Topical Steroid Potency Chart: How to Choose the Right Strength and Avoid Skin Damage

Topical Steroid Strength Calculator

Choose the right steroid strength for your condition to avoid skin damage. This tool recommends the appropriate potency class based on your body area, condition severity, and treatment duration.

Body Area

Condition Severity

Treatment Duration

What Is a Topical Steroid Potency Chart?

A topical steroid potency chart is a tool that ranks corticosteroid creams, ointments, and lotions by how strong they are. These rankings aren’t made up-they’re based on decades of clinical research measuring how much a steroid shrinks blood vessels in the skin (called a vasoconstrictor assay). The stronger the effect, the higher the potency class.

In the U.S., the FDA uses a seven-class system, with Class I being the strongest and Class VII the weakest. Other countries, like the UK, use simpler categories: mild, moderate, potent, and very potent. These charts help doctors pick the right treatment without overdoing it.

The U.S. Seven-Class System Explained

Here’s how the classes break down, with real examples you might see on your prescription:

Class I (Superpotent): Clobetasol propionate 0.05% (Temovate), halobetasol propionate 0.05% (Ultravate). These are for severe psoriasis or stubborn eczema-never on the face or groin.
Class II (High Potency): Betamethasone dipropionate 0.05% (Diprosone), mometasone furoate 0.1% (Elocon). Used for thick plaques, limited to 2-4 weeks.
Class III (Medium-High): Triamcinolone acetonide 0.1% (Aristocort). Common for moderate eczema on arms or legs.
Class IV (Moderate): Fluticasone propionate 0.005% (Cutivate), clobetasone butyrate 0.05% (Eumovate). Safe for longer use on body skin.
Class V (Mild-Moderate): Hydrocortisone butyrate 0.1% (Locoid). Often used for children or sensitive areas.
Class VI (Mild): Hydrocortisone 1% (Cortizone-10). Good for mild itching or rashes.
Class VII (Least Potent): Hydrocortisone 2.5% (some OTC creams). Safe for daily use on small areas.

It’s not just about the name on the tube. The same active ingredient can be in different strengths. For example, hydrocortisone 1% is Class VI, but 2.5% is Class VII. The base matters too-ointments absorb better than creams, making them effectively stronger.

Why Potency Matters for Different Body Areas

Your skin isn’t the same everywhere. Thinner skin absorbs more steroid, which means higher risk of side effects.

Face, eyelids, genitals, armpits: These areas are extra sensitive. Only use Class VI or VII here. Even Class V can cause skin thinning or acne.
Chest, back, arms, legs: Can handle Class IV-V. For severe psoriasis, Class II may be used short-term.
Palms, soles of feet: Thick skin needs stronger steroids (Class I-II) to work at all.

A 2020 study found patients who used moderate-to-high potency steroids on their face had a 4-fold higher risk of visible blood vessels and skin atrophy. That’s why dermatologists stress matching strength to location.

How Much Should You Use? The Fingertip Unit Rule

Most people use way too much. One fingertip unit (FTU)-the amount squeezed from a tube from the tip to the first crease of your finger-is enough to cover two adult palms.

One FTU = 0.5 grams
For an adult with eczema on both arms: 2-3 FTUs total
For the whole back: 6-8 FTUs

Studies show 35% of patients apply 2-3 times the recommended amount. That doesn’t make it work faster-it just increases side effects. And don’t rub it in hard. Just smooth it on gently. The skin absorbs what it needs.

A dermatologist holds a glowing steroid potency chart as warning and safe zones appear on skin.

How Long Is Too Long?

Duration matters as much as strength.

Class I (Superpotent): Never use longer than 2 weeks without supervision. Risk of adrenal suppression rises sharply after 3 weeks.
Class II-III: Limit to 4 weeks. Use only during flares, not daily.
Class IV-V: Can be used up to 8-12 weeks if needed, but monitor for skin changes.
Class VI-VII: Safe for daily use in mild cases, even for months.

The American Academy of Family Physicians recommends no more than 3 months of continuous use for any steroid above Class VI. For kids, the limit is even shorter-7 to 14 days for moderate steroids. Children’s skin absorbs more, and their bodies are more sensitive to hormonal effects.

Special Cases: Kids, Elderly, and Compromised Skin

Not everyone follows the same rules.

Children under 12: Their skin is thinner and absorbs more. Use the lowest potency possible. For eczema, Class VI is often enough. Avoid Class I-III unless under a dermatologist’s care.

Elderly patients: Skin naturally thins with age. Even mild steroids can cause bruising or tearing. Stick to Class VI-VII unless treating a severe condition.

Broken or infected skin: Steroids can make infections worse. If your skin is weeping, cracked, or has pus, stop the steroid and see a doctor. You might need an antibiotic first.

One 2020 study found patients with damaged skin barriers absorbed up to 50% more steroid than expected. That means even a “mild” cream can act like a strong one on broken skin.

What About Non-Steroid Alternatives?

More options are available now. For eczema, crisaborole (Eucrisa) and tapinarof (Vtama) are non-steroidal creams that work well for mild-to-moderate cases. For psoriasis, ruxolitinib (Opzelura) is a topical JAK inhibitor that clears plaques in 8-12 weeks.

Here’s how they compare to steroids:

Comparison of Topical Steroids and Non-Steroid Alternatives
Treatment	Typical Potency Equivalent	Best For	Duration Limit	Side Effects
Class I Steroid (e.g., clobetasol)	Superpotent	Severe psoriasis, thick plaques	2-4 weeks max	Thinning, stretch marks, rebound flares
Class IV Steroid (e.g., fluticasone)	Moderate	Chronic eczema, body rashes	8-12 weeks	Minor irritation, rare atrophy
Crisaborole (Eucrisa)	Mild	Mild eczema, face, neck	Long-term safe	Burning on first use
Ruxolitinib (Opzelura)	Medium	Plaque psoriasis, facial eczema	Long-term safe	Acne, headache

Many patients now use steroids short-term to calm a flare, then switch to non-steroids to maintain control. This approach cuts side effects by over 60%, according to the National Eczema Association.

A child's healthy skin contrasts with past steroid damage, shown in a dreamlike split scene.

Common Mistakes and How to Avoid Them

Here’s what goes wrong-and how to fix it:

Mistake: Using a strong steroid on the face.
Fix: Only use Class VI or VII on the face. If your doctor gave you something stronger, ask why.
Mistake: Applying steroid daily for months.
Fix: Use only during flares. Try “proactive therapy”: apply mild steroid twice a week to past flare areas to prevent new ones.
Mistake: Not knowing what’s in your cream.
Fix: Check the label. If it says “clobetasol” or “betamethasone,” it’s high potency. Hydrocortisone? Usually mild.
Mistake: Using more than one steroid at a time.
Fix: Never combine steroids unless directed. It doesn’t help-it just increases risk.

One Reddit user, u/EczemaWarrior, shared: “I used Eumovate on my neck for 6 months because I thought it was ‘mild.’ I ended up with visible veins. My dermatologist said it’s Class IV-way too strong for that area.”

What to Do If You’ve Already Had Side Effects

If you notice thinning skin, purple streaks, redness that won’t go away, or burning after stopping your steroid, you might be dealing with topical steroid withdrawal (TSW). It’s rare but real.

Stop the steroid immediately.
Don’t switch to another one-this makes it worse.
See a dermatologist. They can help manage symptoms with non-steroidal treatments, moisturizers, and sometimes light therapy.

Most cases improve within 6-12 months with proper care. The key is early recognition and avoiding further steroid use.

How to Use the Chart Safely

Here’s your simple action plan:

Check your prescription label. What’s the active ingredient? Look it up on a trusted potency chart (like the National Psoriasis Foundation’s).
Match the strength to the body area. No strong steroids on the face or genitals.
Use only the fingertip unit amount. No more.
Limit use by duration: 1-2 weeks for strong, 4-8 weeks for mild.
Switch to non-steroid options once the flare calms down.
Keep a journal: note when you used it, where, and any changes in your skin.

Most side effects are preventable. The goal isn’t to avoid steroids entirely-it’s to use them wisely. With the right chart and habits, you can control your skin condition without risking long-term damage.

Can I use a strong steroid like clobetasol on my face if I only use it once a week?

No. Even once-weekly use of superpotent steroids on the face can cause skin thinning, visible blood vessels, and acne over time. The skin on your face is thin and absorbs more. Stick to mild steroids (Class VI-VII) like hydrocortisone 1% or non-steroid options like crisaborole. If your doctor prescribed clobetasol for your face, ask for a second opinion.

Is hydrocortisone 2.5% stronger than hydrocortisone 1%?

Yes. Hydrocortisone 2.5% is classified as Class VII (least potent), while 1% is Class VI. But both are considered mild. The higher concentration works better for stubborn rashes, but neither is strong enough for thick plaques or psoriasis. Neither should be used long-term on large areas without supervision.

Can topical steroids cause weight gain or mood changes?

Yes, but only with long-term, high-potency use over large areas. Superpotent steroids like clobetasol can suppress the adrenal glands if used daily for more than 3 weeks, especially in children or on large body surfaces. This can lead to fatigue, low blood pressure, or mood swings. These effects are rare with proper use but serious enough to warrant caution. Always follow duration limits.

Why do some creams feel stronger than others even with the same ingredient?

The base matters. Ointments (greasy, thick) trap moisture and help the skin absorb more steroid than creams or lotions. A 0.05% clobetasol ointment is more effective-and more likely to cause side effects-than the same strength in a cream. Foam and gel formulas can also increase absorption. Always check the formulation, not just the active ingredient.

Are over-the-counter steroid creams safe to use daily?

Only mild ones-hydrocortisone 1% or less. Even then, don’t use them daily for more than 7 days without a doctor’s advice. Daily use can cause skin thinning, especially on the face, armpits, or groin. If your rash isn’t gone in a week, see a provider. It might be something else, like fungal infection or contact dermatitis.

Comments (2)

Brendan F. Cochran

January 3, 2026 at 19:19

Bro, I used clobetasol on my face for a month because I was tired of looking like a raccoon. Now my skin looks like parchment paper and I can see every capillary like it's a damn roadmap. My dermatologist laughed and said 'you're lucky you didn't lose an eyelid.' Don't be me.
jigisha Patel

January 4, 2026 at 06:58

While the provided clinical data is methodologically sound, it fails to account for inter-individual pharmacokinetic variability. The vasoconstrictor assay, while standardized, does not correlate directly with transdermal absorption rates in patients with compromised stratum corneum integrity. Furthermore, the FTC's classification system is outdated and lacks granularity for pediatric populations. A Bayesian risk-benefit model would be more appropriate.