Corticosteroids- skin treatments, eye drops, and nasal sprays

(Date: April 2023. Version: 2)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

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.

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.

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.

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.

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 allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. 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 https://www.medicinesinpregnancy.org/Login/ to register.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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