When used safely, topical corticosteroids can be effective in treating various skin disorders. However, high dosage levels of topical corticosteroids can cause serious side effects. Long-term treatment with corticosteroids (more than three months) also increases the risk for side effects. Potential side effects include:

• Adverse effects in the skin and eyes. Long-term exposure to topical corticosteroids can result in thinning of the skin, permanent stretch marks in folds, such as in the armpits and behind the knees, swelling of tiny blood vessels beneath the skin surface (particularly in the face), slow healing of wounds and diminishing skin color (hypopigmentation). Cataracts (condition in which the lens of the eye becomes cloudy) and glaucoma (a disease in which fluid pressure slowly rises in the eye, often resulting in vision loss) may also result.
  
  
• Hypothalamic pituitary adrenal axis suppression. High levels of corticosteroids that are absorbed into the bloodstream can reduce the function of the adrenal glands, which produce the body’s natural steroid hormones. This condition can be life-threatening and lead to conditions such as Cushing’s syndrome, a disease characterized by obesity, weakened bones and muscles and thinning of the skin.
  
  
• Growth suppression. Long-term exposure to topical corticosteroids can result in slowed body growth and development, particularly in children.

Some patients who use topical corticosteroids on their face for long periods of time are at risk for developing a condition called steroid-induced rosacea. Symptoms are similar to those of standard rosacea – redness, pimples and thin, wavy red lines – but appear wherever the corticosteroid cream was applied. In some cases, oral or inhaled corticosteroids can also cause this effect. People with steroid-induced rosacea often have facial skin with a distinctive shine. Medications used to treat standard rosacea may be effective in treating steroid-induced rosacea.

Other common side effects of corticosteroids include:

• Topical corticosteroids:
  
  
• • Skin thinning (atrophy) resulting in an increased chance of bruising
  • Increased skin sensitivity
  • Itching or burning skin
  • Numbness in the fingers
  • Raised red spots on the skin
  • Skin blisters filled with blood
  • Stretch marks
    
    
• Oral and intravenous corticosteroids:
  
  
• • Blurred vision
  • Frequent urination
  • Increased appetite
  • Increased thirst
  • Indigestion
  • Flushing of face or cheeks

Women may also experience menstrual irregularity as the result of corticosteroid use.

Some side effects of corticosteroid drugs are considered more dangerous, though rare. An individual should immediately contact a physician if they experience any of these side-effects:

• Blindness
• Bloody stool
• Delayed growth (in children)
• Eye pain
• Hallucinations
• Irregular heartbeat
• Mental depression
• Unusual confusion or excitement
• Unusual increase in hair growth
• Vomiting

It is important to note that the use of corticosteroids can lower a person’s resistance to bacterial and fungal skin infections. Corticosteroids can also cause existing infections to worsen. Therefore, patients taking corticosteroids should contact their physician if signs or symptoms of infection, such as fever, develop.

Patients should also contact their physician if their condition fails to improve with treatment, or if the condition appears to have worsened.