Topical Corticosteroid Therapy: Efficacy of Frequent Application

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Abstract
To the Editor.— Although corticosteroid preparations are among the most commonly used and effective topically applied medications for treating skin diseases, little has been published on the optimum frequency of application. In the 1973 Physicians' Desk Reference (PDR), manufacturers recommend using topically applied corticosteroid preparations from two to four times daily. Most recommend three to four daily applications, as needed. One cream preparation, available in concentrations ranging from 0.025% to 0.2% (a tenfold difference) is to be applied three to four times daily at all concentrations. One manufacturer states that clinical studies indicate that one or two daily applications are often effective, recommending a general dosage of one to three applications daily. It is commonly believed that topically applied steroid preparations are more effective when applied frequently, but we are unaware of clinical studies comparing the efficacy of the standard number of daily applications to a greater number of daily