Topical steroids are grouped by strength because the same medicine behaves differently depending on how potent the preparation is and where on the body it is applied. The classification exists to inform prescribing decisions, and matching a preparation to a person is the prescriber's task rather than a reader's.
Why group these preparations at all?
Topical steroids are not a single thing. They are a family of preparations that share a mechanism, reducing inflammation in the skin, while differing considerably in how strongly they do it.
That variation needs organising, because a prescriber choosing between them is balancing effect against the consequences of applying a stronger preparation than a situation requires. Grouping by strength is how that balance is made discussable. It lets a clinician think in terms of strength categories rather than holding the properties of every individual product in mind.
A strength classification therefore exists, it is published, and it belongs to the bodies that maintain it for the country concerned. What sits in which group, and what the groups are called, is exactly the sort of thing that differs between countries and gets revised.
Why does this page contain no table?
This is the most sensitive page on the site and the decision is deliberate.
Reproducing a strength classification would require naming molecules alongside strength categories, and a list of that kind reads as a guide to selection whatever caveats surround it. Somebody with a tube in the bathroom cabinet and a patch of irritated skin would use it to decide, and that is precisely the decision this site refuses to influence. The classification informs prescribing; it is not a menu.
There is a second reason, and it applies regardless of the first. The classification for a given country would have to be verified against its published source and dated before appearing here, and that verification has not been done. Under this site’s own rules a page publishes without unverified material rather than with an approximation of it. So this one does.
What remains is the part that is genuinely useful to a reader: that the categories exist, what they are for, and what determines where something sits.
What determines a preparation’s strength?
Three things, and the active substance is only one of them.
The molecule itself carries an inherent strength. The concentration in the preparation modifies it. And the base — whether the product is an ointment, a cream, a lotion or a gel — affects how much reaches the skin and how it stays there, sometimes substantially. An ointment and a lotion containing the same substance at the same concentration are not interchangeable.
This is why reading a percentage on a tube tells you much less than it appears to. The number is one input among several, and preparations with similar-looking figures can sit in different strength categories.
Site is the fourth variable and it belongs to the person rather than the product. Skin thickness varies enormously across the body: eyelids, face and skin folds are thin and absorb readily, while palms and soles are thick and absorb poorly. A preparation appropriate in one place may be quite wrong in another, which is why prescribing considers where it is going.
What is worth asking your prescriber?
Ask where this preparation sits in the strength classification and why that strength was chosen. The reasoning is the useful part, and it tells you what is being balanced.
Ask what to do as the skin improves, and how the preparation is meant to be stopped or reduced. This is the question most often left unasked and most often needed later, when the initial conversation has faded and the skin has changed.
Enquire about the base as well as the substance. If an ointment is impractical for your life, that is worth saying at the time rather than quietly using less of it than intended.
Where you have read something worrying, raise it directly. Clinicians hear these concerns constantly and would far rather address them in the room than have a plan quietly abandoned at home.
What this page does not do
It names no molecule, gives no category, no concentration, no quantity, no frequency and no duration. It does not tell you whether a preparation you have is appropriate for anything, and it does not tell you to use or to avoid any product. All of that belongs to the person prescribing, who knows the site, the condition and the rest of your history.
Common questions
Why does this page not list the strength categories?
Because the classification used depends on the country and is maintained by the bodies that publish it, and because a category name without its clinical context invites exactly the self-selection this site avoids. Your prescriber and your pharmacist can tell you where a specific preparation sits.
Why does the site of application matter so much?
Because skin thickness varies enormously across the body. The same preparation behaves differently on the sole of a foot and on an eyelid, which is why prescribing considers where it is going as well as what it is. Site is part of the decision rather than a detail.
Is the strength of the preparation the same as the concentration?
Not straightforwardly. Strength classification reflects the effect a preparation produces, which depends on the active substance, its concentration and the base it is carried in. Two products with similar-looking percentages can sit in different categories, which is one reason reading the number alone misleads.
Why are people often anxious about topical steroids?
There is a long history of concern, some grounded in recognised effects of prolonged or inappropriate use, some amplified well beyond the evidence online. Clinicians are used to the conversation and raising your specific worry is more productive than deciding privately not to follow a plan.
Should I stop using a prescribed preparation if the skin improves?
That is a question for the person who prescribed it, and it is a good one to ask at the time of prescribing rather than later. How and when to stop is part of the plan, and it varies by preparation, site and condition in ways no general page can address.
Sources
- Patient information on skin conditions and treatments — British Association of Dermatologists (United Kingdom) · accessed
- Guidance — National Institute for Health and Care Excellence (England) · accessed
Last updated . How this page was written.