Topical steroids

Also known as topical corticosteroids, glucocorticosteroids, and “cortisone”.

Topical steroids are used to reduce inflammation and itchiness in skin conditions such as eczema or dermatitis. Topical steroids are also known as topical corticosteroids, glucocorticosteroids, and “cortisone”.

What are topical steroids?

Topical steroids are used to reduce inflammation and itchiness in skin conditions such as eczema, dermatitis or psoriasis.

  • They are also known as topical corticosteroids, glucocorticosteroids, and “cortisone”.
  • Topical steroids work by reducing inflammation and the amount of collagen in the skin, and in this way may ease symptoms such as itch, and redness.
  • They are applied to the skin in the form of creams, ointments, lotions, or solutions. 
  • For skin conditions associated with dryness, such as eczema, other treatments such as emollient and moisturisers may also be needed.
  • If an emollient and a topical corticosteroid are prescribed at the same time, one product, i.e. emollient or corticosteroid, should be applied at least 30 minutes before the other; the order of application is not important.  

Different types of topical steroids

There are many types and brands of topical steroids available in New Zealand that vary in potency from mild to very potent. Read more about the different types of topical steroids and formulations

How should I apply a topical steroid?

  • how to apply steroid creamUse topical steroids as instructed by your doctor, who will explain where, how frequently and for how long to apply the medication.
  • Creams or ointments are rubbed gently into the affected skin, until it has disappeared.
  • The amount of topical steroid that you should apply is commonly measured by fingertip units (FTUs),
  • One FTU is the amount of topical steroid that is squeezed out from a standard tube along an adult's fingertip (the distance from the tip of the adult index finger to the first crease). This should cover the area shown by your two palms as shown.
  • View a useful video – see video in right column. Read more about fingertip units (DermNet NZ).
  • In some instances, your doctor may ask you to use plastic to cover treated areas. Covering the treated area with plastic after applying a topical steroid increases the absorption of the steroid, but may also increase side effects. Therefore it is recommended mainly in areas of very thick skin such as the palms of the hand and soles of the feet.  

Possible side effects

Like all medicines, topical steroids can cause unwanted side effects, although not everyone gets them. 

Side effectsWhat should I do?
  • Burning or stinging feeling 
  • This is common when you first start applying the treatment
  • It usually improves as your skin gets used to the treatment
  • Tell your doctor if this feeling continues
  • Thinning of the skin
  • This tends to occur commonly with the potent or very potent topical steroids, and if a plastic covering is used
  • It is less likely to occur with the mild or moderate topical steroids
  • If it does occur, it often reverses when the treatment is stopped
  • Tell your doctor 
  • Permanent stretch marks
  • Bruising
  • Discolouration
  • Thin spidery veins
  • These tend to occur with long-term use of topical steroids
  • Tell your doctor if troublesome
  • May cause or worsen other skin conditions such as acne
  • Tell your doctor

Learn more

Topical steroids DermNet NZ
Topical corticosteroids available in New Zealand (prescription only) BPAC, NZ, 2009
Topical steroids for eczema Patient Info, UK

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ Last reviewed: 15 Jul 2015