From the Guidelines
Topical steroid creams, such as clobetasol propionate (class 1), halobetasol propionate (class 1), and betamethasone valerate (class 4), are effective treatments for psoriasis, with efficacy rates ranging from 58% to 92% 1.
Classification of Topical Steroids
The classification of topical steroids is based on their skin vasoconstrictive activity, ranging from ultra-high (class 1) to low (class 6 and 7) 1.
- Class 1 (superpotent): clobetasol propionate, halobetasol propionate
- Class 2 (potent): desoximetasone
- Class 3,4 (midstrength and upper midstrength): fluticasone propionate, betamethasone valerate
- Class 5,6,7 (least potent, midstrength, and lower midstrength): hydrocortisone
Efficacy of Topical Steroids
The efficacy of topical steroids varies depending on the potency and duration of treatment.
- Class 1 corticosteroids have efficacy rates ranging from 58% to 92% 1
- Class 2 corticosteroids have efficacy rates ranging from 68% to 74% 1
- Class 3,4 corticosteroids have efficacy rates ranging from 68% to 72% 1
Recommendations for Use
When using topical steroids, it is essential to apply a thin layer to affected areas only, typically once or twice daily for 1-2 weeks 1.
- Always use the lowest effective potency for the shortest duration necessary
- Follow a healthcare provider's instructions regarding application frequency and treatment duration
- Be aware of potential side effects, such as skin thinning, stretch marks, increased hair growth, and adrenal suppression, especially with prolonged use of higher-potency steroids 1
From the FDA Drug Label
INDICATIONS AND USAGE: Topical corticosteroids are indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. The topical corticosteroids constitute a class of primarily synthetic steroids used as anti-inflammatory and antipruritic agents. Topical corticosteroids such as clobetasol propionate are effective in the treatment of corticosteroid-responsive dermatoses primarily because of their anti-inflammatory, antipruritic, and vasoconstrictive actions.
The following are topical steroid creams:
- Betamethasone (2)
- Clobetasol (3)
- Triamcinolone (4)
From the Research
Topical Steroid Creams
- Hydrocortisone 2.5% ointment 5
- Betamethasone 0.1% cream 5
- Clobetasol 0.05% foam 5
- Triamcinolone 0.1% ointment 5
- Desoximetasone (high potent) 6
- Hydrocortisone-17-valerate (midpotent) 6
- Clobetasol propionate (superpotent) 6