Can I Use Topical Steroid Creams on My Face?

What You Should Know About Topical Corticosteroids

Topical corticosteroids, also known as cortisone or steroid creams, have been used for decades for various skin conditions. A walk down the aisles of your local pharmacy will reveal a wide variety of brands and preparations available on an over-the-counter basis. Although these creams are widely available, they are only effective when used to treat certain conditions and, like other medical treatments, should be used with caution in certain circumstances.

 

Can I Use Topical Steroid Creams on My Face?

Only certain types of steroid creams can be used on the face. Topical steroids are the most common type of anti-itch cream; other creams containing local anesthetics (such as those found in Lanacane cream) should be avoided due to the possibility of causing contact dermatitis.

The skin on the face is particularly susceptible to the side effects of topical steroids, and getting these medications into the eyes can result in glaucoma or cataract formation. Therefore, only the lowest potency topical steroids should be used on the face. The smallest amount of medication should be used, and only for the shortest amount of time possible. An example of a low potency topical steroid includes the over-the-counter preparation hydrocortisone acetate 1% cream (Cortaid).

Common Side Effects of Topical Steroid Use

Side effects from topical steroids are most often seen on the area of skin where the medication is applied, and the face seems to be particularly prone to these side effects.

Local side effects may include:

  • Thinning of the skin
  • Pigment changes (lighter or darker skin)
  • Telangiectasia (blood vessel) formation
  • Rosacea, perioral dermatitis, and acne
  • Increased susceptibility to infections of the skin
  • Delayed wound healing ability
  • Irritation, redness, burning, stinging and peeling of the skin

Alternatives to Corticosteroid Creams

Alternative creams that can be used on the face include the Elidel and Protopic, which are topical calcineurin inhibitors (TCIs). These medications are approved by the FDA for the treatment of atopic dermatitis in people 2 years of age and older. Unlike topical steroids, TCIs do not cause skin thinning, pigment changes, blood vessel formation, or striae formation, nor do they lose effectiveness with prolonged use. In addition, TCIs can be used on any skin, including the face and eyelids. Just like any medication, however, even TCIs have possible side effects. Learn about the FDA warnings associated with Elidel and Protopic.

Sources:

Rathi, Sanjay K.D'Souza, Paschal, Rational and ethical use of topical corticosteroids based on safety and efficacy. In: Indian Journal of Dermatology. 2012. 57(4): 251-259J

Chen TM, Aeling JL .Topical Steroids. In: Fitzpatrick JE, Morelli JG, eds. Dermatology Secrets. 3rd ed. Philadelphia: Mosby;2007:408-16.

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