Topical corticosteroids in an ointment vehicle are generally more potent than the same concentration of the corticosteroid in a cream or lotion vehicle. Physicians' knowledge of the strength of the corticosteroid to be used and the factors that influence skin penetration should minimize the potential for adverge effects from the application of these compounds. . An ointment is generally the most effective vehicle for treating thick, fissured, lichenified skin lesions. The occlusive nature of the vehicle enhances corticosteroid penetration. Paticnts may consider ointments aesthetically undesirable.
Creams are generally the vehicle of choice for acute and subacute dermatoses.
They may be used on moist skin and in intertriginous areas and are generally aestherically acceptable to patients. Cream vehicles may be drying, and some patients may benefit from the application of a moisturizer in addition to a corticosteroid cream. Creams require preservatives that may be sensitizing. They also may be useful when, for aesthetic or medical reasons. These vehicles frequently contain alcohol and propylene glycol that may cause irritation or burning if applied to acute dermatoses, erosions, or fissures.