Topical steroids
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Background
- The USA system utilizes 7 classes, which are classified by their ability to constrict capillaries
- Class I is the strongest and Class VII is the weakest[1]
Classification
Group I
Very potent: up to 600 times stronger than hydrocortisone
- Clobetasol propionate 0.05% (Dermovate)
- Betamethasone dipropionate 0.25% (Diprolene)
- Halobetasol propionate 0.05% (Ultravate, Halox)
- Diflorasone diacetate 0.05% (Psorcon)
Group II
- Fluocinonide 0.05% (Lidex)
- Halcinonide 0.05% (Halog)
- Amcinonide 0.05% (Cyclocort)
- Desoximetasone 0.25% (Topicort)
Group III
- Triamcinolone acetonide 0.5% (Kenalog, Aristocort cream)
- Mometasone furoate 0.1% (Elocon ointment)
- Fluticasone propionate 0.005% (Cutivate)
- Betamethasone dipropionate 0.05% (Diprosone)
- Halometasone 0.05%
Group IV
- Fluocinolone acetonide 0.01-0.2% (Synalar, Synemol, Fluonid)
- Hydrocortisone valerate 0.2% (Westcort)
- Hydrocortisone butyrate 0.1% (Locoid)
- Flurandrenolide 0.05% (Cordran)
- Triamcinolone acetonide 0.1% (Kenalog, Aristocort A ointment)
- Mometasone furoate 0.1% (Elocon cream, lotion)
Group V
- Fluticasone propionate 0.05% (Cutivate cream)
- Desonide 0.05% (Tridesilon, DesOwen ointment)
- Fluocinolone acetonide 0.025% (Synalar, Synemol cream)
- Hydrocortisone valerate 0.2% (Westcort cream)
Group VI
- Alclometasone dipropionate 0.05% (Aclovate cream, ointment)
- Triamcinolone acetonide 0.025% (Aristocort A cream, Kenalog lotion)
- Fluocinolone acetonide 0.01% (Capex shampoo, Dermasmooth)
- Desonide 0.05% (DesOwen cream, lotion)
Group VII
The weakest class of topical steroids. Has poor lipid permeability, and can not penetrate mucous membranes well.
- Hydrocortisone 2.5% (Hytone cream, lotion, ointment)
- Hydrocortisone 1% (Many over-the-counter brands)
Topical Steroid Potency Ranking[2]
| Brand name | Generic name |
| CLASS 1—Superpotent | |
| Clobex Lotion/Spray/Shampoo, 0.05% | Clobetasol propionate |
| Cordran Tape, 0.05% | Flurandrenolide |
| Cormax Cream/Solution, 0.05% | Clobetasol propionate |
| Diprolene Ointment, 0.05% | Betamethasone dipropionate |
| Olux E Foam, 0.05% | Clobetasol propionate |
| Olux Foam, 0.05% | Clobetasol propionate |
| Psorcon Ointment, 0.05% | Diflorasone diacetate |
| Psorcon E Ointment, 0.05% | Diflorasone diacetate |
| Temovate Cream/Ointment/Solution, 0.05% | Clobetasol propionate |
| Topicort Topical Spray, 0.25% | Desoximetasone |
| Ultravate Cream/Ointment, 0.05% | Halobetasol propionate |
| Ultravate Lotion, 0.05% | Halobetasol propionate |
| Vanos Cream, 0.1% | Fluocinonide |
| CLASS 2—Potent | |
| Diprolene Cream AF, 0.05% | Betamethasone dipropionate |
| Elocon Ointment, 0.1% | Mometasone furoate |
| Florone Ointment, 0.05% | Diflorasone diacetate |
| Halog Ointment/Cream, 0.1% | Halcinonide |
| Lidex Cream/Gel/Ointment, 0.05% | Fluocinonide |
| Psorcon Cream, 0.05% | Diflorasone diacetate |
| Topicort Cream/Ointment, 0.25% | Desoximetasone |
| Topicort Gel, 0.05% | Desoximetasone |
| CLASS 3—Upper Mid-Strength | |
| Cutivate Ointment, 0.005% | Fluticasone propionate |
| Lidex-E Cream, 0.05% | Fluocinonide |
| Luxiq Foam, 0.12% | Betamethasone valerate |
| CLASS 4—Mid-Strength | |
| Cordran Ointment, 0.05% | Flurandrenolide |
| Elocon Cream, 0.1% | Mometasone furoate |
| Kenalog Cream/Spray, 0.1% | Triamcinolone acetonide |
| Synalar Ointment, 0.03% | Fluocinolone acetonide |
| Topicort LP Cream, 0.05% | Desoximetasone |
| Topicort LP Ointment, 0.05% | Desoximetasone |
| Westcort Ointment, 0.2% | Hydrocortisone valerate |
| CLASS 5—Lower Mid-Strength | |
| Capex Shampoo, 0.01% | Fluocinolone acetonide |
| Cordran Cream/Lotion/Tape, 0.05% | Flurandrenolide |
| Cutivate Cream/Lotion, 0.05% | Fluticasone propionate |
| DermAtop Cream, 0.1% | Prednicarbate |
| DesOwen Lotion, 0.05% | Desonide |
| Locoid Cream/Lotion/Ointment/Solution, 0.1% | Hydrocortisone |
| Pandel Cream, 0.1% | Hydrocortisone |
| Synalar Cream, 0.03%/0.01% | Fluocinolone acetonide |
| Westcort Cream, 0.2% | Hydrocortisone valerate |
| CLASS 6—Mild | |
| Aclovate Cream/Ointment, 0.05% | Alclometasone dipropionate |
| Derma-Smoothe/FS Oil, 0.01% | Fluocinolone acetonide |
| Desonate Gel, 0.05% | Desonide |
| Synalar Cream/Solution, 0.01% | Fluocinolone acetonide |
| Verdeso Foam, 0.05% | Desonide |
| CLASS 7—Least Potent | |
| Cetacort Lotion, 0.5%/1% | Hydrocortisone |
| Cortaid Cream/Spray/Ointment | Hydrocortisone |
| Hytone Cream/Lotion, 1%/2.5% | Hydrocortisone |
| Micort-HC Cream, 2%/2.5% | Hydrocortisone |
| Nutracort Lotion, 1%/2.5% | Hydrocortisone |
| Synacort Cream, 1%/2.5% | Hydrocortisone |