From the Guidelines
Topical steroids are not generally recommended for wound healing as they can impair the normal healing process by suppressing inflammation, which is a necessary part of wound repair. The use of topical steroids in wound healing is a topic of debate, and the current evidence suggests that they can have negative effects on the healing process, such as thinning the skin, reducing collagen formation, and increasing the risk of infection 1.
Key Considerations
- The primary goal of wound care is to create an optimal environment for healing, which involves keeping the area clean, moist, and protected.
- Products like petroleum jelly or silicone-based dressings are better options for wound care as they promote a moist environment without the negative effects of steroids.
- If a wound shows signs of excessive inflammation or if there's an inflammatory skin condition around the wound, a healthcare provider might occasionally prescribe a mild steroid like hydrocortisone 1% for very short-term use on the surrounding skin only, not directly on the open wound.
Evidence-Based Recommendations
- The most recent and highest quality study on the topic, published in 2015, recommends the use of clobetasol propionate 0.05% cream or ointment for the treatment of bullous pemphigoid, but this is not directly applicable to wound healing 1.
- The study suggests that topical steroids can be effective in reducing inflammation and promoting healing in certain skin conditions, but this should be balanced against the potential risks and negative effects on wound healing.
- In general, topical steroids should not be used as a first-line treatment for wound healing, and alternative approaches should be considered. For proper wound care, it is essential to consult with a healthcare provider who can assess the specific wound and recommend appropriate treatment.
From the FDA Drug Label
The topical corticosteroids constitute a class of primarily synthetic steroids used as anti-inflammatory and antipruritic agents. Topical corticosteroids share anti-inflammatory, antipruritic and vasoconstrictive actions.
The FDA drug label does not answer the question.
From the Research
Topical Steroids for Wound Healing
- The use of topical steroids for wound healing is a topic of ongoing research, with some studies suggesting that they can be beneficial in certain cases 2, while others indicate that they may inhibit the healing process 3, 4.
- A study published in the Journal of Wound Care found that 79% of patients with chronic leg ulcers benefited from the application of topical corticosteroids, with improvements in healing, pain relief, exudate reduction, and control of hypergranulation tissue 2.
- However, another study published in The Journal of Dermatologic Surgery and Oncology found that topical steroids, including hydrocortisone and fluocinolone acetonide, significantly retarded wound healing in an animal model 3.
- The choice of topical steroid and its application are critical factors in determining its effectiveness and safety, with considerations including the potency of the steroid, the frequency and duration of application, and the individual patient's skin type and condition 5, 6.
Recommended Topical Steroids
- There is no single recommended topical steroid for wound healing, as the most effective treatment will depend on the individual patient's condition and the specific characteristics of the wound.
- However, some studies suggest that lower-potency topical steroids, such as hydrocortisone, may be less likely to inhibit wound healing than higher-potency steroids like fluocinolone acetonide 3, 4.
- The use of topical corticosteroids should be carefully monitored, as prolonged use can increase the risk of adverse effects, including skin atrophy, striae, and rosacea 6.