Corticosteroid ointment: benefits, dosage, rules of use, and side effects

Inflammation of the skin will make it feel uncomfortable. Well, one way to deal with this skin disease is by giving corticosteroid creams or ointments. Actually what is a corticosteroid drug? Is it safe if used continuously?

Function of corticosteroid creams and ointments

Corticosteroids are a class of drugs to stop the inflammatory process, aka inflammation in the body. Corticosteroids work like cortisol, a hormone produced by the body's adrenal glands, by constricting blood vessels and suppressing overreaction of the body's immune system.

The corticosteroid class of drugs is also often referred to as steroids. Corticosteroid drugs are also available in various forms, ranging from oral drugs (drinking), topical / topical (cream, lotion, gel, or ointment), and systemic (infusion or injection).

Topical corticosteroid drugs in the form of creams or ointments are the most commonly prescribed to treat various symptoms of skin diseases.

Of course, there is a difference between a corticosteroid ointment and a corticosteroid cream. The ointment is an oil or fat-based topical medication that contains synthetic steroid hormones. The high concentration of oil makes the ointment feel stickier and last longer on the skin.

Corticosteroid creams are made with a water-based ingredient. Due to this, the cream gets absorbed into the skin more quickly and does not leave a sticky sensation after application. Creams also work better on larger areas of skin because they are easier to apply.

The choice of use is also adjusted by skin conditions. Ointments are more suitable for use on dry, crusted, or thickened skin. Ointments are also appropriate for calluses on the soles of the feet.

Meanwhile, the cream form is more suitable for use on parts of the skin that are more moist, wet, and hairy.

Some types of skin diseases that can be treated with corticosteroid creams or ointments include:

• dermatitis,
• psoriasis,
• skin irritation such as hives or from insect bites,
• skin disease complications of lupus (discoid lupus),
• allergic reactions, as well
• Linchen planus.

Corticosteroid creams and ointments can help relieve the swelling, itching, and redness that is often a symptom of the above skin problems.

Classification of potential topical corticosteroids

This topical drug has a dosage level from low to high, which will be measured by the doctor as needed.

The classification of the potency of a topical steroid drug is based on the dose or amount of its main steroid content, such as fluocinonide, halobetasol, or hydrocortisone, which is determined by a special test.

This test will measure the effect of narrowing of the blood vessels in the upper epidermal layer after using the drug.

Reporting from DermNet, below are the potential levels of corticosteroid ointments and creams ranging from the weakest to the strongest along with the types of drugs.

• Mild. You can buy mild corticosteroids over-the-counter without a doctor's prescription. Some of the drugs are hydrocortisone and hydrocortisone acetate.
• Moderate. Moderate steroids can work 2 - 25 times stronger than mild corticosteroid ointments. Drugs that fall into this category are clobetasone butyrate and triamcinolone acetonide.
• Potent. This drug has a strength of 100 - 150 times greater than the weakest corticosteroid. Medications include betamethasone valerate, betamethasone dipropionate, diflucortolane valerate, and mometasone fuorate.
• Very potent. Drugs with this potency 600 times more potent than mild corticosteroid drugs. One type of drug is clobetasol propionate.

Corticosteroid ointments with a stronger potency of steroids are used to control very severe symptoms of dermatitis. However, the thicker parts of the skin such as the soles of the feet are usually more difficult to absorb topical drugs so that a stronger potency of steroids is needed.

Medicines with strong steroid content are usually given only by prescription and used under a doctor's supervision.

Groups of people who may use topical corticosteroids

This topical medicine is actually safe for use by anyone who has skin problems, from children to the elderly. However, its use is not recommended if your skin has open sores or shows signs of infection (ulcers accompanied by pus).

Corticosteroid ointments should not be used carelessly for skin with acne.

Steroid creams and ointments are safe for use by pregnant women and those who are breastfeeding. However, not in high doses with any kind of potency. Babies are also not allowed to use steroid ointments which are potent because their skin tends to absorb the drug more easily.

If you feel the need to prescribe steroid creams or ointments for pregnant women, breastfeeding mothers, or babies, doctors will usually provide a low dose of the drug with a potency that is not too strong.

If you are a breastfeeding mother and will apply the drug to the breast area, make sure the drug is completely absorbed and the skin is completely clean and dry from the rest of the drug before breastfeeding.

How to use corticosteroid creams and ointments

Corticosteroid ointments and creams are safe for use by children and adults as long as they follow the instructions recommended by the doctor.

The following points on how to use topical steroid ointments or creams for skin diseases that you need to pay attention to.

• Apply the drug only to the affected skin; should not be used as a full body moisturizer.
• Apply about three minutes after bathing in a condition where the skin is still damp (half dry).
• If you are prescribed another type of topical medication, such as an emollient, allow about 30 minutes between applications of the two drugs.
• Medicines should not be used continuously in the long term.

Usually this topical drug is used for 5 days or several weeks until the characteristics of skin disease begin to resolve. If nothing changes, usually the doctor will increase the dose to a higher than before.

Follow your doctor's instructions when you stop using corticosteroid ointments or creams. Under certain conditions, it is necessary to discontinue topical corticosteroids slowly to avoid unwanted side effects. Wrong, in fact, the condition of the skin that has improved is getting worse.

Risk of side effects of long-term use of steroid ointments and creams

In fact, corticosteroid ointments and creams rarely cause side effects when you really use them according to the rules or doctor's supervision. However, long-term use can create problems that are often unavoidable.

In general, below are the possible side effects of corticosteroid ointments.

• Thinning of the skin. Especially if the drug is in high doses and is used in the same area continuously, as a result, the skin tissue underneath will be weakened.
• Cushing syndrome. This syndrome occurs when the hormone cortisol has an abnormal increase. Cushing's syndrome causes a buildup of fat between the neck and shoulders and makes the face appear round.
• Stretch marks (striae). Especially on the inner groin, inner leg, elbows, elbows and knees.

Some other side effects such as acne, folliculitis or loss of skin hair follicles, and addiction to steroids can also occur, but are not very common.

However, in rare cases, this cream can cause:

• aggravate the skin infection that occurs,
• cause acne,
• changes skin color, usually becomes darker, as well
• areas of skin turn red.

In children, it is possible for the corticosteroid ointment to be absorbed into the bloodstream and cause growth-inhibiting side effects.

It is important to remember that corticosteroid treatment is safe when administered according to the dosage and within the prescribed timeframe. Side effects are more likely to occur if you use high doses of corticosteroid ointments or creams or if you use them for a long time.

These side effects will be at a higher risk of occurring in elderly people and children. Therefore, it is better to first discuss with your dermatologist about the side effects that may occur before using it.