20/11/2025
My husband used to tease me that he could treat my patients because all dermatologists recommend are steroid creams! When I was still a registrar on call, he used to pretend to answer my call phone and would answer ‘apply Dovate’ to any query asked.
Is this true? Are steroids the answer to most skin issues?
Absolutely not and even when steroids ARE indicated, you need to know what strength and formulation to use depending on what part of the body you are treating.
Topical corticosteroids (TCS) are available in different strengths, or potencies: mildly potent, moderately potent, potent and very potent. Your derm will decide on the correct strength for you on the basis of the nature of your condition, your age and the area of your body being treated.
While TCS can be prescribed for inflammatory conditions on the face (eczema/ psoriasis/ allergic contact dermatitis for example) – derms will get a little antsy about using stronger potency TCS (such as Dovate) particularly around the eye area:
Why:
It can cause:
• Cataracts or glaucoma
• Skin thinning and atropy
• Skin fragility
• Easy bruising
• Telangiectasias (broken capillaries)
• Collagen breakdown
• Stretchmarks
• Increased risk of spread of infections eg impetigo or herpes
• Rebound worsening of the pre-existing condition unless the • • • corticosteroid is weaned down appropriately and slowly
• Perioral dermatitis
• A rosacea flare
• Acne
So what do we suggest? If you’re going to use a corticosteroid on the face – do so under the supervision of your derm: Advantan can be used to get quick control which we will then wean down to a 1% hydrocortisone such as biocort/ mylocort. But even better are the calcineurin inhibitors (protopic or elidel) or Staquis do not carry any of the risks associated with TCS on the face.
Have you ever had any complications from using a TCS on your face? I once admitted a child with cataracts from TCS use + have never forgotten that lesson!
