Pregnancy Category C: Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels. The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus . Drugs of this class should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time.
References: 1. Bikowski J, Pillai R, Shroot B. The position not the presence of the halogen in corticosteroids influences potency and side effects. J Drugs Dermatol . 2006;5(2):125-130. 2. Del Rosso J, Friedlander SF. Corticosteroids: options in the era of steroid-sparing therapy. J Am Acad Dermatol . 2005; 53(1 Suppl 1):s50-s58. 3. US Food and Drug Administration NDA 017765. Promius Pharma, LLC, Princeton, NJ: Aug 1977. 4. Rosenthal AL. Clocortolone pivalate: a paired comparison clinical trial of a new topical steroid in eczema/atopic dermatitis. Cutis . 1980;25(1):96-98. 5. Kircik LH. A study to assess the occlusivity and moisturization potential of three topical corticosteroid products using the skin trauma after razor shaving (STARS) bioassay. J Drugs Dermatol . 2014;13(5):582-585. 6. Cloderm [package insert]. Princeton, NJ: Promius Pharma, LLC; 2017.
After the molluscum bumps have resolved, persistent skin discoloration called hyperpigmentation may be left alone and allowed to resolve over time. Alternatively, residual hyperpigmentation may be treated with prescription fading creams like hydroquinone 4%, kojic acid, or azelaic acid 15-20%. Over the counter fading creams with 2% hydroquinone may be available like Porcelana. Specially designed prescription creams for particularly resistant skin discoloration using higher concentrations of hydroquinone 6%, 8%, or 10% with a retinoid and a topical steroid may also be formulated by compounding pharmacists. Mild chemical peels and microdemabrasion may also help improve discoloration.