Topical Steroids: Potency and Side Effects

Topical steroids were categorized by potency from mild (grade IV) to very potent (grade I), with examples provided for each category. While mild and moderate steroids (grades III and IV) were rarely associated with side effects, potent and very potent steroids (grades I and II) could lead to both local and systemic side effects. Local side effects included spreading of infection, skin thinning, irreversible striae atrophica, increased hair growth, perioral dermatitis, acne, and mild depigmentation. These effects were particularly severe in children, and it was advised that potency I and II steroids be avoided or used with great care for short periods in pediatric treatment.