Corticosteroids and the eye
If used during lactation clobetasol should not be applied to the breasts to avoid accidental ingestion by the infant. Rebound of pre-existing dermatoses can occur with abrupt discontinuation of clobetasol. We are the leading national charity and safe steroids for sale membership organisation for people affected by psoriasis in the UK. A range (but not all) of specials preferred by the British Association of Dermatologists has been approved for use within Cornwall mainly for prescribing by secondary care.
- These chemicals make blood vessels widen and cause the skin to become inflamed, swollen, and itchy.
- Washing clothing and bedding may reduce product build-up but not totally remove it.
- We sought advice on our assessment from the Dermatology and Pharmacovigilance Expert Advisory Groups of the Commission on Human Medicines.
- Topical steroids may be used separately, or in combination with topical vitamin D treatments.
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Topical steroid ladder (worsening itch 1-5, redness, scratch marks, thickness)
Topical corticosteroids have been used by a large number of pregnant and breast feeding women without any evidence of harmful effects. However, there is limited information about the safety of topical corticosteroid use in pregnancy and during breast feeding. This should be discussed with your doctor or specialist nurse to make sure the benefits outweigh the risks. To avoid transfer to the infant only mild and moderate topical corticosteroids should be used on the breast and around the nipple, and these should be washed off before breastfeeding.
Administration of clobetasol during lactation should only be considered if the expected benefit to the mother outweighs the risk to the infant. Allow adequate time for absorption after each application before applying an emollient. Most adults and children can use topical corticosteroids safely, but there are situations when they are not recommended.
4 Topical corticosteroids
Very potent topical corticosteroids are not usually prescribed for pregnant or breastfeeding women, or for very young children. Sometimes you may be prescribed them under the supervision of a skincare specialist (dermatologist). Children and young people will be guided by their doctor or specialist nurse on the use of mild and moderate steroids and when required, potent steroids will be used to treat severe skin conditions.
If you’re using both topical corticosteroids and emollients, you should apply the emollient first. Squeeze the topical steroid in a line from the last finger crease to the fingertip. One FTU would be sufficient to treat an area equivalent to two adult handprints. Both betamethasone and mometasone are strong corticosteroids and will be effective at treating more severe conditions, so which you choose is down to personal preference and your body’s response.
Use of a combination product containing a steroid plus antibiotic is rarely justified and should not be routinely used, except post intraocular surgery e.g. cataract. A FTU (about 500mg) is the amount needed to squeeze a line from the tip of an adult finger to the first crease of the finger. It should be enough to treat an area of skin double the size of the flat of your hand with your fingers together.
Stronger types, such as beclometasone, betamethasone, clobetasol, fluticasone and mometasone, are only available on prescription.
USE OF TOPICAL CORTICOSTEROIDS IN PREGNANCY
Topical steroids are one of the first treatment options for people whose psoriasis covers only a small amount of their body. The table below shows suitable quantities of dermatological preparations to be prescribed for specific areas of an average adult body based on a single daily application for 2 weeks. Many of these products are cheap to buy and are readily available OTC along with advice from pharmacies.
Potent topical corticosteroid/steroid creams
The extent of percutaneous absorption of topical corticosteroids is determined by many factors, including the vehicle and the integrity of the epidermal barrier. Occlusion, inflammation and/or other disease processes in the skin may also increase percutaneous absorption. Visual disturbance has been reported with systemic and topical corticosteroid use. Clobetasol should be used with caution in patients with a history of local hypersensitivity to other corticosteroids or to any of the excipients in the preparation.
Medicines Information Patient Helpline:
The majority of the available studies do not indicate that use of topical corticosteroids in early pregnancy causes orofacial clefts in the offspring. However, since some data are conflicting, further statistically robust studies that preferably stratify analyses by potency are required to absolutely rule out an increased risk. The available data on other specific malformations are too limited to permit an evidence-based assessment of risk, and further research is therefore required. Due to limited data it is not currently possible to conduct an evidence-based assessment of the risks of spontaneous abortion or adverse neurodevelopmental outcomes in the child following gestational exposure to topical corticosteroids.