Q & A 9: How to differentiate weak and strong steroid?
Dear Dr Irene,
How to differentiate between weak and strong steroid?
AY
Answer:
Dear AY,
Steroids can be classified in many ways according to ‘how strong’ they are. Generally they can be classified into 7 classes; Class 1 (super-potent), Class 2 (potent), Class 3 (upper mid-strength), Class 4 (mid-strength), Class 5 (lower mid-strength), Class 6 (mild) and Class 7 (least potent). Scientifically, their strength or potency is measured on its ability to constrict the underlying skin vessels.
In real life, the strength or potency relates to how well or fast it can work and often also correlates to its ability to cause side effects. In general, the order of potency of some common steroid creams in the market is as follows (in the order from most potent to least potent);
Clobetasol propionate -> Betamethasone dipropionate -> Betamethasone valerate -> Clobetasone butyrate -> Hydrocortisone
Detailed classification of various steroids can be found at http://en.wikipedia.org/wiki/Topical_steroid
Of note, the formulation can also affect the potency of the steroid creams. Ointment tends to be more potent than creams, creams tends to be more potent than lotion.
Dr Irene Lee
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