Topical Steroid Potency Chart: The 7 U.S. Classes Explained (Uses, Safety, and Smart Shopping Guide)

If you shop for skincare to calm eczema, psoriasis, contact dermatitis, or stubborn rashes, you’ve likely seen “topical corticosteroids” (often shortened to “topical steroids”) in your search results. But labels like “super‑potent,” “high‑potency,” and “low‑potency” can be confusing—especially when the same ingredient comes in multiple strengths and vehicles (ointment vs. cream vs. lotion). This comprehensive guide breaks down the current U.S. seven‑class potency system, shows you how to read a topical steroid potency chart, and shares safety tips and buying advice so you can choose confidently and use these medicines wisely. 

What “potency” means (and why it matters)

In dermatology, potency describes how strong a topical steroid’s effect is on the skin. In the United States, topical corticosteroids are categorized into seven classes, from Class I (super‑high/super‑potent) to Class VII (least potent). Potency is determined primarily using a standardized “vasoconstrictor assay,” which measures how much the medicine blanches (constricts) the tiny vessels in skin—a proxy for its anti‑inflammatory strength. The same drug can test stronger or weaker depending on concentration and the base (ointment, cream, foam, etc.). 

Why potency matters:

• Higher potency can clear thick plaques or severe flares faster—but carries higher risk of side effects if misused.
• Lower potency is gentler for thin‑skinned areas (face, eyelids, skin folds) and for children. 

How to use this Potency Chart

• Work with your healthcare provider to match potency to the body site and severity.
• Consider the vehicle: ointments usually enhance absorption more than creams or lotions, making the same steroid effectively “stronger.” Occlusion (e.g., wraps) also boosts absorption. 
• Follow safe duration limits and quantity guidance (see “How much and how long?” below).

Topical Steroid Potency Chart (U.S.): Classes I–VII with common examples

Below are commonly prescribed U.S. examples by class. Exact potency can vary by brand, strength, and vehicle. Always check your specific product label.

• Class I — Super‑high (super‑potent)

  • Clobetasol propionate 0.05% in any vehicle
  • Augmented betamethasone dipropionate 0.05% gel or ointment
  • Halobetasol propionate 0.05% cream or ointment
  • Fluocinonide 0.1% cream
  • Diflorasone diacetate 0.05% ointment (ncbi.nlm.nih.gov)

• Class II — High potency

  • Amcinonide 0.1% ointment
  • Augmented betamethasone dipropionate 0.05% cream or lotion
  • Betamethasone dipropionate 0.05% ointment
  • Desoximetasone 0.25% or 0.05% (various vehicles)
  • Fluocinonide 0.05% (cream, gel, ointment)
  • Halcinonide 0.1% (cream, ointment, solution) (ncbi.nlm.nih.gov)

• Class III — Medium‑to‑high potency

  • Amcinonide 0.1% cream
  • Betamethasone dipropionate 0.05% cream
  • Fluticasone propionate 0.005% ointment
  • Triamcinolone acetonide 0.5% cream or ointment (ncbi.nlm.nih.gov)

• Class IV–V — Medium potency

  • Betamethasone valerate 0.1% (cream, lotion, foam)
  • Desoximetasone 0.05% cream
  • Fluocinolone acetonide 0.025% (cream, ointment)
  • Fluticasone propionate 0.05% cream
  • Hydrocortisone butyrate 0.1% ointment
  • Hydrocortisone probutate 0.1% cream
  • Hydrocortisone valerate 0.2% (cream, ointment)
  • Mometasone furoate 0.1% (cream, lotion, ointment)
  • Triamcinolone acetonide 0.025% or 0.1% (cream, lotion, ointment) (ncbi.nlm.nih.gov)

• Class VI — Low potency

  • Alclometasone dipropionate 0.05% (cream, ointment)
  • Desonide 0.05% in any vehicle
  • Fluocinolone acetonide 0.01% cream
  • Hydrocortisone butyrate 0.1% cream (note: vehicle matters; the ointment form is typically stronger) (ncbi.nlm.nih.gov)

• Class VII — Least potent

  • Hydrocortisone 2.5% (Rx)
  • Hydrocortisone 1% (OTC) in cream, lotion, or ointment (ncbi.nlm.nih.gov)

Shopping tip: If you’re comparing two options with the same active ingredient and strength, the ointment is generally more occlusive and potent than the cream or lotion. Choose lotions, solutions, foams, or gels for hairy areas like the scalp for easier spread. (ncbi.nlm.nih.gov)

Which potency for which body area?

Skin thickness and absorption vary dramatically by site:

• Eyelids and genitals absorb about 30x more than palms.
• Face absorbs more than forearms; soles absorb the least.
• Ointments and occlusion further increase absorption. (dermnetnz.org)

Practical rules of thumb many clinicians follow:

• Face, eyelids, neck, skin folds, and groin: low‑potency (Class VI–VII) in most cases; short courses of medium potency may be considered for severe flares under medical supervision.
• Trunk and extremities: medium potency (Class IV–V) for many rashes.
• Palms/soles, thick plaques: high to super‑high potency (Class II–I) for limited durations. (ncbi.nlm.nih.gov)

How much and how long? Safe use basics

• Frequency: Once daily is often as effective as twice daily and may reduce side effects. (ncbi.nlm.nih.gov)
• Duration: A common framework is up to 3 weeks for super‑high potency and up to 12 weeks for high‑ or medium‑potency agents; low‑potency has no strict maximum, but still use the minimum effective amount. Follow your clinician’s plan. (ovid.com)
• Quantity: Use the “fingertip unit” (FTU)—a strip from the fingertip to the first crease—about 0.5 g. Roughly:
  • One hand (front and back) = 1 FTU
  • One arm = 3 FTUs
  • One foot = 2 FTUs
  • One leg = 6 FTUs
  • Face and neck = 2.5 FTUs
  • Entire body ≈ 40 FTUs (adults) (dermnetnz.org)

Maintenance or “proactive” strategies: For patients with frequent relapses, dermatology guidelines support intermittent (e.g., twice‑weekly) application of a medium‑potency steroid on previously active areas to extend time between flares—often alternated with non‑steroidal options. Your dermatologist can tailor this plan. (ncbi.nlm.nih.gov)

E‑commerce perspective: How to shop smarter for topical steroid therapy and supporting skincare

Because many topical steroids are prescription items in the U.S., shoppers often combine their Rx with over‑the‑counter skincare that improves results and reduces steroid exposure.

• Match the vehicle to the job

  • Ointment for very dry, thickened areas (max occlusion).
  • Cream for everyday use on most body sites—more cosmetically elegant.
  • Lotion, solution, gel, foam for scalp or hairy regions. (ncbi.nlm.nih.gov)

• Build a steroid‑sparing routine

  • Fragrance‑free moisturizers (ceramide‑rich creams, petrolatum‑based ointments) before and after steroid courses can reduce the need for higher‑potency steroids.
  • For atopic dermatitis, non‑steroidal prescriptions (calcineurin inhibitors like tacrolimus or pimecrolimus, PDE‑4 inhibitor crisaborole, and newer topical JAK inhibitors) are guideline‑supported alternatives and adjuncts—ask your prescriber. (aad.org)

• Size, price, and value

  • Check the grams/ounce per price and the expected duration using FTU math to avoid running out mid‑flare.
  • For large areas (e.g., trunk), you may need 30–60 g for a short course; smaller tubes suffice for localized rashes. (ncbi.nlm.nih.gov)

• Sensitive‑area solutions

  • Keep a low‑potency steroid (e.g., hydrocortisone 1% OTC) on hand for face/eyelids and folds, and use for short bursts only, then transition to barrier repair creams to maintain results. (ncbi.nlm.nih.gov)

• Scalp‑specific picks

  • Look for steroid solutions, foams, or shampoos if your prescriber recommends them—vehicles that spread through hair without residue. (ncbi.nlm.nih.gov)

Safety first: Side effects, special populations, and where to be cautious

Potential local effects include skin thinning (atrophy), stretch marks, visible blood vessels, acne‑like eruptions, and perioral dermatitis. Risk rises with higher potency, longer duration, occlusion, and application to thin skin. Systemic absorption is rare but possible with very potent agents on large areas or under occlusion, particularly in children. Pregnant or lactating patients can use topical steroids with medical guidance. (ovid.com)

High‑absorption sites (eyelids, genitals, skin folds) merit extra caution. Use the lowest effective potency and shortest effective course, and avoid potent fluorinated steroids on these areas unless specifically directed. (education.acaai.org)

What about Topical Steroid Withdrawal (TSW)?

TSW is a distressing reaction pattern reported after stopping prolonged, frequent, or high‑potency topical steroid use. The topic is evolving quickly in the medical literature. In March 2025, NIH researchers published proposed diagnostic criteria suggesting TSW may be distinct from eczema relapse and described biologic markers under study—an encouraging step toward clearer recognition and better research. If you think you’re experiencing TSW, seek medical care; do not abruptly stop prescribed treatments without a plan. (niaid.nih.gov)

For a patient‑friendly overview, you can visit the Understanding Topical Steroid Withdrawal Syndrome (TSW) page to learn more: https://phoilex.com/blogs/news/what-is-topical-steroid-withdrawal-syndrome

Quick buyer’s checklist

• Confirm your prescriber’s recommended potency class and vehicle.
• For face/folds: prefer low‑potency; for palms/soles: higher potency (short course).
• Check the active ingredient, strength, and vehicle—potency depends on all three.
• Estimate how much you’ll need using FTUs so you order the right size.
• Pair with a rich, fragrance‑free moisturizer and sunscreen to support skin barrier and reduce steroid exposure between flares. (aad.org)

FAQs

Are OTC topical steroids enough?

For minor, localized itch or irritation, OTC hydrocortisone 1% (Class VII) may be appropriate for a short period. For persistent, widespread, or severe rashes, see a clinician to avoid undertreatment or misuse. (ncbi.nlm.nih.gov)

Can I use my steroid twice a day for faster results?

Not necessarily. Evidence suggests once‑daily use often performs as well as twice daily while reducing side‑effect risk. Follow your prescriber’s instructions. (ncbi.nlm.nih.gov)

How long can I safely use a strong steroid?

General guidance: up to 3 weeks for super‑high potency; up to 12 weeks for high/medium, though many flares are treated in much shorter bursts. Low‑potency use has more flexibility, but all steroids should be used for the shortest effective time. 

What if I get frequent flares?

Ask about “proactive” or “weekend” maintenance (e.g., medium‑potency twice weekly on trouble spots) and non‑steroidal options like calcineurin inhibitors or PDE‑4/JAK inhibitors as part of a steroid‑sparing routine. (ncbi.nlm.nih.gov)

The bottom line

• The U.S. topical steroid potency chart runs from Class I (super‑high) to Class VII (least potent). Match potency and vehicle to the body site and severity. (ncbi.nlm.nih.gov)
• Use fingertip units to measure amount and stick to safe durations. For thin‑skinned areas and kids, lean low‑potency. (dermnetnz.org)
• Build a supportive skincare routine to minimize steroid exposure and extend time between flares—evidence‑based guidelines endorse this approach. (aad.org)
• Stay informed about TSW, an area of active research, and seek medical guidance for individualized plans. (niaid.nih.gov)

If you’re comparing options or building a flare‑care kit, this potency guide plus the shopping tips above will help you choose smarter—and use topical steroids safely and effectively.