It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.
Most clinicians in private practice are regularly faced with challenging dermatologic cases, and a common question arises: How much prednisone is too much? No one can definitively answer this question, as different dogs respond in different ways. Some patients are unaffected by long-term prednisone administration, while others immediately demonstrate polyphagia, polydipsia and polyuria, or incontinence. Still others show signs of iatrogenic Cushing's disease—muscle wasting, a pot-bellied appearance, and muscle weakness—early on in therapy. The best approach is to try the safest treatment first, monitor the patient's response carefully, and adjust the therapeutic protocol if side effects become problematic or the condition does not respond.
Hydrocortisone and betamethasone are examples of low- and high-potency topical corticosteroids. Topical corticosteroids have been ranked in terms of potency into four groups consisting of seven classes. Class I topical corticosteroids are the most potent and Class VII are the least potent. Efficacy and side-effects are greatest with the Class I ultra-high-potency preparations which should only be used for limited time periods (2-3 weeks). Representative preparations by group are listed in the table below. These groups may vary depending on the formulation and concentration and should be considered approximate. In general, ointments are more potent than creams or lotions. Potency is also increased when topical corticosteroids are used under occlusive dressings or in intertriginous areas.