How to Safely Apply Topical Steroid Creams to Your Face

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A walk down the aisles of your local pharmacy will reveal a wide variety of over-the-counter topical corticosteroid brands and preparations. These products are known as cortisone or steroid creams.

mature woman looking at face in mirror
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Topical steroids are the most common and effective type of anti-itch and anti-inflammatory cream. But it's important to use them only as directed by your healthcare provider. This is especially true when it comes to your face, which is a sensitive area.

This article explains how to choose a steroid cream to use on your face, how to do it safely, and side effects to watch out for.

Steroid Cream Potency and Absorption

In the United States, topical steroid creams are categorized by their potency, meaning how strong they are. Group 1 contains the most potent topical steroid creams, referred to as ultra-high-potency. Group 7 contains the least potent topical steroid creams, referred to as low-potency.

Only the lowest-potency topical steroids should be used on your face. This is because the skin on your face is thin. And thin skin absorbs more of the steroid than other areas of your body.

Likewise, sticking to a low-potency steroid is important when applying it to other areas of the body with thin skin. The neck, groin, underneath the breast, and the armpit are among these sensitive areas.

Children are even more susceptible to increased absorption because of their larger ratio of skin surface to body mass.

Examples of low-potency topical steroids include Cortizone 10 (hydrocortisone), which is in Group 7. Kenalog (triamcinolone) is in Group 6.

Some lower-potency corticosteroids, like 1% hydrocortisone, are available over the counter. Others, like 2% hydrocortisone, are available only by prescription.

In general, high- and ultra-high-potency steroids are reserved for areas of the body where the skin is thick, like your palms or the soles of your feet. They are also used for more severe skin diseases that are being treated by a dermatologist, such as psoriasis.

Side Effects

Your face is more vulnerable to developing side effects from topical steroids. These side effects most often appear where the medication was applied. The effects may include:

  • Thinning of the skin
  • Pigment changes (lighter or darker skin)
  • Telangiectasia (enlarged blood vessel formation)
  • Striae (stretch marks)
  • Rosacea, perioral dermatitis, and acne
  • Increased risk of developing skin infections (fungal or bacterial)
  • Delayed wound healing ability
  • Irritation, redness, burning, stinging, and peeling of the skin
  • Contact dermatitis from the topical steroid itself

Many of these side effects do resolve after stopping the steroid, but it may take months. This is why the American Academy of Dermatology recommends closely monitoring the areas (such as the face) where the steroid is being applied.

Continuous use of topical steroids for long periods of time should also be avoided.

Applying a Steroid Cream to Your Face

When applying a steroid cream to your face, it's essential to follow the advice of your healthcare provider. Too little cream may not work and too much increases your risk of side effects.

Be sure to keep the cream away from your eyes. It could cause serious eye problems, like glaucoma or cataracts.

A good rule of thumb when deciding how much steroid cream to apply (for adults) is to use the fingertip unit method. A fingertip unit is defined as the amount of steroid cream that can fit on your fingertip, up to the first crease of your finger.

In general, 2.5 fingertip units may be used on your face per application. Still, confirm with your healthcare provider that this amount is right for you.

Some experts believe that frequent use of topical steroid cream anywhere on the body, not just the face, may make it less effective. This event is called tachyphylaxis. Follow a sensible rule of thumb and use the smallest amount of cream for the shortest time possible.

If a longer-term application is needed for a chronic (long-term) condition, your healthcare provider will likely recommend following a specific schedule. In this way, the steroid amount can be reduced, stopped, and then restarted after a steroid-free period.

Alternatives

Alternative creams that can be used on the face include Elidel and Protopic, which are topical calcineurin inhibitors (TCIs). These medications are approved by the Food and Drug Administration (FDA) for the treatment of atopic dermatitis (eczema) in people who are at least 2 years old.​

Unlike topical steroids, TCIs do not cause skin thinning, pigment changes, blood vessel formation, or striae formation. Nor do they lose effectiveness with prolonged use.

In addition, TCIs can be used on any skin, including the face and eyelids. Just like any medication, however, even TCIs have possible side effects. In fact, there are FDA warnings associated with Elidel and Protopic.

The FDA has ordered that labels on the product boxes warn consumers about "a possible risk of cancer," based on rare reports of skin cancer and lymphoma. Though the risk is low, the agency reminds consumers to use the products "as recommended."

Summary

When using a steroid cream on the face or any thin skin, it's generally best to use a low-potency cream. Avoid getting the medication in your eyes, and follow your healthcare provider's instructions.

Side effects of steroid cream use include thinning of the skin, pigment changes, and problems with wound healing. Your healthcare provider may recommend non-steroid alternatives for use on the face instead.

A Word From Verywell

The bottom line is, only the smallest amount of steroid cream should be applied to your face. However, it should not be so small as to render it ineffective. The cream should also be used for the shortest amount of time possible.

Although these creams are widely available, they're effective only when used to treat specific skin conditions, like eczema or psoriasis. Put another way, slathering on a steroid cream for just any rash is not the way to go. Instead, use the cream only under the guidance of a healthcare provider. 

All said, topical steroids are quite effective, low-risk medications as long as you follow the recommendations for potency, dose, and duration.

Frequently Asked Questions

  • How long can you safely use steroid cream on your face?

    It depends on the strength of the steroid cream. Low-potency creams may be used for up to three months. High-potency steroids shouldn't be used for more than three weeks. However, consult your healthcare provider to determine how long you can safely use the creams.

  • Can you use topical steroid cream when pregnant?

    Yes. A pregnant person can use topical steroid cream. But it should be prescribed at the lowest strength possible. There is some evidence that high-potency, topical steroids can interfere with fetal growth.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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