In 1950, Hench and collaborators won the Nobel Prize in Medicine for their work on the effects of glucocorticoids in rheumatologic diseases. Two years later, Sulzberger and Witten used them to treat inflammatory skin diseases topically with hydrocortisone, called “substance F”. It was not until 1961 that Reichling and Kligman used systemic steroids every other day for the treatment of skin diseases, and in 1982 Johnson and Lazarus tested them as pulsed intravenous therapy in the treatment of pyoderma gangrenosum. Topical and systemic steroids have been used in skin diseases, and have become the first-line treatment in many of these pathologies due to their anti-inflammatory, antiproliferative and vasocontrictor effects. In fact, the anti-inflammatory capacity of topical steroids is related to their vasocontrictor potency, the effect is desired, although if treatments are longer than strictly necessary, it can have consequences such as delicate local and systemic events (the latter mainly in children).

Topical corticosteroids are the most commonly used drugs in dermatological practice. Accurate treatment depends on an accurate clinical diagnosis and proper evaluation of the patient, the area of skin to be treated and the response of the dermatoses to the steroid to be applied. Many patients with dermatoses that respond to topical steroids remain wrongly treated due to inadequate doses and application times, so optimizing treatment will improve clinical outcomes and minimize the risk of complications and adverse effects.

There are several classifications of steroids that divide them according to their anti-inflammatory potency, as shown in the following table: (American Classification of Topical Steroids).