Relative Potency of Corticosteroids

Corticosteroid drugs such as hydrocortisone and prednisone are useful in the treatment of a wide range of health problems, including the skin condition eczema, chronic conditions such as asthma and the disease lupus. Depending on the length of treatment and the strength of the corticosteroid medication used, however, the medication's side effects can range from mild to serious. Knowing how to balance the risks and benefits of corticosteroid potency is vital to a patient's treatment plan.

Function

• The human body naturally produces cortisonelike hormones in the adrenal glands. When corticosteroids are prescribed at higher levels than typically produced in the body, the medication reduces inflammation. This is how corticosteroids help conditions such as asthma and arthritis. They also help suppress the immune system, which helps with autoimmune conditions or reactions in which the body's immune system malfunctions and attacks its own tissues, such as with lupus.

Potency

• The potency of a corticosteroid depends on its type and concentration. Generally, though, ointments and gels are more potent than creams and lotions. A patient should be treated with the lowest concentration that is effective. In most cases, low-potency medications are used in pediatric treatment and on the face, groin and large surface areas for adults. More potent corticosteroids are used when milder medications prove ineffective. Risks include thinning skin, acne and lesions. If used over a wide area, possible systemic reactions include adrenal/glandular problems, Cushing's syndrome and hyperglycemia.

High Potency

• High-potency corticosteroids include amcinonide, betamethasone dipropionate, betamethasone valerate and clobetasol propionate. Other high-potency corticosteroids are desoximetasone, diflorasone diacetate, fluocinonide, flurandrenolide, halcinonide, fluticasone propionate, halobetasol propionate, mometasone furoate and triamcinolone acetonide.

Medium Potency

• Sever corticosteroids are considered medium potency. These include clocortolone pivalate, desonide, flurandrenolide, hydrocortisone butyrate, hydrocortisone valerate and prednicarbate.

Low Potency

• Low-potency corticosteroids include alclometasone dipropionate and hydrocortisone. Also included are lower concentration formulas of medium-potency medications such as desonide and flurandrenolide.

Considerations

• Topical corticosteroids are classified in strength by vasoconstrictor assay or the blanching effect on normal human skin. If taking strong corticosteroids for an extended time, the patient should consider consuming a diet rich in proteins but watch caloric intake to avoid weight gain. Also, he should try to eat plenty of potassium-rich foods while restricting how much salt is consumed.