Topical Corticosteroids
Topical corticosteroids are used for the treatment of inflammatory conditions of the skin (other than those arising from an infection) in particular eczema, contact dermatitis, insect stings, and eczema of scabies. Corticosteroids suppress the inflammatory reaction during use; they are not curative and on discontinuation a rebound exacerbation of the condition may occur. They are generally used to relieve symptoms and suppress signs of the disorder when other measures such as emollients are ineffective. Topical corticosteroids are of no value in the treatment of urticaria and they are contra-indicated in rosacea; they may worsen ulcerated or secondarily infected lesions. They should not be used indiscriminately in pruritus (where they will only benefit if inflammation is causing the itch) and are not recommended for acne vulgaris. Potent topical corticosteroids should be avoided or given only under specialist supervision in psoriasis because, although they may suppress the psoriasis in the short term, relapse or vigorous rebound occurs on withdrawal (sometimes precipitating severe pustular psoriasis). Topical use of potent corticosteroids on widespread psoriasis can lead to systemic as well as to local side-effects.
HYDROCORTISONE ACETATE:
Indications: Mild inflammatory skin disorders, nappy rash.
Contraindications: Untreated skin infections, rosacea, ulcerative skin conditions, perioral dermatitis. Not recommended in acne.
Dose and Administration: Apply sparingly to the affected area(s) twice daily.
HYDROCORTISONE BUTYRATE:
Indications: treatment of conditions responsive to topical corticosteroids e.g. eczema, dermatitis and psoriasis where there is concurrent infection by a microorganism susceptible to chlorquinaldol, or where such infection is to be prevented. Topical corticosteroids are not generally indicated in psoriasis but may be acceptable in psoriasis excluding widespread plaque psoriasis provided warnings are given.
Contraindications: contraindicated in the presence of untreated viral or fungal infections, tubercular or syphilitic lesions, peri-oral dermatitis, acne vulgaris and rosacea and in bacterial infections unless used in connection with appropriate chemotherapy.
Dose and Administration: To be applied evenly and sparingly two or three times daily. Children: Long term treatment should be avoided where possible. Infants: Therapy should be limited if possible to a maximum of seven days.
BETAMETHASONE DIPROPIONATE:
Indications: Steroid responsive dermatoses.
Contraindications: Rosacea, acne, perioral dermatitis, perianal and genital pruritus. Hypersensitivity to any of the ingredients of the Diprosone presentations contraindicates their use as does tuberculous and most viral lesions of the skin, particularly herpes simplex, vacinia, varicella. Diprosone should not be used in napkin eruptions, fungal or bacterial skin infections without suitable concomitant anti-infective therapy.
Dose and Administration: Once to twice daily. In most cases.
BETAMETHASONE VALERATE:
Indications: inflammatory dermatoses that are normally responsive to topical corticosteroid therapy, and are often effective in the less responsive conditions such as psoriasis.
Contraindications: Rosacea, acne and perioral dermatitis. Primary cutaneous viral infections (e.g. herpes simplex, chickenpox). Hypersensitivity to any component of the preparation.
Dose and Administration: A small quantity should be applied gently to the affected area two or three time’s daily until improvement occurs.
BETAMETHASONE DIPROPIONATE SALICYLIC ACID:
Indications: Hyperkeratotic and dry corticosteroid-responsive dermatoses.
Contraindications: Rosacea, acne, perioral dermatitis, perianal and genital pruritus. Hypersensitivity to any of the ingredients of the Diprosalic presentations contra-indicates their use as does tuberculous and most viral lesions of the skin, particularly herpes simplex, vacinia, varicella. Diprosalic should not be used in napkin eruptions, fungal or bacterial skin infections without suitable concomitant anti-infective therapy.
Dose and Administration: Once to twice daily. In most cases a thin film should be applied to cover the affected area twice daily. Dosage in children should be limited to 5 days.
CLOBETASOL PROPIONATE:
Indications: Psoriasis, intractable eczemas, inflammatory dermatoses.
Contraindications: Primary cutaneous viral infections (e.g. herpes simplex, chickenpox), Perianal and genital pruritus, Perioral dermatitis, Acne vulgaris, Rosacea and in the treatment of primary infected skin lesions caused by infection
with fungi (e.g. candidiasis, tinea) or bacteria (e.g. impetigo); or dermatoses in children under one year of age, including dermatitis and napkin eruptions.
Dose and Administration: Apply sparingly to the affected area once or twice daily until improvement occurs. Child Over 1 year, as adult but limit to 5 days.
FLUTICASONE PROPIONATE:
Indications: For the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses such as: eczema including atopic and discoid eczemas; prurigo nodularis; psoriasis (excluding widespread plaque psoriasis); neurodermatoses including lichen simplex; lichen planus; seborrhoeic dermatitis; contact sensitivity reactions; discoid lupus erythematosus; an adjunct to systemic steroid therapy in generalised erythroderma; insect bite reactions; or prickly heat.
Contraindications: Rosacea, acne vulgaris, perioral dermatitis, primary cutaneous viral infections (e.g. herpes simplex, chickenpox). Hypersensitivity to any of the ingredients. Perianal and genital pruritus. The use of fluticasone propionate skin preparations is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi or bacteria. Dermatoses in infants under three months of age, including dermatitis and napkin eruptions. Dose and Administration: For adults, children and infants aged three months and over, apply a thin film to the affected skin areas once or twice daily. Daily treatment should be continued until adequate control of the condition is achieved. Frequency of application should thereafter be reduced to the lowest effective dose.
MOMETASONE FUROATE:
Indications: treatment of inflammatory and pruritic manifestations of psoriasis (excluding widespread plaque psoriasis) and atopic dermatitis.
Contraindications: contraindicated in facial rosacea, acne vulgaris, perioral dermatitis, perianal and genital pruritis, napkin eruptions, bacterial (e.g. impetigo), viral (e.g. herpes simplex, herpes zoster and chickenpox) and fungal (e.g. candida or dermatophyte) infections, varicella, tuberculosis, syphilis or post-vaccine reactions.
Dose and Administration: Adults, including elderly patients and Children: A thin film of should be applied to the affected areas of skin once daily.
MOMETASONE FUROATE-SALICYLIC ACID:
Indications: treatment of hyperkeratotic and dry corticosteroide responsive dermatoses where cornified epithelium may resist peneteration of steroid.
Contraindications: contraindicated in patients who are hypersensetive to mometasone or any other ingredients in the preparation. Rosea, acne, perianal and genital pruritis.
Dose and Administration: Adults, including elderly patients and Children: A thin film of should be applied to the affected areas of skin once daily.
