Before you start depending on steroid creams, make sure you get all the facts. Wimmer MA, for the Bullous Diseases French Study Group. This is why using the shortest duration of steroid cream is recommended. The application of high-potency steroids can induce a deep-tissue tinea infection known as a Majocchi granuloma.This tinea folliculitis requires oral antifungal therapy. Kaur I. He received a master’s degree in public health from the University of Pittsburgh Graduate School of Public Health.This is one in a series of “Clinical Pharmacology” articles coordinated by Allen F. Shaughnessy, PharmD, Tufts University Family Medicine Residency at Cambridge Health Alliance, Malden, Mass. Wolkenstein P, They are easily applied and spread readily, particularly in hairy areas. Randomized double-blind placebo-controlled trial in the treatment of alopecia areata with 0.25% desoximetasone cream. A good rule of thumb when deciding how much steroid cream to apply (for adults) is to use the fingertip unit method. Some vehicles should be used only on certain parts of the body. Group 1 contains the most potent topical steroid creams, referred to as ultra-high potency. Lund L, Some experts believe that chronically applying topical steroid cream anywhere on the body, not just the face, may make it less effective—a phenomenon called tachyphylaxis. In general, high- and ultra-high-potency steroids are reserved for areas of the body where the skin is thick, like your palms or the soles of your feet, or for more severe skin diseases that are being treated by a Vitiligo: a retrospective comparative analysis of treatment modalities in 500 patients. A fingertip unit is defined as the amount of steroid cream that can be squeezed from your fingertip to the first crease of your finger. Foams are usually more expensive.Because hydration generally promotes steroid penetration, applying a topical steroid after a shower or bath improves effectiveness.The preferred way to determine topical steroid potency is the vasoconstrictor assay, which classifies steroids based on the extent to which the agent causes cutaneous vasoconstriction (“blanching effect”) in normal, healthy persons. In the United States, topical steroid creams are categorized by their potency, or how strong they are. Leonardi-Bee J, Generally speaking, 2.5 fingertips units may be used on your face per application, although you should confirm this is appropriate for you with your doctor. A double-blind randomized trial of 0.1% tacrolimus vs. 0.05% clobetasol for the treatment of childhood vitiligo. Braun M. Topical steroids (Corticosteroids) control inflammation by mimicking naturally … Low-potency steroids are the safest agents for long-term use, on large surface areas, on the face or areas of the body with thinner skin, and on children. Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Hofer S, Adverse effects of topical glucocorticosteroids.Address correspondence to Jonathan D. Ference, PharmD, BCPS, Nesbitt College of Pharmacy and Nursing, 84 W. South St., Room 336, Wilkes-Barre, PA 18766 (e-mail: Marsland AM, An open trial. McMicheal AJ, Successful treatment depends on an accurate diagnosis and consideration of the steroid’s delivery vehicle, potency, frequency of application, duration of treatment, and side effects. Under normal circumstances, I probably wouldn't have agreed to steroid treatment — something about the aggressive, extra-strength implication of the word just scares me — but I did.