What is the list of typical topical corticosteroid (steroid) creams from strongest to weakest for a general adult population with no specific medical history?

Topical Corticosteroid Potency Ranking: Strongest to Weakest

Topical corticosteroids are classified into seven potency classes, ranging from Class I (super-high/ultra-high potency) to Class VII (lowest potency), with selection based on the anatomical site, patient age, and severity of the inflammatory condition. 1, 2

Class I: Super-High Potency (Strongest)

• Clobetasol propionate 0.05% (cream, ointment, gel, foam) 2
• Betamethasone dipropionate 0.05% (optimized ointment) 2
• Halobetasol propionate 0.05% 2

Clinical use: Reserved for severe inflammatory conditions on thick-skinned areas (palms, soles); limited to 2-3 weeks maximum duration; avoid on face, genitals, and intertriginous areas 2

Class II: High Potency

• Fluocinonide 0.05% (cream, ointment, gel) 2
• Desoximetasone 0.25% (cream, ointment) 2
• Betamethasone dipropionate 0.05% (standard ointment) 2
• Mometasone furoate 0.1% (ointment) 2

Clinical use: Appropriate for moderate-to-severe dermatoses on body areas; use up to 12 weeks with monitoring 2

Class III: Upper-Mid Potency

• Triamcinolone acetonide 0.5% (cream, ointment) 2
• Fluticasone propionate 0.005% (ointment) 2
• Betamethasone valerate 0.1% (ointment) 2

Clinical use: Suitable for moderate inflammatory conditions on trunk and extremities; can be used for up to 12 weeks 3, 2

Class IV: Mid Potency

• Triamcinolone acetonide 0.1% (cream, ointment) 2
• Mometasone furoate 0.1% (cream) 2
• Fluocinolone acetonide 0.025% 2
• Hydrocortisone valerate 0.2% 2

Clinical use: First-line for many inflammatory dermatoses on body areas; safe for extended use with monitoring 2

Class V: Lower-Mid Potency

• Hydrocortisone butyrate 0.1% 2
• Fluticasone propionate 0.05% (cream) 2
• Betamethasone valerate 0.1% (cream) 2
• Prednicarbate 0.1% 2

Clinical use: Appropriate for mild-to-moderate conditions; safer for facial use in adults when necessary 2

Class VI: Low Potency

• Alclometasone dipropionate 0.05% 1
• Desonide 0.05% 1
• Fluocinolone acetonide 0.01% 1

Clinical use: Preferred for facial and intertriginous areas; safe for children and sensitive skin; no specified time limit for use 1, 2

Class VII: Lowest Potency (Weakest)

• Hydrocortisone 2.5% 1, 4
• Hydrocortisone 1% 1, 4
• Hydrocortisone 0.5-1% (over-the-counter) 1

Clinical use: Safest option for face, neck, genitals, and children; can be used for extended periods with appropriate supervision; minimal risk of atrophy 1, 4, 5

Critical Selection Principles

Anatomical site is the primary determinant of potency selection: Face and neck require Class VI-VII (low-to-lowest potency) due to thinner skin, increased percutaneous absorption, and higher risk of atrophy, telangiectasias, and perioral dermatitis 1, 5, 2

Duration guidelines by potency class:

• Class I (super-high): Maximum 2-3 weeks 2
• Class II-III (high to upper-mid): Up to 12 weeks 2
• Class IV-V (mid to lower-mid): Extended use with monitoring 2
• Class VI-VII (low to lowest): No specified time limit 2

Common pitfall: "Steroid phobia" leads to undertreatment—the vast majority of prescribed topical corticosteroids are mild potency with minimal risk of harm when used appropriately 6

Formulation matters: Ointments are more potent than creams of the same concentration due to enhanced penetration; use creams for weeping/acute lesions and ointments for dry/chronic conditions 4, 2