How do I apply topical steroids?

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Topical steroids are usually applied once a day (sometimes twice a day - your doctor will advise). Rub a small amount thinly and evenly just onto areas of skin which are inflamed. (This is different to emollients which should be applied liberally all over.)

To work out how much you should use each dose: squeeze out some cream or ointment from the tube onto the end of an adult finger - from the tip of the finger to the first crease. This is called a 'fingertip unit'. One fingertip unit is enough to treat an area of skin twice the size of the flat of an adult's hand with the fingers together. Gently rub the cream or ointment into the skin until it has disappeared. Then wash your hands (unless your hands are the treated area).

Note: Dont forget to use emollients as well when you are using a course of topical steroids. (Wait 30-60 minutes after you apply the steroid before applying emollients or vice versa.)

What about side-effects of topical steroids?

Short courses of topical steroids (less than four weeks) are usually safe and usually cause no problems. Problems may develop if topical steroids are used for long periods, or if short courses are repeated often. The concern is mainly if strong steroids are used long-term. Side-effects from mild topical steroids are uncommon.

Thinning of the skin is the most common possible problem. If skin thinning occurs it often reverses when the topical steroid is stopped.
With long-term use of topical steroid the skin may develop permanent striae (like 'stretch' marks), bruising, discolouration, or thin spidery blood vessels (telangiectasia).
Topical steroids may trigger or worsen other skin disorders such as acne, rosacea and perioral dermatitis.
Some topical steroid gets through the skin and into the bloodstream. The amount is usually small and usually causes no problems unless strong topical steroids are used regularly on large areas of the skin. The main concern is with children who need frequent courses of strong topical steroids. The steroid can have an effect on growth. Therefore, children who need repeated courses of strong topical steroids should have their growth monitored.