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<meta name="description" content="Topical dexamethasone has not been studied during breastfeeding. Since only extensive application of the most potent corticosteroids cause systemic effects in the mother, it is unlikely that short-term application of topical corticosteroids would pose a risk to the breastfed infant by passage into breastmilk. However, it would be prudent to use the least potent drug on the smallest area of skin possible. It is particularly important to ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Current guidelines allow topical corticosteroids to be applied to the nipples just after nursing for eczema, with the nipples cleaned gently before nursing.[1,2] Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]">
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<meta name="og:description" content="Topical dexamethasone has not been studied during breastfeeding. Since only extensive application of the most potent corticosteroids cause systemic effects in the mother, it is unlikely that short-term application of topical corticosteroids would pose a risk to the breastfed infant by passage into breastmilk. However, it would be prudent to use the least potent drug on the smallest area of skin possible. It is particularly important to ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Current guidelines allow topical corticosteroids to be applied to the nipples just after nursing for eczema, with the nipples cleaned gently before nursing.[1,2] Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501758_"><span class="title" itemprop="name">Dexamethasone, Topical</span></h1><p class="fm-aai"><a href="#_NBK501758_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 2 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 50-02-2</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134970849" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134970849" alt="image 134970849 in the ncbi pubchem database" /></a><div id="LM85.Drug_Levels_and_Effects"><h2 id="_LM85_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM85.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Topical dexamethasone has not been studied during breastfeeding. Since only extensive application of the most potent corticosteroids cause systemic effects in the mother, it is unlikely that short-term application of topical corticosteroids would pose a risk to the breastfed infant by passage into breastmilk. However, it would be prudent to use the least potent drug on the smallest area of skin possible. It is particularly important to ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Current guidelines allow topical corticosteroids to be applied to the nipples just after nursing for eczema, with the nipples cleaned gently before nursing.[<a class="bibr" href="#LM85.REF.1" rid="LM85.REF.1">1</a>,<a class="bibr" href="#LM85.REF.2" rid="LM85.REF.2">2</a>] Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[<a class="bibr" href="#LM85.REF.3" rid="LM85.REF.3">3</a>]</p><p>Because absorption from the eye is limited, ophthalmic dexamethasone, including ocular inserts, would not be expected to cause any adverse effects in breastfed infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.</p></div><div id="LM85.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Relevant published information was not found as of the revision date.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM85.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Topical application of a corticosteroid with relatively high mineralocorticoid activity (isofluprednone acetate) to the mother's nipples resulted in prolonged QT interval, cushingoid appearance, severe hypertension, decreased growth and electrolyte abnormalities in her 2-month-old breastfed infant. The mother had used the cream since birth for painful nipples.[<a class="bibr" href="#LM85.REF.4" rid="LM85.REF.4">4</a>]</p></div><div id="LM85.Effects_on_Lactation_and_Breastmilk"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM85.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p>(Ophthalmic) <a href="/books/n/lactmed/LM223/?report=reader">Prednisolone</a>; (Topical) <a href="/books/n/lactmed/LM405/?report=reader">Hydrocortisone, Topical</a>, <a href="/books/n/lactmed/LM266/?report=reader">Triamcinolone, Topical</a></p></div><div id="LM85.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM85.REF.1">Vestergaard
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C, Wollenberg
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A, Barbarot
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S, et al.
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European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period.
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J Eur Acad Dermatol Venereol
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2019;33:1644-59.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/31231864" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31231864</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM85.REF.2">Deleuran
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M, Dézfoulian
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B, Elberling
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J, et al.
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Systemic anti-inflammatory treatment of atopic dermatitis during conception, pregnancy and breastfeeding: Interdisciplinary expert consensus in Northern Europe.
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J Eur Acad Dermatol Venereol
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2024;38:31-41.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/37818828" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37818828</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM85.REF.3">Noti
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A, Grob
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K, Biedermann
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M, et al.
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Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves.
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Regul Toxicol Pharmacol
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2003;38:317-25.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/14623482" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14623482</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM85.REF.4">De Stefano
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P, Bongo
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IG, Borgna-Pignatti
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C, Severi
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F. Factitious hypertension with mineralocorticoid excess in an infant.
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Helv Paediatr Acta
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1983;38:185-9.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/6874387" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6874387</span></a>]</div></dd></dl></dl></div></div><div id="LM85.Substance_Identification"><h2 id="_LM85_Substance_Identification_">Substance Identification</h2><div id="LM85.Substance_Name"><h3>Substance Name</h3><p>Dexamethasone, Topical</p></div><div id="LM85.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>50-02-2</p></div><div id="LM85.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Corticosteroids, Topical</p><p>Corticosteroids, Ophthalmic</p><p>Glucocorticoids</p><p>Anti-Inflammatory Agents</p><p>Dermatologic Agents</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501758_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">January 15, 2024</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Dexamethasone, Topical. [Updated 2024 Jan 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM86/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM87/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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