Over the coming year, topical steroids will be labelled with their potencies to aid correct selection and to simplify the advice to patients requiring multiple steroid products of differing potencies. These will be labelled ‘mild steroid’, ‘moderate steroid’, ‘strong steroid’, and ‘very strong steroid’.
Topical steroids are highly effective for the treatment of inflammatory skin conditions such as psoriasis, when prescribed and used appropriately. They are available in different potencies:
- mildly potent (for example, hydrocortisone)
- moderately potent (for example, clobetasone)
- potent (for example, betamethasone)
- very potent (for example, clobetasol) The lowest potency topical steroid for effective treatment should be used and this may mean using different potency products for different body areas.
Adverse reactions have been reported following long-term (generally 6 months or more) use of moderate or stronger potency topical steroids, particularly when used for eczema treatment – these reactions are often referred to as ‘Topical Steroid Withdrawal Reactions’ (TSW)
The risk of these and other serious reactions increases with prolonged use of higher potency steroid products.
Healthcare professionals are being advised to counsel patients when prescribing or dispensing topical steroids, advise on the amount of product to apply, how often, where to apply it and when to stop treatment. If previous discontinuation was associated with reactions that raise suspicion of TSW, alternative treatments should be considered. It is also advised that support to patients living with symptoms of TSW should be provided along with a treatment plan review.
Source:
GOV.UK alert
29 May 2024