Classes of Topical Corticosteroids

Following are the classes of topical steroids:

1. Class 1: Superpotent Corticosteroids: These are used in chronic inflammation of the skin
where the skin is thickened (lichenified), pigmented and/or thick scaled. A few examples
of superpotent steroids are clobetasole propionate and halobetasole propionate.
Indications of superpotent steroids include neurodermatitis, thick scaled psoriasis etc.
2. Class 2: Potent Corticosteroids: These are used in chronic inflammation where the
thickness, pigmentation or scales are less than the above lesions. Examples of potent
steroids are betamethasone dipropionate, halcinonide, fluocinonide. Indications of potent
steroids are: lichen planus, neurodermatitis, moderately severe psoriasis vulgaris, chronic
eczema etc.
3. Class 3: Upper Mid-Strength Corticosteroids: These are used in sub acute inflammation
of the skin. Examples of upper mid-strength steroids are betamethasone valerate and
fluticasone propionate. Uses in sub acute dermatitis, infective eczema, psoriasis, severe
seborrheic dermatitis etc.
4. Class 4: Mid-Strength Corticosteroids: These are used in sub acute and acute
inflammation of the skin. Examples of mid-strength steroids are mometasone furoate,
fluocinolone acetonide 0.025%, and triamcinolone acetonide. Uses in sub acute
dermatitis, infective eczema, moderately severe seborrheic dermatitis, psoriasis, atopic
dermatitis, alopecia areata etc.
5. Class 5: Lower Mid-Strength Corticosteroids: These are used in sub acute and acute
inflammation of the skin. Examples of lower mid-strength corticosteroids are
hydrocortisone butyrate, fluticasone propionate. Uses in infective eczema, seborrheic
dermatitis, mild psoriasis etc.
6. Class 6: Mild Corticosteroids: These are used in acute and sub acute inflammation of the
skin. Examples of mild corticosteroids are desonide, fluocinolone 0.01%, clobetasone.
Uses in sub acute and acute dermatitis, mild seborrheic dermatitis etc.
7. Class 7: Least Potent Corticosteroids: These are used in mild acute and sub acute
inflammation of the skin. Steroid responsive skin diseases of the face, flexures, and
napkin area have to be treated with this class of topical steroids to avoid damage to the
skin. Example of least potent steroids is hydrocortisone 1%.

Topical corticosteroids come in several forms, including creams, lotions and ointments. Creams
and solutions are a class below in potency than ointments. Ointments are greasy and preferred in
chronic dermatitis and scaly diseases like psoriasis. Creams can be used in acute and subacute
skin inflammation. Gels and lotions are preferred in hairy areas and scalp.

Topical corticosteroids in psoriasis and other skin diseases form the mainstay of treatment in
such inflammatory dermatoses. A knowledge of the groups of topical corticosteroids according to
their potency is indeed essential in learning how to avoid side effects of topical steroids in
psoriasis and other steroid responsive skin diseases.
 Potency Ranking of Selected
Topical Corticosteroid Preparations
Class I Betamethasone dipropionate ointment, cream, 0.05% (Diprolene, Diprosone)
(Super Potent) Clobetasol propionate ointment, cream, 0.05% (Temovate, Dermoxin)
Diflorasone diacetate ointment 0.05% (Fluorone, Psorcon)
Halobetasol propionate ointment, cream, 0.05% (Ultravate)

Class II Amcinonide ointment, 0.1% (Cyclocort) Desoximetasone ointment, cream, 0.25%;

(Potent) gel, 0.05% (Topicort, Ibaril) Diflorasone diacetate ointment, 0.05% (Florone,
Maxiflor) Fluocinonide ointment, cream, gel 0.05% (Lidex) Halcinonide cream,
0.01% (Halog) Mometasone furoate ointment, 0.1% (Elocon, Ecural) Triamcinolone
acetonide ointment, 0.5% (Kenalog)

Class III Amcinonide cream, lotion, 0.1% (Cyclocort) Betamethasone valerate ointment,
(Potent) 0.01% (Valisone) Diflorasone diacetate cream, 0.05% (Florone, Maxiflor)
Fluticasone propionate ointment, 0.05% (Cutivate) Fluocortolone cream, 0.25%
(Ultralan) Fluocinonide cream, 0.05% (Lidex E cream, Topsyn) Halcinonide
ointment, 0.1% (Halog) Triamcinolone acetonide ointment, 0.1% (Aristocort A)
Triamcinolone acetonide, cream 0.5% (Aristocort-HP)

Class IV Betamethasone valerate lotion, 0.01% (Valisone, Luxiq) Desoximetasone cream, gel
(Mid-strength) 0.05% (Topicort-LP) Fluocinolone acetonide cream, 0.2% (Synalar-HP) Fluocinolone
acetonide ointment, 0.025% (Synalar) Flurandrenolide ointment, 0.05% (Cordran)
Halcinonide cream, 0.025% (Halog) Hydrocortisone valerate ointment, 0.2%
(Westcort) Mometasone fuorate cream, 0.1% (Elocon, Ecural) Triamcinolone
acetonide ointment, 0.1% (Kenalog)

Class V Betamethasone dipropionate lotion, 0.05% (Diprosone) Betamethasone valerate

(Mid-strength) cream, 0.01% (Valisone) Fluocinolone acetonide cream, 0.025% (Synalar)
Fluocinolone acetonide oil, 0.01% (Dermasmoothe/FS) Flurandrenolide cream,
0.05% (Cordran) Fluticasone propionate cream, 0.05% (Cutivate) Hydrocortisone
butyrate cream, 0.1% (Locoid) Hydrocortisone valerate cream, 0.2% (Westcort)
Triamcinolone acetonide lotion, 0.1% (Kenalog)
Class VI Alclometasone dipropionate ointment, cream, 0.05% (Aclovate) Betamethasone
(Mild) valerate lotion, 0.05% (Valisone) Desonide cream, 0.05% (Desowen, Tridesilon)
Fluocinolone acetonide cream, solution, 0.01% (Synalar) Prednicarbate 0.1% cream
(Dermatop) Triamcinolone acetonide cream,0.1% (Aritstocort)

Class VII Dexamethasone cream, 0.1% (Decadron phosphate) Hydrocortisone, 0.5%, 1%,
(Least Potent) 2.5% (Hytone, others) Methylprednisolone, 1% (Medrol) Topical preparations with
flumethasone, prednis