applying as soon as redness appears, and continue until it has completely cleared (the average use time is 1 to 2 weeks).
  • Ensure you apply enough cream by using the following rule for determining the proper dose: one dose of cream along the tip of the index finger for every surface of redness equal to the size of two palms. 

Be sure to follow the rules

  • Apply once daily, typically in the evening (except with infants, for whom the topical corticosteroid must be applied under diapers in the morning to prevent skin maceration overnight)
  • Never apply a topical corticosteroid to the face without consulting a doctor first
  • Stop application once redness has totally cleared. If even the slightest bit of redness returns, begin reapplying immediately and in sufficient doses
  • Do not apply a topical corticosteroid if the patch is oozing a yellowish fluid, as this could indicate an infection

Are there any side effects?

Yes, topical corticosteroids may cause some side effects on the skin, but only if used incorrectly: for example, an ill-suited product applied for too long.

Skin side effects:

  • skin atrophy
  • stretch marks (striae)
  • abnormal pigmentation
  • small visible blood vessels
  • facial acne
  • hypertrichosis
  • secondary bacterial, viral or fungal infections

Topical corticosteroids have a very slow rate of absorption and are therefore ineffective at the recommended doses over short-term use. This is why it is important to apply the correct dose over 2 to 3 weeks for the treatment to be effective. Similarly, an insufficient dose may cause the condition to become chronic. Of course, for long-term application of topical corticosteroids on large surface areas in very young children (beware of improper use), it is recommended to have the body weight curve monitored regularly by a pediatrician. Additionally, side effects (such as small blood vessels, thinning of the skin, depigmentation) appear only with long-term use (especially if applying a high-potency TC). Feel free to raise any questions or concerns you may have regarding the use of topical corticosteroids with your doctor, dermatologist or pharmacist.

 

Topical and oral corticosteroids are often prescribed in combination. However, several patients and parents feel anxious about using corticosteroids. If you have any doubts, do not hesitate to contact your doctor or dermatologist to address your concerns.

Does your child have atopic eczema? We've made this video to help you show them how to apply their topical corticosteroid.