Topical corticosteroids

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Date: April 2023, Version 2

Quick read

Topical corticosteroids can be used in pregnancy.

What are they?

Topical corticosteroids include hydrocortisone, alclometasone, beclometasone, clobetasone, diflucortolone, fludroxycortide, fluocinolone, fluocinonide, fluocortolone, fluticasone, mometasone and triamcinolone.

Topical medicines are applied to the skin or used as eye drops or nasal sprays. If used as recommended by the manufacturer they are usually absorbed into the bloodstream in only very small amounts.

Corticosteroid skin treatments are used for eczema, dermatitis and psoriasis.

Corticosteroid eye drops are used to treat allergies and inflammation or damage in the eye.

Corticosteroid nasal sprays are used to treat allergies such as hay fever as well as sinusitis and nasal polyps.

Benefits

What are the benefits of using a topical corticosteroid in pregnancy?

Topical corticosteroids can help to control conditions affecting the skin, eyes, and nose.

Good control of a skin condition reduces inflammation, improves quality of life and sleep, and means that an infection caused by scratching is less likely.

Corticosteroid eye drops can reduce unpleasant symptoms of allergy and can help to control some conditions that might damage the eye.

Corticosteroid nasal sprays can help a blocked and/or runny nose and therefore improve health and wellbeing.

Use of a topical corticosteroid might mean that a systemic steroid (taken by mouth resulting in a higher dose in the bloodstream) can be avoided.

Risks

What are the risks of using a topical corticosteroid in pregnancy?

There are no known risks. However, it is always sensible to follow the manufacturer’s instructions when using a topical corticosteroid to ensure that a minimal amount is absorbed into the bloodstream.

Alternatives

Are there any alternatives to using a topical corticosteroid in pregnancy?

Possibly. However, topical corticosteroids are generally considered to be a safe option and there is no need to avoid them in pregnancy.

Women who are planning a pregnancy should speak to their specialist to ensure they are using the most suitable treatment. This can be arranged through the GP or specialist clinic.

If a woman becomes pregnant while taking a topical corticosteroid, she should be reviewed by her doctor to ensure that the treatment is still required, and the dosage is correct.

No treatment

What if I prefer not to use a topical corticosteroid during pregnancy?

The conditions that topical corticosteroids are used to treat can be unpleasant and if untreated, can lead to complications including tissue damage and infection. It is therefore important that they are well-controlled during pregnancy. A doctor will be happy to discuss any concerns.

Will I or my baby need extra monitoring?

As part of routine antenatal care in the UK, women are invited for a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No further scans to check for birth defects will be required due to use of a topical corticosteroid.

Are there any risks to my baby if the father has used a topical corticosteroid?

There is no evidence that topical corticosteroids used by the father can harm the baby through effects on the sperm.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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