Atopic Dermatitis: Noninfected and Infected - Topical Steroids
Classification of Topical Steroids
Most Potent - Class I, Least Potent - Class VII
*High potency
Class I: Super-potent:
- Clobetasol 0.05% ointment, cream, solution, and foam.
Class II: High potency:
- Betamethasone dipropionate 0.05% ointment, lotion, and cream.
- Desoximetasone 0.25% ointment and cream.
- Fluocinonide 0.05% ointment.
- Mometasone furoate 0.1% ointment.
Moderate potency
Class III: Moderate potency:
- Betamethasone valerate 0.1% ointment/ foam.
- Desoximetasone 0.05% cream.
- Fluticasone propionate 0.005% ointment.
- Triamcinolone acetonide 0.1% ointment.
- Triamcinolone acetonide 0.5% cream.
Class IV: Moderate potency:
- Fluocinolone acetonide 0.025% ointment.
- Mometasone furoate 0.1% cream/ lotion.
- Triamcinolone acetonide 0.1% cream.
Class V: Moderate potency:
- Betamethasone valerate 0.1% cream.
- Fluocinolone acetonide 0.01% cream.
- Fluocinolone acetonide 0.025% cream.
- Triamcinolone 0.025% ointment.
Low potency
Class VI: Low potency:
- Alclometasone dipropionate 0.05% ointment and cream.
- Desonide 0.05% ointment, cream, lotion, and foam.
- Fluocinolone acetonide 0.01% oil.
Class VII: Low potency :
- Hydrocortisone 2.5% ointment, cream, and lotion.
- Hydrocortisone 0.5% and 1% (OTC).
*Class I-II: Severe, flaring on body only (strongest). Use with caution: recommend consulting dermatology.
Class III-V: Moderate. Okay for body. DO NOT use on face, axilla, or groin.
Class VI-VII: Mild. Okay for face, axilla or groin.
- Ointment preferred vehicle.
- Ointment vehicle stronger than cream.
Caution: Cream vehicle can cause burning with application to open or inflamed skin.
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.