This sheet is about exposure to topical corticosteroids in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.
What are topical corticosteroids?
Topical corticosteroids are medications that are put directly on the skin to treat skin conditions like eczema, psoriasis, and other rashes. They might be in the form of lotion, cream, ointment, or gel. There are many different corticosteroids. Topical corticosteroids include over the counter products such as hydrocortisone and stronger prescription medications such as clobetasol, betamethasone, and triamcinolone. For questions about a specific topical corticosteroid, talk with your healthcare provider or contact a MotherToBaby specialist.
Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
Does the strength, frequency, or amount of topical corticosteroid used matter?
The strength of a topical corticosteroid refers to the amount of active ingredient(s) in the product. The frequency is the amount of times that it is applied, such as once a day or multiple times per day. The amount refers to the size of medication needed to treat the affected area. These factors matter because they can help providers understand how much medication may be absorbed through the skin and into the bloodstream.
Topical corticosteroids are often a first-line treatment during pregnancy for skin conditions. This is because the amount of medication that can reach the developing pregnancy by absorption through the skin is typically much lower than with medications taken by mouth. This is especially true when the topical corticosteroid is used on small areas of the body, used infrequently, or used on healthy (non-broken) skin.
Certain parts of the body can absorb medication more easily than other areas. For example, the skin on the face and groin are thinner and more medication can potentially be absorbed when those areas are treated, compared with other parts of the body. More medication can also be absorbed through broken skin or if applied under a bandage or dressing. The stronger the topical corticosteroid, the more likely a higher amount will be absorbed into the blood. It is usually suggested to use the lowest effective strength for the shortest time needed to treat your condition.
I use topical corticosteroids. Can it make it harder for me to get pregnant?
It is not known if using topical corticosteroids can make it harder to get pregnant.
Does using topical corticosteroids increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Use of topical corticosteroids is not expected to increase the chance of miscarriage.
Does using topical corticosteroids increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like topical corticosteroids, might increase the chance of birth defects in a pregnancy.
Studies looking at topical corticosteroid exposure have not found an increased chance of birth defects. In many cases, only a small amount of the corticosteroid is expected to be absorbed from topical exposure, with little medication getting into the blood and reaching the developing pregnancy.
Does using topical corticosteroids in pregnancy increase the chance of other pregnancy-related problems?
Not all topical corticosteroids have been well studied for use in pregnancy. When used as directed, topical corticosteroids are not expected to increase the chance of pregnancy complications. The use of very strong corticosteroids over large areas of the body for a long time might be associated with lower birth weight.
Does using topical corticosteroids in pregnancy affect future behavior or learning for the child?
It is not known if using topical corticosteroids can increase the chance of behavior or learning issues. However, because very little medication is expected to be absorbed through the skin and reach the developing pregnancy, a risk is unlikely.
Breastfeeding while using topical corticosteroids:
Not all topical corticosteroids have been well studied for use in breastfeeding. In most cases, typical use of topical corticosteroids would not be expected to pose a risk to a breastfed baby, as the amount that gets through the skin and enters the milk is expected to be small. In cases where very strong corticosteroids are applied to large areas of the body or used for a long period of time, more medication could enter the milk. Topical corticosteroids applied to the breast or nipple area should be wiped off before breastfeeding or coming into contact with your baby’s skin and mouth. Wash your hands well after applying the medication. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man uses topical corticosteroids, could it affect fertility or increase the chance of birth defects?
It is not known if topical corticosteroids could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
There is a registry for betamethasone in the treatment of autoimmune diseases. You can call 877-311-8972. For information online: https://mothertobaby.org/pregnancy-studies/.
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