Topical Steroid Selector Quiz
TL;DR
- Elocon (mometasone) sits in the mid‑potency range, ideal for moderate eczema and psoriasis.
- Hydrocortisone is the lowest‑potency over‑the‑counter option, best for mild irritation.
- Triamcinolone and Betamethasone offer stronger relief for resistant plaques.
- Clobetasol is a super‑potent steroid reserved for short‑term use on thick lesions.
- Calcineurin inhibitors (tacrolimus, pimecrolimus) provide steroid‑free control for sensitive areas.
What is Elocon?
Elocon is a topical corticosteroid containing mometasone furoate, approved for treating inflammatory skin disorders such as eczema, psoriasis and allergic dermatitis. It belongs to the class of synthetic glucocorticoids and is classified as a mid‑strength (class III) steroid in the United Kingdom. The formulation is available as a 0.1% cream or ointment, typically prescribed for 2‑4 weeks before tapering.
How topical steroids are graded
Dermatologists use a potency scale from 1 (very mild) to 4 (very strong) to guide prescription. The scale reflects how deeply the drug penetrates the epidermis and how long its anti‑inflammatory effect lasts. Potency influences side‑effects like skin thinning, stretch‑mark formation and systemic absorption. Understanding where a drug lands on the scale helps patients and clinicians match treatment intensity to disease severity.
Common alternatives to Elocon
Below are the six most‑frequently prescribed alternatives, each introduced with a short, micro‑data‑rich definition.
Hydrocortisone is a low‑potency (class I) topical steroid used for mild irritations, insect bites and minor dermatitis. It is widely sold over the counter in 1% and 2.5% creams, making it a first‑line option for children and sensitive skin.
Triamcinolone acetonide is a mid‑potency (class II‑III) corticosteroid that treats moderate eczema, psoriasis and discoid lupus. Available in 0.025% cream, 0.1% ointment and spray forms, it provides stronger relief than hydrocortisone without the high‑risk profile of super‑potent steroids.
Betamethasone dipropionate is a high‑potency (class III‑IV) steroid used for thick plaques of psoriasis or severe eczema. Its 0.05% cream or ointment penetrates deep layers, delivering rapid symptom control but requiring careful monitoring.
Clobetasol propionate sits at the top of the potency ladder (class IV). It is reserved for short‑term therapy of thick, chronic lesions such as lichen planus or keratosis pilaris that have not responded to lower‑strength agents.
Tacrolimus ointment is a non‑steroidal calcineurin inhibitor approved for atopic dermatitis on the face, neck and skin folds. It works by suppressing immune activation rather than by vasoconstriction, offering a steroid‑free alternative with a low risk of skin atrophy.
Pimecrolimus cream is another calcineurin inhibitor, similar to tacrolimus but formulated for delicate areas like eyelids and intertriginous zones. It is indicated for mild‑to‑moderate eczema when steroids are contraindicated.
Side‑by‑side comparison
| Drug | Potency (UK class) | Typical Indications | Prescription status (UK) | Average monthly cost (GBP) |
|---|---|---|---|---|
| Elocon (mometasone furoate 0.1%) | III (mid‑strength) | Eczema, psoriasis, allergic dermatitis | Prescription‑only | £12‑£18 |
| Hydrocortisone 1%‑2.5% | I (mild) | Minor irritations, insect bites | OTC | £3‑£5 |
| Triamcinolone acetonide 0.025%‑0.1% | II‑III (moderate) | Moderate eczema, psoriasis | Prescription‑only | £8‑£14 |
| Betamethasone dipropionate 0.05% | III‑IV (high) | Severe psoriasis, chronic eczema | Prescription‑only | £15‑£22 |
| Clobetasol propionate 0.05% | IV (very high) | Thick plaques, lichen planus | Prescription‑only | £20‑£28 |
| Tacrolimus 0.1% ointment | Non‑steroidal | Facial/neck eczema, steroid‑phobia | Prescription‑only | £30‑£45 |
| Pimecrolimus 1% cream | Non‑steroidal | Delicate‑area eczema | Prescription‑only | £28‑£38 |
When to choose Elocon over the rest
If you are dealing with a rash that is neither too mild nor extremely stubborn, Elocon often hits the sweet spot. Its mid‑potency delivers faster itch relief than hydrocortisone while keeping the risk of skin thinning lower than high‑potency options like betamethasone. For most adults with moderate plaque psoriasis or atopic dermatitis, a two‑week course of Elocon followed by a taper to a milder steroid works well.
Scenarios where another agent may be better
- Very mild irritation - hydrocortisone 1% is enough and avoids a prescription.
- Resistant plaques - jump to betamethasone or clobetasol for a short burst, then step down.
- Facial or intertriginous eczema - consider tacrolimus or pimecrolimus to prevent atrophy.
- Children under 2years - low‑potency hydrocortisone is usually safer.
- Long‑term maintenance - intermittent use of a low‑potency steroid combined with moisturisers reduces rebound flare-ups.
Practical tips for safe use
- Apply a thin layer, rubbing gently until the film disappears.
- Limit use on the face, groin or armpits to 1‑2 weeks unless directed otherwise.
- Combine with emollients; a moisturizer applied after the steroid can improve barrier function.
- Monitor for signs of thinning, stretch marks or telangiectasia - discontinue if they appear.
- Never cover treated skin with occlusive dressings unless a doctor advises.
Related concepts and next steps
Understanding how calcineurin inhibitors (tacrolimus, pimecrolimus) fit into the treatment ladder helps you avoid steroid over‑use. The term atopic dermatitis refers to chronic, itchy eczema that often starts in childhood; its management frequently cycles between steroids and steroid‑free agents. Psoriasis involves rapid skin cell turnover, so higher‑potency steroids or vitaminD analogues may be necessary. For readers wanting deeper insight, explore topics such as "topical steroid potency classification", "systemic absorption of corticosteroids" and "non‑steroidal skin immunomodulators".
Decision‑making checklist
- Identify the severity of the rash (mild, moderate, severe).
- Check the body area - delicate zones prefer non‑steroids.
- Consider patient age and any history of steroid sensitivity.
- Review cost and prescription requirements.
- Plan a tapering schedule to minimise rebound.
Frequently Asked Questions
Can I use Elocar (Elocon) on my face?
Elocon is a mid‑potency steroid, so short‑term use on the face is acceptable for moderate eczema, but you should limit treatment to 1‑2 weeks and follow a doctor’s tapering plan to avoid thinning.
How does mometasone compare to hydrocortisone in terms of side‑effects?
Mometasone (Elocon) is stronger, so it carries a higher risk of local side‑effects like skin atrophy if used excessively. Hydrocortisone is very mild; side‑effects are rare unless applied over large areas for long periods.
When should I switch from a steroid to a calcineurin inhibitor?
If you need long‑term control on the face, neck or skin folds, or if you notice thinning with steroids, discuss moving to tacrolimus or pimecrolimus with your dermatologist.
Is it safe to use Elocon on children?
Elocon can be prescribed for children over 12months, but clinicians usually start with the lowest effective potency (often hydrocortisone) and reserve mometasone for moderate cases.
How long does a typical course of Elocon last?
Most doctors advise a 2‑4‑week regimen, followed by a taper to a milder steroid or moisturiser to keep the condition in check.
Can I combine Elocon with other topical treatments?
Yes, you can layer a moisturizer after the steroid. Avoid using two active steroids simultaneously, and be cautious mixing with retinoids or salicylic acid unless directed.
