frequency of administration and duration of treatment of a topical corticosteroid

Last reviewed 09/2021

Generally, once or twice daily application is recommended for most topical steroids regardless of the potency (1)

  • more frequent applications may be necessary in skin with thick stratum corneum
  • intermittent scheduling (e.g. - every other day, weekends only) can be used as maintenance therapy of chronic conditions
  • very potent or potent preparations should be managed by dermatologists (2)
  • nonmedicated emollient creams or ointments can be used daily as a substitute during drug free intervals (1)

Topical steroids are generally used in short bursts to treat exacerbations of a disease so the duration of treatment is generally between 3 - 7 days (3)

  • regular use for more than four weeks is not recommended for any topical corticosteroid without review
  • use of potent preparations regularly for more than 7 days should be avoided (2)
  • repeat prescriptions should be under supervision and the patient should be reviewed regularly (2)
  • tolerance and tachyphylaxis may occur in response to chronic use of topical steroids (4)

Clinicians should attempt to alternate between topical corticosteroids and non-corticosteroid preparations (2). In patients who do not have improvement of symptoms after 3-7 days, diagnosis should be reassessed and the following conditions should be considered as the cause

  • infection
  • hypersensitivity reaction to the base or the steroid
  • non compliance of the patients due to the concerns about side effects of steroids
  • tolerance or tachyphylaxis - alternative steroids with the same potency can be used in these patients (3)

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