Weaker topical steroids are utilized for thin- skinned and sensitive areas, especially areas under occlusion, such as the armpit, groin, buttock crease, breast folds. Weaker steroids are used on the face, eyelids, diaper area, perianal skin, and intertrigo of the groin or body folds. Moderate steroids are used for atopic dermatitis , nummular eczema , xerotic eczema , lichen sclerosis et atrophicus of the vulva , scabies (after scabiecide) and severe dermatitis . Strong steroids are used for psoriasis , lichen planus , discoid lupus , chapped feet, lichen simplex chronicus , severe poison ivy exposure, alopecia areata , nummular eczema, and severe atopic dermatitis in adults. 
As a result of this, expert panels are reluctant to endorse topical steroids being sold over-the-counter. They fear that parents wouldn't understand the risks when buying the drugs to use at home. While in most cases the effects of topical steroids on the HPA axis means only the child is at minimal risk, if they undergo a stressful physiologic (rather than psychologic) event such as trauma, surgery, or serious infection, they might have life-threatening complications. The effects on the HPA axis are reversible and usually return to normal within weeks.
Alternative creams that can be used on the face include the Elidel and Protopic , which are topical calcineurin inhibitors (TCIs). These medications are approved by the FDA for the treatment of atopic dermatitis in people 2 years of age and older. Unlike topical steroids, TCIs do not cause skin thinning, pigment changes, blood vessel formation, or striae formation, nor do they lose effectiveness with prolonged use. In addition, TCIs can be used on any skin, including the face and eyelids. Just like any medication, however, even TCIs have possible side effects. Learn about the FDA warnings associated with Elidel and Protopic .