Corticosteroids- skin, eye, and nose

(Date: December 2016. Version: 1)

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 Public Health England 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.

What are they?

Corticosteroids are a group of medicines that dampen the immune response and are used to treat inflammation. Topical corticosteroids are applied to external parts of the body such as the skin (as creams and ointments to treat conditions like psoriasis and eczema), the nose (as drops or sprays, to treat allergies, sinusitis, and nasal polyps), and the eyes (as drops or ointments, to treat allergies, eye injuries, and inflammatory eye conditions such as uveitis).

Corticosteroids that are used on the skin include alclometasone, beclomethasone, betamethasone, clobetasol, clobetasone, diflucortolone, fludroxycortide, fluocinolone, fluocinonide, fluticasone, hydrocortisone, and mometasone.
Corticosteroids that are used as nasal sprays or drops include beclometasone, betamethasone, budesonide, fluticasone, mometasone, and triamcinolone.
Corticosteroids that are used as eye treatments include betamethasone, dexamethasone, fluorometholone, hydrocortisone, loteprednol, and prednisolone.

What are the benefits of using topical corticosteroids in pregnancy?

Topical corticosteroids can relieve the itching, irritation, and inflammation associated with some allergic and inflammatory conditions. Their use can therefore greatly improve quality of life and may be required to prevent complications that can be caused by uncontrolled inflammation of skin and eyes. In general, unless topical corticosteroid treatments are applied to very large areas of skin, or to damaged tissue, they are not well absorbed into the bloodstream. This usually means that they are unlikely to reach the unborn baby in large enough amounts to cause any problems.

Are there any risks of using topical corticosteroids in pregnancy?

Overall, the available data does not raise concern that topical corticosteroids when used as prescribed can harm a baby in the womb. However, steroid treatments come in different ‘strengths’ (the medical term for this is ‘steroid potency’). No studies have accurately investigated outcomes in pregnant women only using potent topical corticosteroids. If you are using a ‘high strength’ corticosteroid, as a precaution, your doctor may advise that you try one with a lower potency during pregnancy.

Are there any alternatives to using topical corticosteroids in pregnancy?

Sometimes. Depending on the underlying condition that is being treated, there may be different (non-corticosteroid) medicines that can be used. Additionally, some inflammatory conditions improve on their own in pregnancy due to changes to the immune system, meaning that a treatment may no longer be needed.

Women using topical corticosteroids who are planning a pregnancy or fall pregnant should consult their doctor or specialist so that their medication can be reviewed.

What if I prefer not to use medicines in pregnancy?

Depending on the underlying medical condition, continuing either a corticosteroid or a different medication during pregnancy may be advised to avoid complications. Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Will my baby need any extra monitoring?

As part of routine antenatal care, most women will be offered a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. Women who have used a topical corticosteroid in early pregnancy will not usually need any extra monitoring.

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

There is no evidence that topical corticosteroids used by the father around the time of conception can harm the baby.

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

Feedback request 

WE NEED YOUR HELP! Do you have 3 minutes to complete a short, quick and simple 12 question user feedback form about our bumps information leaflets? To have your say on how we can improve our website and the information we provide please visit here.

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.

My bump’s record

Create your own ‘My bump’s record’.

Provide information about your pregnancy to help women in the future.

Login to my bumps

Join my bumps