[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-568574-105":3,"detail-sidebar-cat-1-en-105":74,"doc-detail-568574-en":120},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":67,"head_meta":69,"extra_data":71,"updated_unix":73},105,"en","steroid-ladder-first-choice-drug-potency-ladder-and-usage-guidance","STEROID LADDER - First choice - Drug potency ladder and usage guidance","","A formulary steroid potency ladder (GMMMG) classifies topical corticosteroids by strength, naming specific products and their active ingredients, and defines options for selected choices. It warns against use on sensitive sites and in specific conditions, including eyelids, face, groin, armpits, genitals, children, and psoriasis. Safety guidance highlights rare central serous chorioretinopathy risk and includes “top tips” on correct potency selection, application timing, steroid-free days, infection signs, and when to contact a GP. Guideline dates are provided (April 2019; review January 2022).",{"@graph":14,"@context":66},[15,34,49],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/steroid-ladder-first-choice-drug-potency-ladder-and-usage-guidance/568574/",4,{"url":32,"name":10,"@type":35,"author":36,"headline":10,"publisher":39,"fileFormat":42,"inLanguage":8,"description":12,"dateModified":43,"datePublished":43,"encodingFormat":42,"isAccessibleForFree":44,"interactionStatistic":45},"DigitalDocument",{"name":37,"@type":38},"Noah","Person",{"url":19,"name":40,"@type":41},"DocShare","Organization","application/pdf","2026-10-13",true,{"@type":46,"interactionType":47,"userInteractionCount":4},"InteractionCounter",{"@type":48},"ViewAction",{"@type":50,"mainEntity":51},"FAQPage",[52,58,62],{"name":53,"@type":54,"acceptedAnswer":55},"What is the “steroid ladder” and how is it used?","Question",{"text":56,"@type":57},"It organizes topical corticosteroids into potency tiers (e.g., very potent, potent, moderate, mild) so clinicians and patients can choose the correct strength for the correct body area, following the ladder.","Answer",{"name":59,"@type":54,"acceptedAnswer":60},"Which areas and conditions should topical steroids not be used on?",{"text":61,"@type":57},"Do not use on eyelids, face, groin, armpits, genitals, children, or psoriasis. The document also cautions about rare risks with local or systemic administration.",{"name":63,"@type":54,"acceptedAnswer":64},"When should patients seek urgent or routine GP review during steroid treatment?",{"text":65,"@type":57},"If skin breaks, blisters, shows yellow heads, becomes weepy, or suddenly worsens (infection signs), continue treatment and make an urgent GP appointment. If eczema is not clearing after seven days, continue the steroid but arrange a GP review.","https://schema.org",{"og:url":32,"og:type":68,"og:title":10,"og:site_name":40,"og:description":12},"article",{"robots":70,"canonical":32},"index,follow",{"doc_id":72,"site_id":7},568574,1791871467,{"code":4,"msg":75,"data":76},"success",[77,82,87,92,97,102,106,111,116],{"id":78,"doc_module":22,"doc_module_name":25,"category_name":79,"show_sort_weight":80,"slug":81},11,"Presentations",90,"presentations",{"id":83,"doc_module":22,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},12,"Resumes",80,"resumes",{"id":88,"doc_module":22,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},14,"Invoices",70,"invoices",{"id":93,"doc_module":22,"doc_module_name":25,"category_name":94,"show_sort_weight":95,"slug":96},15,"Posters",60,"posters",{"id":98,"doc_module":22,"doc_module_name":25,"category_name":99,"show_sort_weight":100,"slug":101},16,"Social Media",50,"social-media",{"id":103,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":104,"slug":105},17,40,"forms",{"id":107,"doc_module":22,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},18,"Letters",30,"letters",{"id":112,"doc_module":22,"doc_module_name":25,"category_name":113,"show_sort_weight":114,"slug":115},21,"Paper Templates",5,"papers-templates",{"id":117,"doc_module":22,"doc_module_name":25,"category_name":118,"show_sort_weight":4,"slug":119},158,"General","general-158",{"code":4,"msg":75,"data":121},{"doc_id":72,"user_id":122,"nickname":37,"user_avatar":123,"doc_module":22,"category_id":103,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":124,"file_id":125,"file_url":126,"file_type":127,"file_size":128,"view_count":4,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":129,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":130,"faqs":131,"seo_title":132,"seo_description":12,"update_tm":73,"read_time":22},8796095462418,"https://ap-avatar.wpscdn.com/avatar/80000253c1241d02b47?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778826106357471780","Formulary (GMMMG) | 1‐ First choice | 2‐ Second choice  \nSTEROID LADDER  \nVery Potent  \nDermovate (clobetasol proprionate 0.05%)  \nDermovate scalp lotion (clobetasol proprionate 0.05%) Etrivex shampoo (clobetasol proprionate 500 micrograms/g)  \nPotent  \nSee Drug safety update  \nCorticosteroids: rare risk of central serous chorioretinopathy with local as well as systemic administration  \nDO NOT  \nUSE ON  \n• Eyelids  \n• Face  \n• Groin  \n• Armpits  \n• Genitals  \n• Children  \n• Psoriasis  \nBetnovate (betamethasone valerate 0.1% in a water miscible base)  \nBetacap (betamethasone valerate 0.1% containing coconut oil derivative)  \nLocoid (hydrocortisone butyrate 0.1%)  \nSynalar (fluocinolone acetonide 0.025%)  \nElocon (mometasone furoate 0.1%)  \nWith antibacterial  \nFucibet (betamethasone valerate 0.1%, fusidic acid 2%) Synalar C (fluocinolone acetonide 0.025%, clioquinol 3%)  \nSynalar N (fluocinolone acetonide 0.025%, neomycin sulfate 0.5%)  \nWith salicylic acid  \nDiprosalic  \n(betamethasone diproprionate 0.05%, salicylic acid 3%)  \nWith vitamin D (for use in psoriasis only)  \nDovobet  \n(betamethasone diproprionate 0.05%, calcipotriol 50micrograms/g)  \nEnstilar  \n(betamethasone diproprionate 0.05%, calcipotriol 50micrograms/g)  \nModerate  \nBetnovate RD (betamethasone valerate 0.25%) Eumovate (clobetasone butyrate 0.05%) Fludroxycortide Tape (4 micrograms/cm2) Modrasone (Alclometasone dipropionate 0.05%)  \nWith Urea  \nAlphaderm (hydrocortisone 1%, urea 10%)  \nWith antifungal and antibacterial  \nTrimovate  \n(clobetasone butyrate 0.05%, oxytetracycline 3%, nystatin 100,000units/g)  \nMild  \nHydrocortisone 1%  \nSynalar 1 in 10 Dilution (fluocinolone acetonide 0.0025%)  \nWith antibacterial  \nFucidin H  \n(hydrocortisone 1%, fusidic acid 2%)  \nWith antifungal  \nCanestan HC (hydrocortisone 1%, clotrimazole 1%) Daktacort (hydrocortisone 1%, miconazole nitrate 2%) Nystaform HC  \n(hydrocortisone 1%, nystatin 100,000units/g, chlorhexidine 1%)  \nClinicians are reminded that a prescription for treatment of mild dry skin should not  \nroutinely be offered in primary care as the condition is appropriate for self‐care.  \n• Products containing antibacterials should be applied twice daily for 7‐14 days maximum per infective flare (check individual product details) . Patients should then revert to a steroid that does not contain antimicrobials to control flares unless the skin is infected.  \nGuideline date: April 2019 Review date: January 2022  \nSTEROID Top Tips  \n• Apply topical steroids after an emollient by accurately‘colouring in’ any redsore areas highlighted by the application of the emollient. Steroid can be applied as soon as the emollient can no longer be seen on the skin, which can be a few minutes.  \n• Apply the correct potency topical steroid to the correct body area (see ladder) . Never use very potent steroids on the face, genitals, armpits and groin, and only use mild steroids on the eyelids and under a nappy for a maximum of 5‐7 days.  \n• Always use the mildest strength steroid that clears eczema but ensure that regular ‘steroid free’ days can be achieved. If not it may be better to increase the strength of steroid if the body area being treated allows this.  \n• Apply the topical steroid every morning and night (except Elocon which is once daily) until the skin is completely clear.  \n• Apply the topical steroid immediately as soon as the eczema returns.  \n• If the eczema is not clearing after seven days of using a topical steroid patients should continue to use it but make an appointment to see their GP to review therapy.  \n• If skin becomes broken, develops blisters or yellow heads, is weepy or suddenly worse all over (signs of infection) patients should continue treatment but make an urgent appointment to see their GP.  \n• If the topical steroid stings on application or the eczema patches just aren't clearing then the GP may consider changing the treatment to an ointment as these don’t tend to contain preservatives and are more hydratin","cbCaijcB4rx1NkxJ","https://ap.wps.com/l/cbCaijcB4rx1NkxJ","pdf",152397,"English","# Steroid Ladder\n## Potency tiers and product examples\n## Do not use warnings and safety notes\n## Steroid Top Tips\n## Guideline and review dates","[{\"question\":\"What is the “steroid ladder” and how is it used?\",\"answer\":\"It organizes topical corticosteroids into potency tiers (e.g., very potent, potent, moderate, mild) so clinicians and patients can choose the correct strength for the correct body area, following the ladder.\"},{\"question\":\"Which areas and conditions should topical steroids not be used on?\",\"answer\":\"Do not use on eyelids, face, groin, armpits, genitals, children, or psoriasis. The document also cautions about rare risks with local or systemic administration.\"},{\"question\":\"When should patients seek urgent or routine GP review during steroid treatment?\",\"answer\":\"If skin breaks, blisters, shows yellow heads, becomes weepy, or suddenly worsens (infection signs), continue treatment and make an urgent GP appointment. If eczema is not clearing after seven days, continue the steroid but arrange a GP review.\"}]","STEROID LADDER - First choice - Drug potency ladder and usage guidance | PDF"]