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Corticosteroids are the most potent and effective local anti-inflammatory medications available and have a striking ability to inhibit cell division. They are the therapy of choice in most inflammatory condition  like eczema, dermatitis and psoriasis. You should remember that topical steroids are used for supression or relieve signs and symptoms of most skin conditions, and they are not curative therapy for skin conditions.

There are many topical steroids available, and they differ in potency and formulation. The risk of side effects from topical corticosteroids is directly  related to its potency , duration of therapy, frequency of application and anatomical area. Low potent corticosteroids have less side effects than Ultra potent  topical corticosteroids. To minimise the side effects of  Ultra potent topical corticosteroids limiting its use to maximum of 50 gm per week and maximum of 2 weeks is recommended. After 2 weeks or after an acute condition is on controlled,dosing can be reduced and with a tapering maintenance therapy and major side effects can be reduced.

Multiple potential adverse effect  are associated with use of topical corticosteroids.The most common are discussed below.

Skin atrophy and maceration: Skin atrophy and maceration are frequent findings if potent corticosteroids are used for longer time, especially when used with occlusive technique. This is reversible after discontinuation of therapy within 2-6 months.
Striae: They are Most common around the groin, axillae, and inner thigh.They are usually not reversible, but it may fade over period of time.
Telangiectasia: They are small visible distended blood vessels seen in skin surface . They are commonly seen on the face, neck, chest and sometimes on upper thigh and below knee. They are often reversible, but sometimes can be permanent. For permanent telangiectasia , Sclerotherapy  is the first line of therapy.
Abnormal hair growth: Sometime longterm use of topical corticosteriods might result in fine hair growth around the areas but it is reversible.
Hypopigmentation: Sometime hypopigmentation can occur with the use of potent therapy, most common in dark skinned people. This hypopigmentation is a reversible one.
Supression of Infections: Corticosteroids have ability to supress the infection. So, sometime symptoms and signs of bacterial,fungal or any viral infection may be masked which might further results in worsening of the conditions without being recognized.
Rebound dermatitis: When sudden discontinuation of corticosteriods, rebound dermatitis might occur. So the therapy must be taper for few weeks before discontinuation.
Systemic side effects: High potent topical corticosteroids used for a longer duration of time may induce mild hypercortisolism, hyperglycemia, Hypothalamic-pituitary axis suppression, and rarely cusing’s syndrome and growth retardation in children. Children and elderly are at higher risk of side effects.

Tachyphylaxis: Tachyphylaxis or Tolerance might occur after a few weeks of therapy. If an inflammatory skin condition gets worsens after initial good response, tolerance to the anti-inflammatory effects of topical corticosteroids should always be suspected. This can be prevented by limiting the frequency of application per day. This is a reversible condition and can be managed by stopping therapy for a few days ( 4 days ), and then resuming with the same treatment or any other  alternate agent.

Other common side effects might be: Purpura ( Bruising with with minimal trauma), and Acneform/Rosacea like eruptions ( common on face).

Topical corticosteroids treatment  are being used for more than 50 years in skin therapy and they bear minimal risk if used properly with a proper prescription of a dermatologist and a regular supervision. They are safe if used with appropriate potency and strength for appropriate skin condition.

If you have any questions regarding  topical corticosteroids you can ask us at DermaTalk Skin Care Forums


  1. embracing health
    January 21, 2009 at 2:27 pm

    This is one of the reasons why I switch from using harsh substances to natural ones. I ave tried using corticosteroid before and my skin problem gets worst. Thanks for sharing this informative details

  2. Cascia @ Healthy Moms
    January 21, 2009 at 8:20 pm

    Very interesting information! I just found your blog and love it. I am looking forward to reading more.

  3. Timur I. Alhimenkov
    January 27, 2009 at 6:21 pm

    Great! Thank you!
    I always wanted to write in my site something like that. Can I take part of your post to my blog?
    Of course, I will add backlink?

    Sincerely, Your Reader

  4. 010081
    January 28, 2009 at 4:44 am

    oh sure you can if its for information purpose..and yea sure i would love backlinks..

  5. Healthhype
    January 28, 2009 at 7:39 pm

    Corticosteroid ointments should not be used on eyelids, or at least not in high concentration or for prolonged time.

    Corticosteroid ointments may aggravate Fordyce’s bumps on lips (ectopic oil glands that also appear in mouth mucosa).

  6. Darren Tan
    January 31, 2009 at 4:00 pm

    My mom is a nurse, got to show her this. 🙂 this is scary… thanks for sharing, i bet most people are oblivion to this..


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    March 3, 2009 at 11:41 am

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  11. Anonymous
    November 4, 2011 at 12:52 pm

    Are there many people who have cider as their particular Rosacea trigger? I feel as if it might be my own and I am trying to find suggestions about how to scale back my outbreaks

  12. T Zwane
    March 23, 2013 at 5:57 am

    Thank you for sharing this information, I have a serious skin problem and I tend to use steroids quiet often! I will share this information with people I know!

  13. gerardnco
    February 23, 2014 at 10:36 am

    hi, my daughter was prescribed clarelux mousse for her scalp psoriasis, I was advised to wear gloves when applying it and I didn’t anyhow after using it daily for two weeks on and two weeks off my daughter started complaining about things and having previously suffered from side effects myself I looked them up, I do believe we are prone to side effects but they included, moon face, paranoia ,headaches, eye irritation, mood swings, sight problems, nightmares, extremely smelly flatulence, weight gain and although my daughter isn’t menstrual yet I myself missed a period and have been a bit irregular since and have extremely tender breasts, my daughter has developed an anal fissure which im not sure is related but I don’t know nor does anyone else it seems, the mousse worked great for her scalp but I feel its not worth all the side effect sand 6 months later we are sill waiting on them to leave us

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