Is Steroid tachyphylaxis preventable?

Abstract

Summary DNA synthesis in hairless mouse epidermis was studied during twice daily and 72‐hourly application regimes of Metosyn, Betnovate and Dermovate ointments, and of 0.05% fluocinonide solution, in order to determine a treatment schedule for continuous suppression of epidermal cell DNA synthesis. Tachyphylaxis occurred with all the twice daily regimes but not with the 72 hourly application regimes of Dermovate and Betnovate ointments during the time of study. The onset of tachyphylaxis was delayed when fiuocinonide was applied in solution as opposed to ointment (Metosyn) form. Varying the steroid preparation within a 72 hourly application regime did not prevent the development of tachyphylaxis by 150 h.

A Study of Systemic and Topical Effects of Topical Steroid Application through the Comparison of Two Application Schedules

“…In clinical manifestations, tachyphylaxis is one of the greatest problems of steroid treatment. And as Clement et al demonstrated, tachyphylaxis was avoidable by employing a 72-hourly application regimen with some steroid ointments (6). In this experiment, we compared twice a week to daily applications with regard to long-term systemic effects.…”

“…Differences in application schedules may cause significant differences in the systemic and topical effects of these steroids. Clement (6), for example, reported that tachyphylaxis did not occur with 72-hour schedules, although it did with some twice daily routines. Woodford et al (7) contended that once daily application was clinically the most advantageous.…”