Topical Steroids
Topical steroids (also known as corticosteroids) which are applied to the skin are the most widely used treatment for psoriasis. There are many different types of topical steroids used to treat psoriasis and they are available in different strengths. This means that your healthcare team can choose an appropriate strength depending on the severity of your psoriasis and its position on your body.
How do they work?
Topical steroids have an anti-inflammatory action. This means that they reduce the swelling, irritation and redness associated with psoriasis
When are they used?
Topical steroids are generally used if your psoriasis is mild or limited to small areas of the body such as the knees and elbows.
Strong topical steroids may be used on the trunk of the body, the limbs, the palms of the hands, the soles of the feet and on the scalp. Milder topical steroids can be used on the face and sensitive areas, such as under the arms.
How are they administered?
Topical steroids are applied directly to the surface of the skin. The number of times per day you have to apply your topical steroid will vary depending on the type of steroid you are using. Your healthcare team will advise you how often your topical steroid should be applied. Usually topical steroids need to be applied between one and three times daily for 2–4 weeks.
The short duration of treatment also minimises the risk of your psoriasis becoming tolerant to treatment, that is, it becomes less effective.
The finger tip unit (FTU) is used to judge how much topical steroid is needed. One FTU is the length between the tip of your finger and your first joint.
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The number of FTUs to use varies depending on the area of your body that needs to be treated and your size. In adults, for example, two fingertips of cream will typically cover both hands or one foot.
In children, the number of FTUs to use will depend on the child’s size. Please ask your healthcare team if you are unsure of the amount of topical steroid you or your child should be using. It is important to apply your topical steroid correctly to your skin. This will improve the likelihood of the treatment working effectively.
Tips for applying topical steroids
- Wash your hands before and after applying
- If you are also applying an emollient, leave at least 30 minutes between application of the emollient and the topical steroid.
Advantages and disadvantages
There are many different types of topical steroid available so your healthcare team will be able to choose one that is appropriate for you to use.
Topical steroids can cause irritation, burning, stinging, redness and thinning of the skin and are only recommended for short-term use. Once treatment with topical steroids has stopped, psoriasis can return and may be more severe than before. You may also develop tolerance to the topical steroid you are using, that is, your treatment may start to lose its effect.
If you have any questions about topical steroids, you may want to discuss them with a member of your healthcare team.