Authors´ conclusions: potent and moderate topical corticosteroids are probably more effective than mild topical corticosteroids, primarily in moderate or severe eczema; however, there is uncertain evidence to support any advantage of very potent over potent topical corticosteroids. Effectiveness is similar between once daily and twice daily (or more) frequent use of potent topical corticosteroids to treat eczema flare-ups, and topical corticosteroids weekend (proactive) therapy is probably better than no topical corticosteroids/reactive use to prevent eczema relapse (flare-ups). Adverse events were not well reported and came largely from low- or very low-certainty, short-term trials. In trials that reported abnormal skin thinning, frequency was low overall and increased with increasing potency.
Reviewers´ commentary: moderate or high potency corticosteroids are recommended for the treatment of eczema, preferably once daily and preventively twice a week if the patient has frequent relapses. Very high potency corticosteroids should be avoided because they do not improve clinical efficacy and have more side effects.