Steroids - Topical Steroid Vehicles

A topical steroid vehicle refers to the type of base in which the medication is contained. The most common vehicles are creams and ointments, but topical steroids can also produced as gels, lotions, solutions, and sprays. The choice of vehicle used is important because some vehicles are more potent than others. For example, a topical steroid in an ointment base will be more potent than the same topical steroid in a cream or lotion base. This difference in potency is related to several factors including how occlusive the vehicle is and how well it absorbs into the skin. The following are characteristics of the different topical steroid vehicles:

Steroid Creams
A cream base is a mixture of oils and water and usually contains a preservative.

• White color
• Greasy texture
• Versatile use - can be used on most skin areas
• Most often prescribed
• Has emollient properties
• Repeated use can cause a drying effect
• Useful for areas where skin touches skin (groin, rectal area, armpits)

Steroid Ointments
An ointment base has some oils that are primarily greases such as petroleum jelly and little or no water. Many are preservative-free.

• Translucent
• Greasy texture that persists on the skin surface
• Provides more lubrication
• Greater penetration of medicine than creams therefore ointments have a higher potency than creams (see steroid list)
• Work best on chronic thickened skin lesions
• Not recommended for areas where skin touches skin (groin, rectal area, armpits) or with rashes that are acute, vesicular, or weeping.

Steroid Gels
A gel base is a mixture of propylene glycol and water. Some gels also contain water.

• Clear color
• Jellylike consistency
• Can have a drying effect
• Useful for "wet" rashes and in scalp areas where other vehicles can mat the hair

Steroid Solutions and Lotions
Solution or lotion bases contain water and alcohol as well as other chemicals.

• Clear or milky appearance
• Useful for use on the scalp because they leave no residue
• Can cause stinging and drying