The systemic effects of topical corticosteroids are generally limited because only about 3% of the medication in topical preparations is absorbed systemically following 8 h of contact with normal skin [4]. Absorption varies with different types and doses of preparations and the nature and extent of underlying skin conditions. When corticosteroids are used for long term or on large areas of the skin, they might have systemic effects [5–9].

Breastfeeding provides many advantages to both mother and infant. One of the major reasons for early cessation of breastfeeding in mother is nipple and breast dermatosis. The use of topical corticosteroids in special circumstances such as breastfeeding is an area, which is filled with uncertainty. The US Food and Drug Administration (FDA) labels topical corticosteroids as pregnancy risk category C, meaning that animal studies have shown adverse fetal effects, but there are no adequate and well-controlled studies in pregnant women [10]. Studies regarding safety of topical corticosteroids in nursing mother are still sparse, but what is certain is that if significant concentration of corticosteroids reaches into systemic circulation of mother, it may lead to adverse effects not only in mother but also in breastfed infants. Nevertheless, topical corticosteroids remain the mainstay of treatment in a number of inflammatory dermatoses, in lactating females. These disorders may be preexisting dermatoses like psoriasis, atopic dermatitis, autoimmune blistering disorders, etc., or they may first appear during pregnancy itself and persist into postpartum period, e.g., pemphigoid gestationis, prurigo of pregnancy. In addition many of these inflammatory conditions may be localized to breast and nipple area only. A number of these disorders require the use of systemic steroids which a physician always feels hesitant to prescribe in a lactating female. In such scenario topical steroids play a very critical role in their management, but lack of information and clarity regarding the risk of topical corticosteroids leads to physician’s uncertainty and often results in underprescription, followed by weakened adherence to the regimen and compromised therapeutic effectiveness.