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Steroid ladder for eczema

Written by Healthwords's team of doctors and pharmacists based in UK | Updated: 26.01.2023 | 1 min read

Health care professionals use a steroid ladder for prescribing creams to patients, often starting with the mildest possible steroid before moving on to the next one up the ladder.

Topical steroids reduce inflammation on the skin, have immunosuppressive properties and vasoconstrictive properties. Hydrocortisone is mainly used in children and on the face.  On the body your doctor may advise using the 1% and on the face to use 0.5%.   In adults, your doctor may start from moderate strength and work upwards but it all depends on the severity of the skin. An example of steroid creams and their potency are detailed below.

Mild and moderate steroids

Hydrocortisone 1% is a mild steroid and can be bought over the counter from the local pharmacy. An example of a moderate steroid is Eumovate (Clobetasone B 0.05%). It should be noted that these should not be used on the eyelids. 

Potent steroids

Betnovate (0.1%) is an example of a potent steroid. These are very strong prescription medications and should not be used on the eyelids, face, groin, armpits, genitals or in children without expert opinion.

Very potent steroids

The top of the ladder, very potent steroids such as Dermovate (Clobetasol P 0.05%). Like the previous level, these should not be used on the eyelids, face, groin, armpits, genitals or in children.

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