Steroid Creams for Skin: Safe Use, Risks, and Benefits

Topical steroids: What they are and how they work

Topical steroids, also called topical corticosteroids, are used to treat a variety of inflammatory skin conditions such as rashes, insect bites, eczema, psoriasis, and more.

While these medications can be very effective in relieving inflammation, irritation, and redness, long-term use can cause serious side effects.

It is important to understand when and how to best use topical steroid creams to get the benefits and minimize the side effects.

Steroid creams are typically used for short-term relief of redness, itching, and swelling.

Long-term use of topical steroids can cause side effects such as thinning of the skin, dry skin, perioral dermatitis, and withdrawal symptoms.

Talk to your doctor or dermatologist about the proper use of topical steroids to minimize side effects.

What are topical steroids?

Topical steroids are medications that are applied to the skin to relieve inflammation, redness, and itching.

They mimic cortisol, a hormone that the body produces naturally in response to inflammation.

By mimicking the anti-inflammatory properties of cortisol, topical steroids can help calm an overactive immune response in the skin and reduce redness, swelling, itching, and discomfort.

These medications are applied directly to the skin and work locally, rather than affecting the entire body like oral steroids.

Topical steroids vary in effectiveness, from mild (like 1% hydrocortisone) to very strong (like clobetasol propionate), and come in a variety of formulations, including creams, ointments, and gels.

Common topical steroids

There are many types of topical steroids, but the most commonly used include:

Hydrocortisone. A mild corticosteroid that is often used to temporarily relieve itching and inflammation caused by minor skin irritations, such as rashes and insect bites.

Hydrocortisone is available over the counter, but stronger hydrocortisone requires a prescription.

Dexamethasone. A mild corticosteroid that is often used to treat sensitive areas, such as the face or groin.

Dexamethasone is often used to treat mild to moderate eczema, dermatitis, or allergic reactions.

Fluocinolone acetonide. A low- to medium-strength corticosteroid used to treat conditions such as eczema, psoriasis, and seborrheic dermatitis.

Betamethasone. A medium- to high-potency corticosteroid used to treat conditions such as psoriasis, eczema, and lichen planus.

Betamethasone is often used to treat moderate skin conditions that don’t respond to milder steroids.

Clobetasol. Clobetasol is one of the most potent topical steroids and is used to treat more severe psoriasis, lichen planus, and lupus.

What are topical steroids used for?

Topical steroids can be used to treat a variety of inflammatory skin conditions. However, they are not usually used as a long-term treatment because they can have side effects.

In the short term, steroid creams can help relieve inflammation-related symptoms such as redness, swelling, and itching.

Skin conditions that topical steroids can help treat include:

Eczema (atopic dermatitis)

Psoriasis

Contact dermatitis

Seborrheic dermatitis

Lichen planus

Vitiligo

How do topical steroids work?

Topical steroids specifically target inflammation of the skin, which is the cause of the redness, swelling, and itching seen in many skin conditions.

These medications penetrate the outer layer of the skin and reach deeper into the skin, reducing the release of pro-inflammatory substances such as cytokines and prostaglandins that cause swelling and irritation.

Topical steroids not only modulate the immune system, but they also constrict the small blood vessels in the skin, which reduces blood flow to the inflamed area.

This helps to relieve the redness and warmth that often accompanies skin inflammation.

In conditions such as psoriasis, topical steroids can also slow the overproduction of skin cells, which prevents the formation of the thick, scaly patches that are characteristic of the disease (3).

Side effects of topical steroids

While effective, topical steroids can have side effects, especially if used incorrectly. These include:

Thinning of the skin.

Long-term use of steroid creams can make the skin thinner and more sensitive because the drugs impair collagen production and the skin’s ability to retain moisture.

Stretch marks. Prolonged use in certain areas, such as the thighs or armpits, can lead to a loss of skin elasticity and thickness, which can cause stretch marks.

Perioral dermatitis. Excessive use of steroid creams in the oral area can disrupt the skin barrier and cause inflammation, leading to a red, pinpoint rash called perioral dermatitis.

Topical steroid withdrawal (TSW). Sudden discontinuation of topical steroid use after long-term use can trigger what is known as topical steroid withdrawal symptoms.

Redness, irritation, and other symptoms of inflammation may return or even worsen.

Increased susceptibility to infection. Steroids can suppress the skin’s immune system, which can promote the growth of bacteria and fungi.

Using topical steroids

Proper use of topical steroids is essential to maximize their benefits and minimize potential side effects. Always taper your dose of a potent steroid gradually rather than stopping it abruptly.

Your doctor can help you avoid withdrawal symptoms.

If possible, avoid long-term use of topical steroids to minimize side effects.

Mild steroids, such as hydrocortisone, can usually be used for 1 to 2 weeks without side effects, while stronger steroids, such as clobetasol, are usually only used for short periods of time unless otherwise prescribed by your doctor.

Apply steroid creams as directed by your doctor, or 1 to 2 times daily if you are using an over-the-counter cream or ointment.

To determine the correct amount of product to use, use the fingertip rule (FTU): Apply enough cream or ointment to the skin to reach from the tip of your index finger to the first joint.

This amount is enough for two palm-sized areas.

Also, be sure to maintain your daily skin care routine while using topical steroids, unless otherwise directed by your doctor.

A skin barrier repair moisturizer can help maintain the strength and integrity of the skin barrier while using a steroid cream.

Alternatives to topical steroids

If your doctor has prescribed topical steroids for a specific purpose, use them.

However, if you’re looking for an alternative to steroids to relieve minor symptoms of skin inflammation without the side effects of long-term steroid use, consider these anti-inflammatory skin care products.

Summary: Are topical steroids good or bad?

Topical steroids can be very helpful if prescribed and used correctly. They can quickly relieve symptoms of conditions like eczema and psoriasis, making life more pleasant.

However, they’re not usually suitable for long-term use or as a one-size-fits-all solution.

If you’ve been prescribed topical steroids, be sure to follow your doctor’s instructions to minimize side effects like thinning skin or withdrawal symptoms.

While these medications can relieve symptoms, they are not a cure for inflammatory skin conditions and should be used as part of a more comprehensive skin care plan tailored to your skin’s specific needs.

DQH Knowledge drop: In your 20s, your skin cell turnover decreases. (Cell turnover is a key component in keeping your skin youthful.) You know what else slows down? Your collagen production. Starting in your 20s, collagen decreases by about 1 percent per year. Should you want to prevent fine lines and wrinkles, start by eliminating behaviors that contribute to premature aging. “If it’s bad for you, it’s bad for your skin,” says dermatologist Michel Somenek. “Cigarette smoking reduces blood flow to the skin and causes premature wrinkling and a dull skin texture. Making the repeated pursed motion to inhale can also cause smoker’s lines. Alcohol and recreational drugs are toxins for the skin that damage its cellular structure and DNA,” Somenek tells us. “The faster you eliminate vices while you are young, the better chance your skin and body have to recuperate.” Also, adopting an anti-aging routine in your 20s is key. After all, the best offense is a good defense. We spoke to Somenek and experts Joshua Ross and Audrey Kunin to find out more. Keep reading for the best anti-aging products for your 20s, according to skincare professionals. Sunscreen “We all know that the sun is the number one cause of skin aging and starting the prevention in your 20s is very important,” Ross says. “The majority of your sun damage won’t start to appear until you’re in your 30s, so don’t wait until you see it surface or you’ll be behind the curve. Stay ahead of it with a good-quality zinc-based sunscreen worn daily.” Farmacy Green Defense Daily Mineral Sunscreen An invisible sunscreen with SPF 30, plus botanical extracts meant to protect skin with tons of antioxidants. Bonus: It’s clean and fine to use under makeup. Bareminerals Complexion Rescue™ Tinted Moisturizer Broad Spectrum SPF 30 Although we recommend you use your SPF and moisturizer separately, we also understand moments when you don’t have time or energy for that extra step. For those times, this bareMinerals moisturizer is a great thing to have on hand. Vitamin C Serum “A great introduction to anti-aging is to start with a vitamin C serum in your morning skincare routine,” Ross says. “It’s a powerful antioxidant that will neutralize free radicals and brighten the skin.” He adds that it’s a great way to counteract the effects of the sun’s harmful rays, which, as previously mentioned, are among the biggest causes of premature aging. Drunk Elephant C-Firma™ Vitamin C Day Serum The Drunk Elephant C-Firma is a lightweight serum that promises to give skin a glow by combining the brightening powers of vitamin C with ferulic acid, l-ascorbic acid, and vitamin E. The included sodium hyaluronate is meant to replace hydration loss, so you shouldn’t have to deal with any irritation. Sunday Riley C.E.O. Rapid Flash Brightening Serum This potent serum is jam-packed with vitamin C (15 percent, to be exact), which means it’s a potential superstar at both brightening skin and dousing it in antioxidants. Peptides Using peptides on your skin has many benefits, says Somenek. “The skin barrier is what defends the body against pollution, UV rays, bacteria, and toxins. It can be damaged by several everyday factors. Using topical peptides aids in building a stronger barrier,” he says. “Peptides comprise elastic fibers, which are a type of protein. These fibers help to make skin appear taut and firm. Peptides can also help repair damaged skin, relieve inflammation, and even out skin tone. Some peptides can kill acne-causing bacteria that is common in 20-somethings.” Kunin agrees, saying, “Peptides are an excellent entry point for supporting collagen.” She recommends looking for face and eye treatments that contain these collagen-boosting powerhouses. Charlotte Tilbury Magic Eye Rescue Cream This Charlotte Tilbury super-emollient eye cream has a base of coconut oil and shea butter (read: it’s incredibly hydrating). Botanicals plus peptides are meant to help reduce dark circles and boost collagen, respectively. This creamy moisturizer serves up potent collagen-boosting peptides and pycnogenol, and antioxidant-rich vitamin C. “Instead of sitting on top of the skin, peptides penetrate the outer layer so they go deep. The ‘signals’ they send tell the cells to produce elastin and collagen, which are needed for youthful-looking skin,” explains Somenek. At-Home Peel Pads Remember that skin cell turnover fiasco we talked about earlier? One way to help support it is by exfoliating. “Exfoliation is important to help keep skin fresh and luminous,” Kunin says. She recommends using at-home peel pads as an easy and effective way to exfoliate. “The goal in your 20s is to fight the slowing pace of cell turnover. It is wise to use products that gently exfoliate, yet still remove oil and other impurities. Products that have Alpha Hydroxy Acids (AHA) or Beta Hydroxy Acids (BHA) are a good choice.” According to Somenek, you should only exfoliate two to three times a week. “People of all ages are guilty of over-exfoliating and that can be too much of a good thing,” he says. Dermadoctor Kakadu C Intensive Vitamin C Peel Pad A few swipes of this Derma Doctor powerful peel pad promise to leave your skin glowing and smooth, thanks to the seven (yes, seven) types of chemical exfoliants, including AHA and BHA. It also contains vitamin C via Kakadu plum extract for added brightening and antioxidant protection. KEY INGREDIENTS Kakadu plum extract is sourced from the Kakadu plum, a fruit grown in northern Australia. It contains vitamin C, which restores the skin’s natural barrier, increases collagen production, and soothes irritation. Dr. Dennis Gross Skincare Alpha Beta® Universal Daily Peel Pads These are the gold standard of peel pads, with a cult following and over 900 five-star reviews on Sephora. They’re easy to use and contain a blend of anti-aging exfoliating acids. Emollient Night Cream “In your 20s, you need to start upping the hydration in your skincare routine. You may have been cautious of over-moisturizing because of acne in your teens, but as you enter your 20s, your skin transitions and becomes drier,” Ross says. “I recommend an emollient night cream added into your evening skincare regimen.” “Twenty-somethings need to make sure that they are not using creams that will clog their pores and cause excess oil production,” says Somenek. Opt for non-comedogenic products. Cerave Skin Renewing Night Cream One great choice is the CeraVe Skin Renewing Night Cream, which is a non-comedogenic night cream that leaves skin soft and glowy. It combines the moisturizing powers of ceramides and hyaluronic acid. RoC Retinol Correxion Max Hydration Creme “The best night cream ingredients contain retinol, benzoyl peroxide, and/or salicylic acid or hyaluronic acid. The goal is to moisturize, yet remove excess oil,” says Somenek. This Roc Retinol Correxion cream fits the bill as it contains both hyaluronic acid and retinol so it promises to moisturize while also being non-comedogenic.

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