Use of steroid creams during pregnancy

The aims of this leaflet

This leaflet is designed to tell you more about the use of steroid creams in pregnancy, the benefits and possible problems

What are steroid creams?

Steroids are produced naturally by the body. They reduce inflammation and have been altered to make it possible to use them directly on the skin rather than having to take steroid tablets. Using them directly on the skin for skin conditions reduces the side effects for other organs compared to taking them as tablets.

What are steroid creams used for?

They are used to treat many itchy skin conditions in pregnancy, including eczema, sometimes psoriasis, atopic eruption of pregnancy and the specific pregnancy skin diseases polymorphic eruption of pregnancy and pemphigoid gestationis.
It is important during pregnancy to use treatments that are as safe as possible for both mother and baby.

How to use steroid creams safely during pregnancy?

The use of emollients, (moisturising) creams and ointments can help with the inflammation and discomfort of the skin as can bathing or showering in emollient and soap substitutes and this can lessen the need for steroid creams. 
Steroid creams or the greasier steroid ointments are often necessary to relieve symptoms like itch and inflammation. The steroid cream or ointment should only be applied to affected areas of skin and a mild (for example hydrocortisone) or moderate steroid cream should be used. The amount should be as small as possible, and ideally only 1-2 small (15-30gm) tubes should be used for a few days and intermittently. However, if the condition is severe then application of a stronger steroid cream or ointment to the skin in larger quantities is still better than steroids given by mouth. 

Are the treatments safe for the baby and mother?

Mild to moderate strength steroid creams or ointments appear to be safe during pregnancy and can be used safely, but stronger steroid creams and ointments may cause problems with the growth of the unborn baby, so that they may be born small. 

Is any special monitoring required?

Yes, regular review at an antenatal clinic important if the mother is using large amounts (more than 50gm, 1/2 large tube per month or over 200-300gm, 2-3- large tubes in the whole pregnancy) of steroid creams or ointments.  

Where can I get more information? 

http://www.euroderm.org/images/stories/guidelines/EDF-Guideline-on-Steroids-in-Pregnancy.pdf
 
 
This leaflet has been prepared by the EADV task force “skin disease in pregnancy”, it does not necessarily reflect the official opinion of the EADV.
Updated 24.5.2013