Can topical corticosteroid (steroid) cream be applied to the genital area?

From the Guidelines

Topical corticosteroid creams can be applied to the genital area, but only with caution and under medical supervision, as they can be effective in treating inflammatory skin conditions such as lichen sclerosus, as shown in a study published in the British Journal of Dermatology 1. When applying topical corticosteroids to the genital area, it is essential to follow the doctor's instructions precisely and use only a thin layer of cream. The genital skin is thinner and more absorbent than other body areas, increasing the risk of side effects like skin thinning, stretch marks, and increased susceptibility to infections. Some key points to consider when using topical corticosteroids on the genital area include:

• Using low-potency steroid creams like hydrocortisone 0.5-1% for short periods (usually 3-7 days) to treat inflammatory skin conditions affecting the genitals, such as eczema, dermatitis, or lichen sclerosus.
• Avoiding the use of medium or high-potency steroid creams on genital skin unless specifically prescribed by a healthcare provider, as they can increase the risk of side effects.
• Monitoring symptoms closely and discontinuing use if they do not improve within a few days of treatment or if they worsen, and consulting a healthcare provider for alternative treatments. According to a study published in the British Journal of Dermatology, clobetasol propionate 0.05% can be an effective treatment for lichen sclerosus, with significant improvement in discomfort and skin tightness, and also in urinary flow in some patients 1. However, it is crucial to use this medication under medical supervision and follow the recommended treatment regimen to minimize the risk of side effects. In terms of treatment regimens, a study published in the British Journal of Dermatology recommends applying clobetasol propionate 0.05% ointment once daily, at night, for 4 weeks, then on alternate nights for 4 weeks, and then twice weekly for a further 4 weeks, before review 1. Ultimately, the decision to use topical corticosteroids on the genital area should be made in consultation with a healthcare provider, taking into account the individual's specific condition and medical history.

From the FDA Drug Label

Warnings For external use only Do not use in the genital area if you have a vaginal discharge.

When using this product avoid contact with eyes do not use more than directed unless told to do so by a doctor do not put directly into the rectum by using fingers or any mechanical device or applicator

The use of topical corticosteroid cream, such as hydrocortisone, in the genital area is restricted. It should not be used in the genital area if there is a vaginal discharge. Additionally, it should not be inserted into the rectum. Therefore, topical corticosteroid cream can be applied to the genital area, but with caution and only under certain conditions, and it is recommended to consult a doctor before use 2.

From the Research

Topical Corticosteroid Use in the Genital Area

• The use of topical corticosteroids in the genital area has been studied in various conditions, including genital lichen sclerosus and genital erosive lichen planus 3, 4, 5, 6, 7.
• Studies have shown that topical corticosteroids, such as clobetasol propionate 0.05% cream, can be effective in treating these conditions, with significant improvements in symptoms and quality of life 3, 5, 6, 7.
• The efficacy of topical corticosteroids in the genital area has been demonstrated in both men and women, with studies showing improvements in symptoms such as itching, burning, and pain 3, 4, 5, 6, 7.

Safety and Adverse Effects

• The safety of topical corticosteroids in the genital area has been evaluated in several studies, with most reporting no significant adverse effects 3, 4, 5, 6, 7.
• However, some studies have reported potential risks, such as skin atrophy and latent infections, particularly with long-term use 5.
• It is essential to carefully evaluate the benefits and risks of topical corticosteroid use in the genital area and to monitor patients for potential adverse effects 3, 4, 5, 6, 7.

Specific Corticosteroids and Regimens

• Clobetasol propionate 0.05% cream has been shown to be effective in treating genital lichen sclerosus and genital erosive lichen planus 3, 4, 5, 6, 7.
• Other topical corticosteroids, such as mometasone furoate 0.05% and methylprednisolone aceponate 0.1% cream, have also been studied, with varying degrees of efficacy 3, 7.
• The optimal potency and regimen of topical corticosteroids for use in the genital area are still being researched and debated 3, 4, 5, 6, 7.