Topical corticosteroid therapy and its effect on the hypothalamic-pituitary-adrenal axis.

All clinically effective topical corticosteroids have the potential for suppressing the pitutary-adrenal axis if large amounts are applied under occlusion on extensive areas. Recovery of the axis function occurs rapidly. In children, however, the risk of chronic suppression of the adrenal axis function with impairment of growth after topical treatment with potent steroids is a real one. Potent steroids in children should, therefore, only be used on refractory areas with carefully controlled quantities.