Topical corticosteroids ("steroids") are commonly for the treatment of psoriasis.
They are generally prescribed for use once or twice a day to help control a psoriasis flare.
Corticosteroids should not be used for long periods of time. Always use your medication exactly as prescribed by your doctor.
Corticosteroids come in various strengths, ranging from very weak (Class 7) to superpotent (Class 1). Low-potency corticosteroids may be prescribed to treat areas with thin skin, such as the face, groin and breasts. More potent corticosteroids are generally used on thicker skin, such as the knees and elbows. Stronger corticosteroids tend to be faster and more effective at clearing psoriasis lesions, but they must be used more cautiously because they have a greater risk of causing side effects.
Though they may be used alone to treat mild flares of psoriasis, topical corticosteroids are usually combined with other psoriasis treatments in moderate to severe cases.
- Topical medications. Corticosteroids may be used with other topical medications such as anthralin, coal tar, calcipotriene (Dovonex®), tazarotene (Tazorac®), and salicylic acid. In fact, they may reduce the skin irritation caused by some of these other medications.
- Phototherapy. Corticosteroids can be applied to the skin of those undergoing phototherapy, such as PUVA.
- Systemics. Corticosteroids may be prescribed in combination with systemic medications, including methotrexate, cyclosporine, acitretin (Soriatane®) and biologics (Enbrel®, Humira®, Remicade®, Stelara®).
Side Effects of Corticosteroids
Side effects are more likely to occur from the use potent corticosteroids or as a result of corticosteroids being applied to thin skin. Potential side effects include the following:
- skin thinning (atrophy)
- lightening or darkening of the skin
- easy bruising
- stretch marks
- dilated surface blood vessels.
Some of the side effects may go away after the medication is stopped, but other changes may be permanent.
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