Applying a steroid spray (Nasacort AQ, etc) onto the skin before applying a topical patch helps decrease skin irritation.
Some patients complain of skin redness or itching after applying Duragesic and other patches.
Providers sometimes prescribe a corticosteroid nasal spray or inhaler to use on the site BEFORE applying the patch to prevent rashes.
The sprays are used because of concerns that the emollients in steroid creams and ointments will affect patch adhesion. Plus the metered-dose delivery allows for easy application.