A standard unit used for topical corticosteroid application is the fingertip unit. The choice of which agent, concentration, and formulation to use depends on the condition being treated, the location on the body, characteristics of the lesion, and patient factors such as age. A prescription for topical corticosteroids should include the medication name, concentration, formulation, directions for application, and amount. High- and medium-potency corticosteroids should be used for no more than 12 weeks at a time. There is no evidence that topical corticosteroids lose effectiveness over time (tachyphylaxis).23 However, corticosteroid withdrawal (i.e., corticosteroid addiction) can occur upon cessation after prolonged use on the face and genitals, causing erythema, scaling, stinging, burning, papules, pustules, and edema.24 Differentiation from hypersensitivity to other components of the topical treatment is important if contact sensitization is suspected. Contact sensitization to topical corticosteroids can also occur but is rare.
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