Topical Corticosteroid Potency Guide
Topical steroids are classified into 7 potency groups (group 1 = super-high, group 7 = least potent). Vehicle matters — ointments are more potent than creams of the same drug.
Go-To Agents by Tier
| Tier | Drug | Strength | Notes |
|---|---|---|---|
| Low (group 6) | Desonide | 0.05% cream/lotion/foam | Safe for face, groin, axilla, children |
| Medium (group 4) | Triamcinolone acetonide | 0.1% cream/ointment | Workhorse for body eczema, psoriasis |
| High/Super (group 1) | Clobetasol propionate | 0.05% cream/ointment | Thick plaques, palms/soles; limit to 2 weeks |
Practical Tips
- Face/folds/children: Max group 6 (desonide); avoid fluorinated steroids
- Scalp: Solutions, foams, or shampoos work best
- Occlusion (wraps, diapers) increases absorption — step down potency accordingly
- Atrophy risk increases with potency, duration, and occluded sites
- Tachyphylaxis: Rotate or pulse to prevent tolerance with high-potency agents
Source: UpToDate — Topical corticosteroids: Use and adverse effects