Guidance on prescribing topical steroids reminds practitioners to prescribe the least strong steroid which is effective for the least possible length of time. A balance must be struck between efficacy and reducing adverse effects. Education is crucial to maximise efficacy and reduce adverse effects. Use of printed information may be helpful (including detail of how to use emollients and topical steroids) and education involving practice nurses to help improve efficacy of treatments and information for patients. Examples can be obtained from the British Association of Dermatologists and the National Eczema Society.
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.