Topical Steroid Vehicles

The Importance of the Topical Steroid Base

Hydrocortisone ointment.
Hydrocortisone ointment.. ROBERT BROOK/Getty Images

A topical steroid vehicle refers to the type of base in which the medication is contained. The most common vehicles are creams and ointments, but topical steroids can also come as gels, lotions, solutions and sprays.

Topical steroids are an important part of the treatment plan for most people with a skin disorder such as eczema. When eczema flares up, applying cream, lotion or ointment containing a steroid will reduce inflammation, ease soreness and irritation, reduce itching, and relieve the need to scratch, allowing the skin to heal and recover.

Steroids are naturally occurring substances that are produced in our bodies to regulate growth and immune function. There are many different kinds of steroids, including “anabolic steroids” such as testosterone and “female hormones” such as estrogen, and corticosteroids such as cortisol, which is produced by the adrenal glands. Corticosteroids are the type of steroid used for eczema. Corticosteroids have many functions in the body, but among other things they are very effective at controlling inflammation. The way corticosteroids reduce inflammation is very complicated, but it involves temporarily altering the function of a number of cells and chemicals in the skin.

The choice of vehicle is important because some vehicles are stronger than others. For example, a topical steroid in an ointment base will be more potent than the same topical steroid in a cream or lotion base. This difference in potency is related to several factors including how well the vehicle keeps water from evaporating out of the skin and how well it absorbs into the skin.

The following are characteristics of the different topical steroid vehicles:

Steroid Creams

A cream base is a mixture of oils and water and usually contains a preservative.

  • White color
  • Greasy texture
  • Versatile use - can be used on most skin areas
  • Most often prescribed
  • Has emollient properties
  • Repeated use can cause a drying effect
  • Useful for areas where skin touches skin (groin, rectal area, armpits)

Steroid Ointments

An ointment base has some oils that are primarily greases such as petroleum jelly and little or no water. Many are preservative-free.

  • Translucent
  • Greasy texture that persists on the skin surface
  • Provides more lubrication
  • Greater penetration of medicine than creams therefore ointments have a higher potency than creams (see steroid list)
  • Work best on chronic thickened skin lesions
  • Not recommended for areas where skin touches skin (groin, rectal area, armpits) or with rashes that are acute, vesicular, or weeping.

Steroid Gels

A gel base is a mixture of propylene glycol and water. Some gels also contain water.

  • Clear color
  • Jellylike consistency
  • Can have a drying effect
  • Useful for "wet" rashes and in scalp areas where other vehicles can mat the hair

Steroid Solutions and Lotions

Solution or lotion bases contain water and alcohol as well as other chemicals.

  • Clear or milky appearance
  • Useful for use on the scalp because they leave no residue
  • Can cause stinging and drying

Source:

National Eczema Association. Topical Corticosteroids.

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