Topical glucocorticoids

Topical Glucocorticoids

A tube of hydrocortisone cream

Topical glucocorticoids, also known as topical corticosteroids, are medications applied to the skin to reduce inflammation and treat a variety of dermatological conditions. These medications are derivatives of the hormone cortisol and are used to manage conditions such as eczema, psoriasis, and dermatitis.

Mechanism of Action

Topical glucocorticoids work by mimicking the effects of cortisol, a hormone produced by the adrenal glands. They exert their effects by binding to glucocorticoid receptors in the skin, leading to a reduction in the production of inflammatory mediators such as prostaglandins and leukotrienes. This action results in decreased inflammation, redness, and itching.

Classification

Topical glucocorticoids are classified based on their potency, which ranges from mild to very potent. The classification is as follows:

• Mild: Hydrocortisone
• Moderate: Clobetasone butyrate
• Potent: Betamethasone valerate
• Very potent: Clobetasol propionate

The choice of potency depends on the severity of the condition, the area of the body being treated, and the age of the patient.

Indications

Topical glucocorticoids are indicated for a variety of inflammatory skin conditions, including:

• Eczema
• Psoriasis
• Contact dermatitis
• Seborrheic dermatitis
• Lichen planus

Side Effects

Purpura, a possible side effect of topical glucocorticoids

While effective, topical glucocorticoids can cause side effects, especially with prolonged use. Common side effects include:

• Skin thinning (atrophy)
• Stretch marks (striae)
• Purpura
• Telangiectasia

Systemic absorption can occur, leading to more serious side effects such as adrenal suppression and Cushing's syndrome.

Special Considerations

When prescribing topical glucocorticoids, it is important to consider the following:

• Site of application: Areas with thinner skin, such as the face and groin, are more susceptible to side effects.
• Duration of use: Long-term use should be avoided to minimize the risk of side effects.
• Patient age: Children are more sensitive to the effects of glucocorticoids and may require lower potency formulations.

Complications

Cataract, a potential complication of systemic absorption

In rare cases, systemic absorption of topical glucocorticoids can lead to complications such as:

• Cataracts
• Glaucoma
• Adrenal insufficiency

Related Pages

• Corticosteroid
• Dermatology
• Inflammation