Topical steroids are one of the most common topical treatments for psoriasis. They are derived from the natural corticosteroid hormones produced by the adrenal glands. Corticosteroids control inflammatory responses in the body, among other important functions, making them an ideal anti-inflammatory agent to reduce swelling and redness/discoloration caused by lesions.
Steroids come in various strengths, ranging from very strong or “superpotent” to very weak or “least potent.” You can learn more about potency classification and which steroids fit each classification by looking at the National Psoriasis Foundation’s Topical Steroid Potency Chart.
Things to keep in mind when using a topical steroid:
- Apply a small amount of the steroid on the affected areas only.
- Don’t use a topical steroid for longer than three weeks without consulting your health care provider.
- Refrain from abruptly discontinuing a topical steroid as it can cause your psoriasis to flare.
- Unless the medication is formulated for the eye area, do not use steroids on, in or around the eyes, as cataracts and glaucoma can result.
- The more potent the steroid, the more effective it is in clearing psoriasis, but the risk of side effects is greater.
- Low-strength steroids are good for treating the face, groin and breasts, but care must be taken as the risk of side effects is greater in sensitive skin areas.
Potential side effects of topical steroids include skin damage, such as skin thinning, changes in pigmentation, easy bruising, stretch marks, redness and dilated surface blood vessels. Steroids can be absorbed through the skin and affect internal organs when applied to widespread areas of skin, used over long periods of time, or used with excessive occlusion.
There are some combination treatment options available. For instance, calcipotriene combined with the steroid betamethasone dipropionate slows skin cell growth, flattens lesions, removes scale and reduces itch and inflammation. Common side effects of this treatment include itching, rash, skin thinning and burning. Less common side effects include redness of the skin, folliculitis, skin irritation, worsening of psoriasis, skin color changes and swollen fine blood vessels at the application site.
Have more questions about whether a topical treatment is for you? Your health care provider can provide you with more information related to these treatments, and discuss if they are a fit for your treatment plan. Please speak with your health care provider about the use of topical steroid treatments on children affected by psoriasis.