Table of ContentsView AllTable of ContentsWhat They AreStrengthsTreatmentFormulations
Table of ContentsView All
View All
Table of Contents
What They Are
Strengths
Treatment
Formulations
Topical steroids are grouped into classes based on their performance and concentration.Class I steroids, such as clobetasol propionate, are the strongest and require a prescription; Class VII steroids, such ashydrocortisone, are the weakest and available over-the-counter (OTC). Topical steroids also come in a variety of forms, including creams and gels.
This article explains how topical steroids work, which steroid creams are the strongest, medication options, and the side effects that may come with them.
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What Are Topical Steroids?
Topical steroids are medications that reduce inflammation in your skin.
Inflammation is a sign of an immune response. The treatment is applied to an affected area of skin to help reduce symptoms such as rashes, scaly patches, itching, pain, redness, or swelling.
For example,eczema, also known as atopic dermatitis, is a group of skin conditions that lead to itchy and inflamed skin with a scaly rash. Eczema is common in children.If you experience a flare-up of eczema, you can apply a cream to help you stop scratching the area and allow your skin to heal.
Topical steroids may be used for other skin conditions such as:
Which Topical Steroid Is Strongest?
Topical steroids come in a range of strengths and formulations. They are divided into seven classes based on how strong they are, with the strongest in Class I (class one), and the weakest in Class VII (class seven).
Class I topical steroids are approximately 600 to 1,000 times stronger than those in Class VII.
It is important to note that the percentages listed on a product labeldo notreflect the product’s strength. For example, a 0.01% Class I topical steroid is far more potent than a 3% Class VII steroid.
Topical Steroids Class I
The strongest topical steroids include:
Topical Steroids Class II
These topical steroids are considered highly potent:
Topical Steroids Class III
These topical steroids are considered potent:
Topical Steroids Class IV
These topical steroids are considered moderately potent:
Topical Steroids Class V
These topical steroids are considered somewhat potent:
Topical Steroids Class VI
These topical steroids are considered mild:
Topical Steroids Class VII
These topical steroids are considered the least potent:
Treatment Considerations
The appropriate steroid strength, or potency, depends on a variety of factors.
For example, babies absorb topical steroids much faster than adults, so they may require a low-potency steroid.
Areas of the body where skin touches skin, such as the armpits or under the breasts, or sensitive areas of skin such as the eyelids, also absorb topical steroids quickly and may only need a low-potency formulation.
However, thick, rough skin on the palms of your hands and the soles of your feet usually absorbs topical steroids more slowly than other parts of the body, so those areas typically require a more potent steroid.
Side Effects
The greater the potency of a topical steroid, the greater the risk of side effects. Common side effects of topical steroids include:
Topical Steroid Withdrawal
It is possible to overuse topical steroids, which could result in withdrawal symptoms. This can happen if you use mid- to high-strength topical steroids frequently, for a long time, or on sensitive parts of your body like your face or genitals.
Generally speaking, you should not use low-strength topical steroids for more than three months. High-strength topical steroids should not be used for more than three weeks.
Withdrawal symptoms occur when you stop using topical steroids but may take up to two weeks to appear. They may include:
If you think you are experiencing withdrawal symptoms, talk to your healthcare provider. It’s possible to mistake eczema or other skin conditions for topical steroid withdrawal, so it’s important to get a proper diagnosis and start an alternative treatment if appropriate.
Your healthcare provider can help you weigh the risks and benefits of using a topical steroid and to find a strength that may be best suited for your skin condition.
How long the drug should be used will also vary based on your condition.
Topical steroids are usually applied in a thin layer and massaged into your skin anywhere from one to four times a day.They can come in different forms including the following:
Summary
Topical steroids are medications applied to the skin to reduce inflammation and irritation.
They come in over-the-counter and prescription options with a range of strengths and formulations. Class VII steroids, which includes OTC hydrocortisone creams, are the mildest, while Class I are the strongest.
Your doctor can help you to decide if a topical steroid makes sense for treating your skin condition and what potency and length of treatment may be most helpful in your case.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stephen K, Stacey D, Mceleney M.Topical corticosteroids: Choice and application.Am Fam Phys. 2021;103(6):337-343.American Academy of Pediatrics.Eczema in babies and children.Humbert P, Guichard A.The topical corticosteroid classification called into question: towards a new approach.Exp Dermatol.2015;24(5):393-5. doi:10.1111/exd.12677American Osteopathic College of Dermatology.Steroids (topical).Lax S, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Datab Syst Rev. 2022 Mar;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2Harvey J, Lax S, Lowe A, et al.The long-term safety of topical corticosteroids in atopic dermatitis: A systematic review.Skin Health Dis. 2023 Oct;3(5):e268. doi:10.1002/ski2.268American Family Physician.Choosing topical corticosteroids.National Eczema Association.Education announcement: use of topical steroids for eczema.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stephen K, Stacey D, Mceleney M.Topical corticosteroids: Choice and application.Am Fam Phys. 2021;103(6):337-343.American Academy of Pediatrics.Eczema in babies and children.Humbert P, Guichard A.The topical corticosteroid classification called into question: towards a new approach.Exp Dermatol.2015;24(5):393-5. doi:10.1111/exd.12677American Osteopathic College of Dermatology.Steroids (topical).Lax S, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Datab Syst Rev. 2022 Mar;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2Harvey J, Lax S, Lowe A, et al.The long-term safety of topical corticosteroids in atopic dermatitis: A systematic review.Skin Health Dis. 2023 Oct;3(5):e268. doi:10.1002/ski2.268American Family Physician.Choosing topical corticosteroids.National Eczema Association.Education announcement: use of topical steroids for eczema.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Stephen K, Stacey D, Mceleney M.Topical corticosteroids: Choice and application.Am Fam Phys. 2021;103(6):337-343.American Academy of Pediatrics.Eczema in babies and children.Humbert P, Guichard A.The topical corticosteroid classification called into question: towards a new approach.Exp Dermatol.2015;24(5):393-5. doi:10.1111/exd.12677American Osteopathic College of Dermatology.Steroids (topical).Lax S, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Datab Syst Rev. 2022 Mar;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2Harvey J, Lax S, Lowe A, et al.The long-term safety of topical corticosteroids in atopic dermatitis: A systematic review.Skin Health Dis. 2023 Oct;3(5):e268. doi:10.1002/ski2.268American Family Physician.Choosing topical corticosteroids.National Eczema Association.Education announcement: use of topical steroids for eczema.
Stephen K, Stacey D, Mceleney M.Topical corticosteroids: Choice and application.Am Fam Phys. 2021;103(6):337-343.
American Academy of Pediatrics.Eczema in babies and children.
Humbert P, Guichard A.The topical corticosteroid classification called into question: towards a new approach.Exp Dermatol.2015;24(5):393-5. doi:10.1111/exd.12677
American Osteopathic College of Dermatology.Steroids (topical).
Lax S, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Datab Syst Rev. 2022 Mar;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2
Harvey J, Lax S, Lowe A, et al.The long-term safety of topical corticosteroids in atopic dermatitis: A systematic review.Skin Health Dis. 2023 Oct;3(5):e268. doi:10.1002/ski2.268
American Family Physician.Choosing topical corticosteroids.
National Eczema Association.Education announcement: use of topical steroids for eczema.
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