Topical Steroid Potency Chart: The 7 U.S. Classes Explained (Uses, Saf

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)

U.S. Potency Class	Strength Level	Common Examples	Typical Body Areas	Max Duration Guidelines
Class I	Super-potent (strongest)	Clobetasol propionate 0.05%, Augmented betamethasone dipropionate 0.05% ointment, Diflorasone diacetate 0.05% ointment	Thick plaques on palms, soles, elbows, knees (never face/folds)	2–3 weeks maximum; limit to 50g/week for clobetasol
Class II	High-potency	Fluocinonide 0.05%, Desoximetasone 0.25%, Betamethasone dipropionate 0.05% cream	Trunk, arms, legs for moderate-severe psoriasis/eczema	2–4 weeks; reassess if stepping up from mid-potency
Class III	Upper mid-potency	Triamcinolone acetonide 0.5%, Fluticasone propionate 0.005% ointment	Body surfaces with thicker skin; avoid thin-skin areas	4–6 weeks with monitoring
Class IV	Mid-potency	Triamcinolone acetonide 0.1%, Fluocinolone acetonide 0.025% ointment	General body use; transitional step before higher potency	Up to 8 weeks; commonly used maintenance option
Class V	Lower mid-potency	Fluticasone propionate 0.05% cream, Hydrocortisone valerate 0.2%	Face (short-term), larger body areas in children	2–4 weeks on sensitive areas
Class VI	Low-potency	Desonide 0.05%, Fluocinolone acetonide 0.01%	Face, eyelids, groin, armpits, infant/pediatric use	Safe for 2–4 weeks; often first-line for delicate skin
Class VII	Least potent	Hydrocortisone 1% (OTC), Hydrocortisone 2.5% (Rx)	Face, skin folds, elderly fragile skin, mild rashes	Generally safe for longer use; OTC option for mild flares

Vehicle Type	Relative Potency Effect	Best Used For	Key Considerations
Ointment	Highest penetration (most potent delivery)	Dry, thick, scaly plaques; psoriasis on palms/soles	Greasy feel; enhances absorption significantly—same drug may be Class I in ointment vs Class II in cream
Cream	Moderate penetration	Moist or weeping lesions; general everyday use	Cosmetically preferred; fluticasone propionate cream is less potent than its ointment form
Lotion/Solution	Lower penetration	Scalp, hairy areas, large body surfaces	Easy to spread; evaporates quickly so less occlusive effect
Gel/Foam	Variable (often moderate-high)	Scalp psoriasis, areas where ointment is impractical	Alcohol-based gels may sting on broken skin

Frequently Asked Questions

Q: Is desonide 0.05% safe to use on my baby's facial rash?

Desonide 0.05% is a Class VI (low-potency) topical steroid and is considered one of the safest options for infants and facial use in pediatric dermatology. It's commonly prescribed for mild eczema and rashes on delicate areas because thin skin absorbs medications more readily, making potent steroids risky. Most pediatric guidelines support short-term use (2–4 weeks) under medical supervision. Always apply a thin layer and avoid the eye area. If the rash doesn't improve within a week or worsens, consult your pediatrician for reassessment.

Q: Can I use OTC hydrocortisone 1% on my toddler's face for eczema?

Hydrocortisone 1% (Class VII, least potent) is generally considered safe for short-term use on a 2-year-old's face for mild eczema flares, according to most pediatric guidelines. Apply a thin layer once or twice daily for no more than 7–14 days. However, facial skin in toddlers is very thin and absorbs medications more efficiently, so monitor for any skin thinning or irritation. If the eczema is moderate-to-severe or doesn't respond within a week, a pediatrician may recommend prescription-strength desonide (Class VI) instead.

Q: Why did my dermatologist prescribe different strength steroids for my elbows versus near my eyes?

Skin thickness varies dramatically across the body, which directly affects how much medication absorbs. Eyelid skin is about 10 times thinner than elbow skin, so it absorbs steroids much more efficiently—and is far more vulnerable to side effects like thinning, stretch marks, or glaucoma risk near eyes. That's why dermatologists typically prescribe Class I or II steroids for thick psoriasis plaques on elbows, while using Class VI or VII for periorbital areas or skin folds. This site-specific prescribing approach maximizes effectiveness while minimizing risks.

Q: What potency class is betamethasone dipropionate 0.05%, and why does it appear in different classes?

Standard betamethasone dipropionate 0.05% cream is typically Class II (high-potency), while the ointment formulation can also be Class II. However, "augmented" betamethasone dipropionate 0.05% uses an optimized vehicle that enhances penetration, pushing it into Class I (super-potent). This is why you'll see the same drug listed in multiple classes—the vehicle formulation significantly affects potency. The augmented version (brand name Diprolene) delivers more medication into the skin, making it appropriate for resistant plaques but requiring stricter duration limits.

Q: How long can I safely use Class I super-potent steroids like clobetasol for severe psoriasis plaques?

Current dermatology guidelines (including 2025 AAD recommendations) advise limiting Class I topical corticosteroids to 2–3 consecutive weeks maximum for thick psoriatic plaques. Total weekly application should not exceed 50 grams of clobetasol. For severe eczema flares, many guidelines recommend no more than 2 weeks of continuous use. After this period, step down to a mid-potency steroid or implement a "pulse" schedule (weekends only, for example). Prolonged use increases risks of skin atrophy, striae, and hypothalamic-pituitary-adrenal axis suppression.

Q: Will OTC hydrocortisone 1% work for contact dermatitis from a new necklace, or do I need a prescription?

For mild allergic contact dermatitis from jewelry (typically nickel allergy), OTC hydrocortisone 1% can provide relief for minor rashes. Apply twice daily for up to 2 weeks while avoiding the offending jewelry. However, if the rash is blistering, spreading, weeping, or doesn't improve within 7 days, you'll likely need prescription-strength treatment—either hydrocortisone 2.5% (prescription required, slightly stronger) or a mid-potency steroid like triamcinolone 0.1%. Severe reactions may also benefit from oral antihistamines for itching.

Q: Are generic topical steroids like generic clobetasol as effective as brand-name versions?

FDA-approved generic topical corticosteroids must demonstrate bioequivalence to brand-name products, meaning they deliver the same amount of active drug with comparable absorption. Generic clobetasol, triamcinolone, and other steroids are considered therapeutically equivalent when they have an "AB" rating. However, inactive ingredients in the vehicle can occasionally cause different skin feel or minor irritation variations. For most patients, generics work identically and cost significantly less. If you notice a difference after switching, discuss vehicle preferences with your pharmacist or dermatologist.

Q: How does the U.S. 7-class potency system differ from European or WHO classifications?

The U.S. uses a 7-class system where Class I is the strongest and Class VII is the weakest—ranked primarily by the vasoconstrictor assay (McKenzie-Stoughton test), which measures skin blanching response. European systems typically use 4 categories (mild, moderate, potent, very potent) with "very potent" being strongest. This can cause confusion: a "Class I" steroid in the U.S. (super-potent) would be "very potent" in Europe, while European "Class I" (mild) corresponds roughly to U.S. Class VI-VII. Always verify which classification system a reference uses.

Q: What is topical steroid withdrawal, and how do I safely taper off high-potency steroids?

Topical steroid withdrawal (TSW) can occur after prolonged use of mid-to-high potency steroids, causing rebound redness, burning, and worsening skin symptoms when stopped abruptly. Safe tapering strategies include: gradually reducing application frequency (daily to every other day to twice weekly), stepping down potency classes (Class II to Class IV to Class VI), or switching to non-steroidal alternatives like tacrolimus. For Class II steroids used longer than 4 weeks, a 2–4 week taper is generally recommended. Always taper under medical guidance, especially after prolonged facial or widespread use.

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.

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