Topical Steroid Ladder Potency Strength Chart

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Jason Vergara

Jason has worked in the Australian tech space over the past decade. With a previous history of severe eczema and TSW, he is passionate about human-centred technology that creates access to healthcare. Jason is the author of Taper: An Integrative Approach to TSW

Topical steroids are commonly prescribed to manage inflammatory skin conditions such as eczema, psoriasis, and dermatitis. These medications are available in various formulations, including creams, ointments, gels, and solutions, each suited to different skin types and areas of the body.

The effectiveness of a topical steroid is determined by its potency, which reflects the concentration of the active ingredient required to achieve the desired therapeutic effect. Higher-potency steroids deliver stronger effects but carry a greater risk of side effects, especially with long-term use, while lower-potency options are typically considered safer and prescribed for extended application or use on sensitive areas.

 

Potency Strength Brand Name Generic Name
Super-potent Ultra-high Diprolene Ointment, 0.05% Augmented betamethasone dipropionate
Cormax Cream/Solution, 0.05% Clobetasol propionate
Clobex Lotion/Spray/Shampoo, 0.05% Clobetasol propionate
Olux Foam, 0.05% Clobetasol propionate
Olux E Foam, 0.05% Clobetasol propionate
Temovate Cream/Ointment/Solution, 0.05% Clobetasol propionate
Topicort Topical Spray, 0.25% Desoximetasone
Psorcon Ointment, 0.05% Augmented diflorasone diacetate
Psorcon E Ointment, 0.05% Diflorasone diacetate
Vanos Cream, 0.1% Fluocinonide
Cordran Tape, 4mcg/sq. cm. Flurandrenolide 4 mcg/cm2
Lexette Foam, 0.05% Halobetasol propionate
Ultravate Cream/Ointment, 0.05% Halobetasol propionate
Ultravate Lotion, 0.05% Halobetasol propionate
Bryhali Lotion, 0.01% Halobetasol propionate
High Cyclocort Ointment, 0.1% Amcinonide
Diprolene Ointment, 0.05% Betamethasone dipropionate
Diprolene Cream/Lotion, 0.05% Augmented betamethasone dipropionate
Topicort Cream/Ointment, 0.25% Desoximetasone
Topicort Gel 0.05% Desoximetasone
Florone Cream, 0.05% Augmented Diflorasone diacetate
Florone Ointment, 0.05% Diflorasone diacetate
Lidex Cream/Gel/Ointment/Solution, 0.05% Fluocinonide
Halog Ointment/Cream, 0.1% Halcinonide
Elocon Ointment, 0.1% Mometasone furoate
Cyclocort Cream/Lotion 0.1% Amcinonide
Diprolene AF Cream 0.05% Betamethasone dipropionate
Diprolene Lotion 0.05% Betamethasone dipropionate
Psorcon Cream, 0.05% Diflorasone diacetate
Cutivate Ointment, 0.005% Fluticasone propionate
TRIDERM Triamcinolone acetonide 0.5%
Moderate (Medium) Luxiq Aerosol Foam 0.12% Betamethasone valerate
Topicort LP Cream, 0.05% Desoximetasone
Synalar Ointment 0.025% Fluocinolone acetonide
Cordran Ointment, 0.05% Flurandrenolide
Westcort Ointment, 0.2% Hydrocortisone valerate
Elocon Cream/Lotion, 0.1% Mometasone furoate
Kenalog Cream/Ointment, 0.1% Triamcinolone acetonide
Kenalog Spray, 0.2% Triamcinolone acetonide
CREAM: BETA-VAL/BETADERM; LOTION: VALISONE/BETA-VAL Betamethasone valerate 0.1%
Cloderm Cream, 0.1% Clocortolone pivalate
Synalar Cream 0.025% Fluocinolone acetonide
Capex Shampoo Fluocinolone acetonide
Derma-Smoothe/FS Fluocinolone acetonide
Cutivate Cream/Lotion 0.05% Fluticasone propionate
Cordran Cream/Lotion, 0.05% Flurandrenolide
Locoid Cream/Lotion/Ointment/Solution, 0.1% Hydrocortisone butyrate
Pandel Cream, 0.1% Hydrocortisone probutate
WESTCORT Cream Hydrocortisone valerate 0.2%
DermAtop Cream/Ointment, 0.1% Prednicarbate
Low Aclovate Cream/Ointment, 0.05% Alclometasone dipropionate
LOTION, CREAM, OINT: DESOWEN; GEL: DESONATE/DESRX; FOAM: VERDESO 3 Desonide 0.05%
Synalar Cream/Solution, 0.01% Fluocinolone acetonide
LOTION, GEL, CREAM, OINT: CORTIZONE 10; SOLUTION: SCALPICIN/TEXACORT 7 Hydrocortisone 0.5% – 2.5%
Cetacort Lotion, 0.5%/1% Hydrocortisone
Cortaid Cream/Spray/Ointment Hydrocortisone
Hytone Cream/Lotion, 1%/2.5% Hydrocortisone
Micort-HC Cream, 2%/2.5% Hydrocortisone
Nutracort Lotion, 1%/2.5% Hydrocortisone
Synacort Cream, 1%/2.5% Hydrocortisone

 

Topical Steroid Ladder

The term “topical steroid ladder” refers to a framework categorizing corticosteroid creams based on their potency, ranging from mild to super potent. This ladder serves as a practical tool for gradually reducing the strength of topical steroids, which can aid in tapering off their use or identifying the lowest effective dose for symptom management.

The ladder is typically divided into four levels of potency. The lower levels correspond to mild or low-potency steroids, while the higher levels represent stronger formulations. For instance, the initial level may involve a low-potency steroid, whereas the highest level involves a super potent formulation.

The purpose of this approach is to initiate treatment with a higher-potency steroid, followed by a gradual step-down to weaker options as the condition improves. This method allows for symptom relief while minimizing the risks associated with prolonged exposure to potent corticosteroids.

Very potent or super potent (up to 600 times as potent as hydrocortisone)

  • Clobetasol propionate
  • Betamethasone dipropionate (in an optimised vehicle)

Potent (100–150 times as potent as hydrocortisone)

  • Betamethasone valerate
  • Betamethasone dipropionate (cream, ointment, gel)
  • Diflucortolone valerate
  • Hydrocortisone 17-butyrate
  • Mometasone furoate
  • Methylprednisolone aceponate

Moderate (2–25 times as potent as hydrocortisone)

  • Clobetasone butyrate
  • Triamcinolone acetonide

Mild

  • Hydrocortisone
  • Hydrocortisone acetate

 

 

Frequently Asked Questions

Clobetasol Comparisons

What is the difference between clobetasol and betamethasone?

Clobetasol propionate is a superpotent corticosteroid, typically used for severe inflammatory skin conditions. Betamethasone dipropionate is a potent corticosteroid, suitable for moderate to severe conditions. Clobetasol is classified as stronger than betamethasone.

 

Is clobetasol stronger than hydrocortisone?

Yes, clobetasol propionate is significantly stronger than hydrocortisone. Clobetasol is classified as a superpotent corticosteroid, while hydrocortisone is a low-potency corticosteroid.

 

What is stronger: clobetasol or triamcinolone?

Clobetasol propionate is stronger than triamcinolone acetonide. Clobetasol is a superpotent corticosteroid, while triamcinolone is a medium-potency corticosteroid.

 

How does fluocinonide compare to clobetasol?

Fluocinonide is a high-potency corticosteroid, whereas clobetasol propionate is a superpotent corticosteroid. Clobetasol is stronger than fluocinonide.

 

How does halobetasol compare to clobetasol?

Halobetasol propionate and clobetasol propionate are both superpotent corticosteroids, and their strengths are similar. The choice depends on specific formulation and clinical considerations.

 

How does clobetasol propionate compare to triamcinolone acetonide?

Clobetasol propionate is stronger than triamcinolone acetonide. Clobetasol is classified as superpotent, while triamcinolone is medium-potency.

 

How does clobetasol compare to fluocinonide?

Clobetasol propionate is stronger than fluocinonide. Clobetasol is superpotent, while fluocinonide is classified as high-potency.

 

Betamethasone Comparisons

What is the difference between betamethasone and hydrocortisone?

Betamethasone is a potent corticosteroid, while hydrocortisone is a low-potency corticosteroid. Betamethasone is stronger and used for more severe inflammatory conditions compared to hydrocortisone.

 

How does betamethasone compare to triamcinolone?

Betamethasone is classified as a potent corticosteroid, whereas triamcinolone is a medium-potency corticosteroid. Betamethasone is stronger than triamcinolone.

 

How does betamethasone dipropionate compare to triamcinolone acetonide?

Betamethasone dipropionate is a potent corticosteroid, while triamcinolone acetonide is medium-potency. Betamethasone dipropionate is stronger than triamcinolone acetonide.

 

How does betamethasone valerate compare to betamethasone dipropionate?

Betamethasone dipropionate is stronger than betamethasone valerate. Both are potent corticosteroids, but dipropionate is used for more severe conditions.

 

Is betamethasone stronger than prednisone?

Betamethasone, when applied topically, is stronger than prednisone. Prednisone is primarily used as an oral corticosteroid and has systemic effects, whereas betamethasone is used topically for localized conditions.

 

How does betamethasone compare to fluocinonide?

Betamethasone dipropionate is a potent corticosteroid, while fluocinonide is classified as a high-potency corticosteroid. Fluocinonide is stronger than betamethasone in most formulations.

 

How does betamethasone compare to clobetasol?

Clobetasol propionate is a superpotent corticosteroid, while betamethasone dipropionate is a potent corticosteroid. Clobetasol is stronger than betamethasone.

 

Triamcinolone Comparisons

How does triamcinolone compare to hydrocortisone?

Triamcinolone is a medium-potency corticosteroid, while hydrocortisone is a low-potency corticosteroid. Triamcinolone is stronger than hydrocortisone.

 

Is triamcinolone stronger than mometasone?

Mometasone furoate is stronger than triamcinolone acetonide. Mometasone is classified as a potent corticosteroid, while triamcinolone is medium-potency.

 

How does triamcinolone compare to clobetasol?

Clobetasol propionate is a superpotent corticosteroid, while triamcinolone acetonide is a medium-potency corticosteroid. Clobetasol is significantly stronger than triamcinolone.

 

How does fluocinonide compare to triamcinolone?

Fluocinonide is a high-potency corticosteroid, while triamcinolone acetonide is a medium-potency corticosteroid. Fluocinonide is stronger than triamcinolone.

 

What is stronger: triamcinolone 0.1% or 0.025%?

Triamcinolone 0.1% is stronger than triamcinolone 0.025% due to its higher concentration of the active ingredient.

 

How does triamcinolone compare to cortisone?

Triamcinolone is a medium-potency corticosteroid, while cortisone is a low-potency corticosteroid. Triamcinolone is stronger than cortisone.

 

How does triamcinolone acetonide compare to mometasone furoate?

Mometasone furoate is stronger than triamcinolone acetonide. Mometasone is a potent corticosteroid, while triamcinolone is medium-potency.

 

How does triamcinolone acetonide compare to hydrocortisone cream?

Triamcinolone acetonide is stronger than hydrocortisone cream. Triamcinolone is medium-potency, while hydrocortisone is low-potency.

 

How does triamcinolone compare to betamethasone for eczema?

Betamethasone dipropionate is stronger than triamcinolone acetonide. Betamethasone is a potent corticosteroid, while triamcinolone is medium-potency.

 

How does triamcinolone ointment compare to cream?

Triamcinolone ointment is generally more occlusive and better for dry, thickened skin, while triamcinolone cream is lighter and better suited for moist or weeping areas. Both have the same active ingredient and potency.

 

Hydrocortisone Comparisons

How does hydrocortisone compare to clobetasol?

Clobetasol propionate is a superpotent corticosteroid, while hydrocortisone is a low-potency corticosteroid. Clobetasol is significantly stronger than hydrocortisone.

 

How does hydrocortisone compare to triamcinolone?

Triamcinolone acetonide is a medium-potency corticosteroid, while hydrocortisone is a low-potency corticosteroid. Triamcinolone is stronger than hydrocortisone.

 

Is betamethasone stronger than hydrocortisone?

Yes, betamethasone dipropionate is stronger than hydrocortisone. Betamethasone is classified as a potent corticosteroid, while hydrocortisone is low-potency.

 

How does hydrocortisone compare to desonide?

Desonide is a low-potency corticosteroid, similar in classification to hydrocortisone. Both are used for mild inflammatory skin conditions, but hydrocortisone is generally considered slightly less potent than desonide.

 

Is hydrocortisone cream stronger than ointment?

No, hydrocortisone ointment is stronger than cream due to its more occlusive nature, which enhances absorption of the active ingredient.

 

How does hydrocortisone 2.5% compare to 1%?

Hydrocortisone 2.5% is stronger than 1% due to its higher concentration of the active ingredient. Both are classified as low-potency corticosteroids.

 

Mometasone Comparisons

Is triamcinolone stronger than mometasone?

No, mometasone furoate is stronger than triamcinolone acetonide. Mometasone is classified as a potent corticosteroid, while triamcinolone is medium-potency.

 

How does mometasone compare to triamcinolone for eczema?

Mometasone furoate is stronger than triamcinolone acetonide and is typically used for more severe eczema cases. Both can be effective depending on the severity and location of eczema.

 

How does mometasone furoate compare to triamcinolone acetonide?

Mometasone furoate is more potent than triamcinolone acetonide. Mometasone is classified as potent, while triamcinolone is medium-potency.

 

Fluocinonide Comparisons

How does fluocinonide compare to clobetasol?

Clobetasol propionate is stronger than fluocinonide. Clobetasol is classified as a superpotent corticosteroid, while fluocinonide is high-potency.

 

How does fluocinonide compare to triamcinolone?

Fluocinonide is stronger than triamcinolone acetonide. Fluocinonide is classified as a high-potency corticosteroid, while triamcinolone is medium-potency.

 

What’s the difference between fluocinonide and fluocinolone?

Fluocinonide is a high-potency corticosteroid, while fluocinolone acetonide is a low-potency corticosteroid. Fluocinonide is used for more severe inflammatory skin conditions compared to fluocinolone.

 

How does fluocinonide compare to betamethasone?

Fluocinonide is typically stronger than betamethasone dipropionate. Fluocinonide is high-potency, while betamethasone is potent.

 

Desonide Comparisons

How does desonide compare to hydrocortisone?

Desonide is slightly stronger than hydrocortisone. Both are classified as low-potency corticosteroids, but desonide has a slightly higher efficacy.

 

How does desonide compare to triamcinolone acetonide?

Desonide is weaker than triamcinolone acetonide. Desonide is a low-potency corticosteroid, while triamcinolone is medium-potency.

 

Picture of Jason Vergara

Jason Vergara

Jason has worked in the Australian tech space over the past decade. With a previous history of severe eczema and TSW, he is passionate about human-centred technology that creates access to healthcare. Jason is the author of Taper: An Integrative Approach to TSW

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Topical steroid withdrawal (TSW) and chronic eczema may present with similar symptoms and should not be mistaken for one another. A proper diagnosis must be made by a qualified healthcare professional. The information on this website is not medical advice and does not replace any medical advice or treatment from your doctor. TSW Assist does not provide any medical advice, diagnosis, or treatment. Please refer to our Terms of Use and Privacy Policy

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