Topical corticosteroids (“steroids”) are the cornerstone of treatment for many skin disorders. Topical corticosteroids are often employed first line in the treatment of cutaneous T-cell lymphoma (CTCL) because they are safe and easy to use, relatively inexpensive, and have high response rates, especially for early stage (stage 1A or 1B) disease.
Topical corticosteroids have local anti-inflammatory effects, and can be especially helpful in alleviating itching. Topical corticosteroids are packaged in a variety of formulations (“vehicles”), including creams, ointments, lotions, foams, gels and solutions. In general, ointments are the most potent (strongest), followed by creams. Steroid strength can be increased even further by using them under an occlusive bandage. The steroid strength may not relate to the concentration (%) listed on the tube, and different types of steroids are available in different strengths. Dermatologists will usually prescribe several different topical corticosteroids for different areas of the body, with milder steroids for the face, armpits and groin, and stronger ones for the body, hands and feet.
Local side effects from topical corticosteroids can occur. Common side effects include skin atrophy (thinning), which can look like striae (stretch marks) or easy bruising. Localized skin acne or fungal infections can also occur. With widespread and long-term (months and months) use, topical steroids can be absorbed into the bloodstream and cause decreased activity of the adrenal glands.