From the Guidelines
Yes, you can apply steroid cream to blisters, but it should be done carefully and only when appropriate, as evidenced by the British Association of Dermatologists' guidelines for the management of bullous pemphigoid 2012 1. For mild to moderate inflammatory blisters caused by conditions like eczema, contact dermatitis, or poison ivy, a low to medium potency steroid cream such as hydrocortisone 1% or triamcinolone 0.1% can help reduce inflammation, itching, and discomfort. However, it's crucial to note that steroid creams should not be used on infected blisters, as they can worsen the infection, and signs of infection include increased pain, warmth, redness, pus, or yellow crusting 1. The management of bullous pemphigoid with topical corticosteroids, such as clobetasol propionate 0.05% cream, has been validated in controlled studies, with an initial dose of 30-40 g per day, applied in two applications over the entire body, including both normal skin and blisters and erosions, but sparing the face 1. Key considerations for the use of steroid creams on blisters include:
- Apply a thin layer to the affected area 1-2 times daily for up to 7-10 days
- Avoid using steroid creams on infected blisters or those caused by burns, friction, or viral infections like herpes or shingles, as they may delay healing or spread the infection
- Monitor for signs of infection and discontinue use if they occur
- Consult a healthcare provider for proper diagnosis and treatment if blisters are severe, widespread, or don't improve within a few days of treatment.
From the Research
Steroid Cream on Blisters
- The use of steroid cream on blisters is a topic of discussion in various medical studies.
- According to 2, corticosteroids are used as a first-line systemic therapy for patients with moderate to severe bullous pemphigoid and pemphigus vulgaris, which are autoimmune blistering diseases.
- However, the use of systemic steroids has dramatically reduced mortality from these two autoimmune blistering disorders, but treatment is also associated with multiple side effects, especially when used long-term.
- In the context of post-traumatic blisters, 3 suggests that the use of systemic antibiotics and steroids has not been supported by the literature and should be avoided unless indicated due to other reasons.
- On the other hand, 4 reports that a combined topical steroid, antibiotic, and antifungal preparation can be used to treat chronic wounds displaying abnormal and excessive inflammation, and that this treatment can improve healing rates and reduce symptom burden.
- Additionally, 5 provides guidance on the choice and application of topical corticosteroids, including their classification by strength and the risk of adverse effects, and recommends correct patient application using the fingertip unit method.
- It is essential to note that the use of steroid cream on blisters should be tailored to the individual patient's condition, and several other factors must be carefully considered in choosing appropriate therapy, including diagnosis, severity of the condition, presence of comorbidities, and ability to tolerate systemic therapy, as mentioned in 2 and 3.
- Furthermore, 6 discusses the efficacy and safety of topical analgesics, including topical steroids, in common use today, and provides strength of recommendation taxonomy (SORT) levels for various topical analgesics.