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Topical Corticosteroids
Isabel C. Valencia &
Francisco A. Kerdel
CLINICAL FORMULATIONS
Topical steroids come in many different vehicles
and dosage forms. The clinical potency of a topical
corticosteroid depends not only on the inherent
potency of the molecule but also on factors such as
the vehicle and the nature of the skin onto which it
is applied. The vehicle in which the steroid is incorporated may be as important as the steroid molecule itself because the vehicle affects the amount
of steroid that is released in any given period of
time. Very occlusive vehicles, such as ointments,
potentiate glucocorticoid effects because they provide increased hydration of the stratum corneum
and increase its permeability. By covering the skin
with an occlusive dressing such as plastic wrap, this
effect can be heightened as much as 100-fold. The
solubility of the glucocorticoid in the vehicle also
affects penetration into the epidermis. Propylene
glycol is one agent commonly used to dissolve
the glucocorticoid in the vehicle, and it is found
in many topical glucocorticoid preparations.32 In
general, compounds that contain higher amounts
of propylene glycol tend to be more potent.