"Topical Steroid Holiday"

Abstract

Daily use of low-potency topical steroids is a frequently observed pediatric prescribing pattern.1 Many clinicians believe such a strategy is safe because low-potency topical steroids usually do not suppress levels of plasma cortisol or produce systemic side effects. However, daily use of low-potency steroids may result in suppression of plasma cortisol levels.1-4 Suppression of plasma cortisol levels after use of topical steroids has been observed in a biphasic pattern. There is suppression within 2 weeks of starting daily therapy, then recovery to normal despite continued use, then suppression again after 4 to 6 weeks of daily therapy.2,3