Topical corticosteroids are widely used in the treatment of certain skin conditions, acute or chronic. According to a still widespread idea, these creams and ointments are photosensitizing and therefore should not be used before or during exposure to the sun. But what really is this photosensitization? Santé sur le Net takes stock of this issue.
Topical corticosteroids, a therapeutic class of choice in dermatology
Topical corticosteroids include drugs based on corticosteroids used as topicals, that is to say, creams, gels or ointments containing one or more corticosteroids. Corticosteroids are incorporated into products for skin use for several of their pharmacological properties:
- Anti-inflammatories;
- Anti-allergic;
- Anti-pruritic;
- Cytostatic and anti-proliferative;
- Immunosuppressant;
- Atrophying.
Therapeutic indications of topical corticosteroids
For one or more of these properties, topical corticosteroids are used in routine practice in a wide range of therapeutic indications:
- Chronic skin conditions, such as atopic dermatitis, psoriasis, or eczema ;
- Acute skin conditions, such as skin lesions following an insect bite or a flare-up of dyshidrosis.
Topical corticosteroids and the sun: drug photosensitization
While topical corticosteroids play an important role in the management of various skin conditions, there is still a widespread misconception, both among health professionals and the general public. This received an idea according to which topical corticosteroids are photosensitizing. Drug photosensitization is defined as an exaggerated reaction of the skin to the sun, following the intake of a drug. It can for example cause abnormally severe sunburn in relation to the duration of exposure to the sun.
This photosensitization is not found only with drugs used directly on the skin. Some drugs taken by mouth, for example, some diuretics or antibiotics, are photosensitizing. In practice, there are a large number of photosensitizing drugs, which can be identified by a symbol on their packaging: a sun half hidden by a cloud in a red triangle. For a long time, and even among health professionals, the idea circulated that topical corticosteroids were photosensitizing, which often led to the cessation of treatment for certain chronic skin diseases for the duration of the summer season.
Topical corticosteroids and the sun: continue treatments during the summer
In reality, topical corticosteroids are not photosensitizing. Nevertheless, since their action can lead to a change in skin color or skin lesions, these changes have often been perceived as an effect of photosensitization.
For example, in atopic dermatitis, the action of topical corticosteroids reduces inflammation and causes changes in skin pigmentation and lesions, but this mechanism is unrelated to photosensitization.
While vigilance must be required during the summer period for all photosensitizing drugs, this vigilance does not concern topical corticosteroids. The usual treatment for patients with chronic skin conditions should continue during summer and periods of sun or UV exposure. Health professionals, doctors, and pharmacists can provide the best advice to patients to reconcile sun and skin health, without stopping topical corticosteroids.