How to Pick a Topical Corticosteroid for Psoriasis

If you're trying to fight off the itchy patches that come with psoriasis, you're probably no stranger to creams, gels, and ointments. There are lots out there, but one of the strongest weapons in your arsenal is something called a topical corticosteroid. It can control the inflammation that makes your skin look puffy and red.

"Topical" is just a fancy word for something you put on your skin. You can't buy a corticosteroid like that without a prescription from your doctor. The two of you will work together to find the strength and dose that works best for you.

How Strong Should It Be?

Corticosteroids come in a wide variety of strengths. They're ranked on a scale of 1 through 7. If it's labeled "1" it means the drug is "super potent" or very strong. When it has a "7" it's got a rating of "least potent" or very weak.

Your doctor will weigh several different things before he suggests a specific corticosteroid for you. He'll consider your age, how severe your disease is, and the part of your body that's got an outbreak. He'll also go over with you the potential side effects from the treatment.

Weaker corticosteroids are best if you need to use it on sensitive areas such as your face, groin, or breasts. Your doctor may also prescribe a lower-strength version if you have to use it for a long time. Mild to mid-strength ones can be used for children.

You may need a stronger one if you have a severe form of psoriasis. It's also a good choice for spots with thicker skin, such as your palms or the soles of your feet.

Will I Get Side Effects?

Whether you get them depends a lot on the strength of the corticosteroid, how large an area you spread it on, and how long you use it. To lower your risk, your doctor may look for the weakest one that can get the job done in the shortest time.

Some common side effects that could happen to you:

  • Thinning of your skin
  • Changes in skin coloring
  • You bruise easily
  • Stretch marks
  • Skin gets reddish
  • Broken blood vessels
  • Increased hair growth in localized areas
  • Infections
  • You become sensitive to light

Corticosteroids can be absorbed through your skin and sometimes cause health problems such as high blood pressure, high blood sugar, and a hormonal problem called Cushing's syndrome.

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How to Use a Topical Corticosteroid

A few simple tips can help you get the best results -- and keep you safe, too:

Follow instructions. Don't wing it. Your doctor will tell you how often to apply the medicine.

Don't overdo it. When you put it on your skin, use a small amount and only on the area that needs treatment.

Skin only. Never use a topical corticosteroid on your eyes unless your doctor tells you to. It can cause glaucoma or cataracts.

Keep an eye on the calendar. Use this treatment only for as long as your doctor says you should.

Don't stop suddenly. If you do it can cause your psoriasis to flare up. To keep that from happening, your doctor will slowly decrease the amount you use.

WebMD Medical Reference Reviewed by Debra Jaliman, MD on February 12, 2018

Sources

SOURCES:

National Psoriasis Foundation: "Mild Psoriasis: Topical Steroids."

National Eczema Association: "Topical Corticosteroids."

American Academy of Family Physicians: "Choosing Topical Corticosteroids."

American Academy of Dermatology: "Psoriasis: Recommendations for Topical Corticosteroids."

National Institute of Neurological Disorders and Stroke: "NINDS Cushing's Syndrome Information Page."

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