Allergic sensitivity to topical corticosteroids is usually only picked up when an eczematous dermatitis being treated by a topical corticosteroid fails to respond to treatment or worsens. In cases of persistent or exacerbating dermatitis treated with corticosteroid preparations, corticosteroid sensitivity should be considered. However, it may also be due to irritation from or allergy to other components of the preparation such as preservatives . Lanolin , ethylenediamine , quaternium-15 and the antibacterial agent neomycin , are all known to be potent sensitisers.
Topical corticosteroids are available in a wide range of different strengths, from Class 1 (very strong) to Class 7 (very weak). Stronger corticosteroids are generally more effective in reducing moderate to severe symptoms, such as thick, chronic plaques, but are also more likely to cause side effects 2 . Lower strength corticosteroids are generally better for milder symptoms and for very sensitive areas of the body (such as the face or groin areas) and stronger strengths are better for areas with thicker skin (such as the knees and elbows).
There is no evidence of safe and effective use of topical corticosteroids in pregnant mothers. Therefore, they should be used only if clearly needed. Long term use and large applications of topical corticosteroids may cause birth defects in the unborn. It is not known whether topical corticosteroids enter breast milk. Therefore, caution must be exercised before using it in nursing mothers. Topical corticosteroids should not be applied to the breasts of nursing mothers unless the mothers instructed to do so by the physician.