Topical corticosteroids are steroid medications compounded in a formulation for topical use, where they are applied directly to the skin instead of taken orally. A doctor may prescribe them for the treatment of skin conditions, pain, and inflammation. Most pharmacies stock a range of them in their prescription products, and it is also possible to buy very mild topical corticosteroids without the need for a prescription.
Steroid medications boost the levels of compounds the body normally produces in its adrenal gland. They reduce inflammation and tend to suppress the immune system so it does not react as powerfully to the presence of infection or irritation. These medications can be dangerous in the long term because they disrupt hormone levels and cause potentially serious side effects. Doctors are typically careful about prescribing steroids, because they want to limit risks to their patients.
In the case of topical corticosteroids, the dose can be very low, because the patient applies the drug directly to the area of interest. The drug also bypasses the digestive tract, and thus is less likely to cause systemic side effects because it doesn't pass through the kidneys and the liver. This makes topical corticosteroids much safer for use than oral or injectable medications, and it may be possible to use them longer than other medications, as the cumulative effect will build up slowly over time.
These medications are not risk free. Some patients may experience more inflammation and irritation after using topical corticosteroids, and can develop skin rashes and other problems. Skin thinning is also a documented problem with many drugs, especially if the patient uses them for a long time, and this can increase the risk of ulceration and infection. Patients on topical corticosteroids can also experience immune depression and may not be as able to fight infections.
Directions for use of topical corticosteroids are usually standardized. The drug can come in a cream, ointment, or gel, and the user will need to apply it to clean, dry skin. Some drugs have applicators that can be used to smear an even layer of medication onto the affected area. The medication must be allowed to completely absorb, and users should wash their hands after applying their topical corticosteroids to limit absorption through the fingers. The medication needs to be kept in a cool, dry place, out of reach of other members of the household. Discolored or malodorous medications should be discarded.