Have you ever used corticosteroids ointments❓❓❓

Topical glucocorticoid is a very commonly used topical drug. Some people think that it is a panacea that can cure skin diseases such as itching, redness and swelling. However, some people refuse to use it because it contains steroids. The following are some practical knowledge about topical glucocorticoids.

1. Classification and intensity.

According to the different types and concentrations of glucocorticoids, topical glucocorticoids can be divided into 4 categories: super strong, strong, medium and weak. The same glucocorticoid has different strengths at different concentrations.

Commonly used topical glucocorticoids
Super strong	Clobetasol propionate	0.02%	1.    It is suitable for severe and hypertrophic skin lesions. 2.      Not for use in children <12 years old. 3.    Do not use on soft skin area. 4.    Long-term use in a small area. 5.    Do not exceed 50g per week. 6.    Continuous medication should not exceed 2-3 weeks. 7.    * They can be used with caution in children.
	Betamethasone valerate	0.1%
	Halometasone	0.05%
	Halcinonide	0.1%
	Fluocinolone	0.2%
Strong	Beclomethasone dipropionate	0.025%
	Betamethasone valerate	0.05%
	Fluocinolone	0.025%
	*Fluticasone propionate	0.05%
	*Mometasone furoate	0.1%
Medium	Prednisolone acetate	0.5%	1.    Suitable for mild to moderate skin lesions. 2.    It should not be used for a long time in a large area. 3.    It can be applied continuously for 4-6 weeks. 4.    Children <12 years old try not to use it continuously for more than 2 weeks.
	Dexamethasone acetate	0.05%
	Clobetasone butyrate	0.05%
	Hydrocortisone butyrate	1%
	Triamcinolone acetonide	0.025%
	Fludrocortisone acetate	0.025%
	Fluocinolone acetonide	0.01%
Weak	Hydrocortisone acetate	1%	1.    Suitable for mild to moderate skin lesions. 2.    Apply to the soft skin areas. 3.    Suitable for children <12 years old. 4.    It can be used in a larger area in a short time. 5.    It can be used for a long time if necessary.
	Methylprednisolone acetate	0.025%
	Desonide	0.05%
	Fluocinolone acetonide	0.0025%

Although fluticasone propionate and mometasone furoate are both strong glucocorticoids, they are less absorbed throughout the body when used externally. They are suitable for use by the elderly, infants and in a large areas.

2. The choice of topical glucocorticoids in various populations.

Children and the elderly: It is advisable to choose weak glucocorticoids, and use strong and super strong types with caution.

Pregnant women: Glucocorticoids should be used with caution in pregnant women. Weak or medium types can be selected when they must be used.

Soft skin areas: The face, neck, armpits, groin, inner thighs, perineum and other soft skin areas have a high drug absorption rate, so strong glucocorticoids should not be used. When it must be used, desonide, mometasone furoate and hydrocortisone can be used.

Ointment: The ointment dosage form has an encapsulating effect, which enhances the drug penetration ability. Ointment is suitable for keratinized, hypertrophic and desquamative skin, especially palms and soles. It is not recommended for non-hypertrophic, keratinized skin lesions on soft skin areas such as the face. Ointment should not be used in skin areas where babies wear diapers.

Creams, gels and solutions: They are suitable for all kinds of skin lesions and are also suitable for thick hair areas.

3. Indications.

Dermatitis, eczema, papular urticaria, erythema scaly skin disease, autoimmune skin disease, etc.

4. Contraindications.

Impetigo (bacterial infection), tinea hand and foot (fungal infection), shingles (viral infection), rosacea, acne, skin ulcers, etc. It is also not suitable for acute urticaria. The redness and itching caused by acute urticaria should be relieved with appropriate antihistamines (such as cetirizine, loratadine).

5. Dosage:

The most commonly used method for estimating the amount is the "fingertip unit"(FTU).

FTU: It refers to the amount of ointment squeezed from the ointment tube (with a diameter of 5mm) to an adult's fingertip (from the end of the index finger to the horizontal line of the first knuckle joint). A fingertip unit is about 0.5g ointment.

Estimate the skin area with the palm of your hand, and then calculate the FTU based on the area. Use about 0.5 FTU per palm area.

6. Adverse reactions.

The correct use of topical glucocorticoids is relatively safe. Long-term or large amounts of topical glucocorticoids may induce or aggravate local infections, leading to skin atrophy, telangiectasia, hirsutism, pigment changes, hormone dependence and other adverse reactions.

Patients should actively monitor for adverse reactions: The strong and super strong types are once every 2 weeks, the medium types are once every 3-4 weeks, and the weak types are once every 4-6 weeks.