Precautions and warnings

When topical corticosteroids are absorbed into the body, they can sometimes temporarily reduce the activity of the hypothalamic-pituitary-adrenal (HPA) axis. This can lead to symptoms like Cushing’s syndrome, high blood sugar, and sugar in the urine. These side effects are more likely if strong steroids are used, if they are applied to large areas of skin, used for a long time, or covered with airtight dressings.

Because of these risks, patients using strong topical steroids on large areas—especially under dressings—should have regular check-ups. Tests like urinary free cortisol and ACTH stimulation may be done to see if the HPA axis is suppressed. If suppression occurs, doctors may lower the dose, use the medication less often, or switch to a weaker steroid.

Usually, the HPA axis returns to normal quickly after stopping the steroid. However, sometimes people may have withdrawal symptoms and need to take corticosteroids by mouth for a short time. Children can absorb more of these medications through their skin, so they are at greater risk for side effects.

If skin irritation happens, stop using the topical steroid and treat the irritation appropriately.

If there is a skin infection, start using the right antifungal or antibacterial treatment at the same time. If the infection doesn’t improve quickly, stop using the steroid until the infection is under control.

Contraindications

People who are allergic to any ingredient in topical corticosteroids should not use them.

Mode of actions

Hydrocortisone is a type of corticosteroid medicine that helps reduce inflammation and weaken the body's immune response. It works by stopping certain white blood cells from moving to inflamed areas and by making blood vessels less leaky. Hydrocortisone can also be used to replace hormones in people who don’t make enough of a natural hormone from their adrenal glands.

A local anesthetic works by making nerves less able to send pain signals. It does this by stabilizing the nerve cell membranes, lowering the amount of sodium that gets into the cells, and raising the threshold needed for the nerve to send a signal.

Dosage & Administration

Topical corticosteroids are generally applied to the affected area as a thin film three to four times daily depending on the severity of the condition. Occlusive dressings may be used for the management of psoriasis or recalcitrant conditions. If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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