Topical steroid creams and ointments should be applied in a thin layer and massaged into the affected area one to four times a day.
For most skin conditions, this regimen should continue until the rash resolves. Chronic skin conditions that wax and wane, such as psoriasis or eczema, benefit from the intermittent application of a topical steroid to prevent recurrences. Because topical steroids can cause side effects, the spacing of intermittent applications should be discussed with a health care provider before proceeding.
A topical steroid can be absorbed into the skin more quickly through a process known as occlusion.
Occlusion involves applying the topical steroid to the affected area and wrapping it in plastic wrap or cloth and securing it with tape. The plastic wrap keeps perspiration close to the skin and hydrates the stratum corneum, the top layer of the epidermis. Hydrated skin is able to absorb topical medication much more efficiently than dry skin, providing faster relief.
Occlusion dressings need to be left on for at least 2 hours at a time. Because of this, they are usually applied at bedtime. The occlusion method should only be used under the care of a health care provider since it significantly increases the potency of a topical steroid. Because occlusion promotes a moist environment, it increases the risk of developing bacterial infections and should not be utilized more than 3 days in a row.