Topical corticosteroids rarely cause serious side effects if they are used as instructed.
Things that increase your risk of getting side effects include:
- the potency (strength) of the topical corticosteroid
- the length of treatment – the longer you use a topical corticosteroid, especially on a daily basis, the greater the risk
- the area of skin being treated – the larger the area you are treating with a topical corticosteroid, the greater the risk
- your age – young children and people aged over 70 have a greater risk because their skin tends to be thinner than other age groups
Types of side effects
Side effects can affect the patch of skin being treated, known as local side effects, or they can affect other parts of the body, known as systemic side effects.
Local side effects
Local side effects are the most common. They usually occur on the face, in folds of skin and in areas that have been treated many times during the past months or years.
Local side effects include:
- burning or stinging of the skin – this is a common side effect that usually occurs when you start treatment; it improves as your skin gets used to the medication
- worsening of a pre-existing skin infection
- thinning of the skin – this can make the affected skin more vulnerable to damage; for example, you may bruise more easily than normal
- acne, or worsening of existing acne
- rosacea – a condition that causes the face to become red and flushed
- changes in skin colour – this is usually more noticeable in people with black or brown skin
- excessive hair growth on the area of skin being treated
- contact dermatitis – some people find they have a mild allergic reaction to the substances in a particular topical corticosteroid, which results in skin irritation
- stretch marks – these are narrow, streak-like lines that can develop on the surface of the skin
These local side effects should disappear after you have finished your treatment with corticosteroids. However, if you have stretch marks, it is likely they will be permanent, though they will probably become less noticeable over time.
Systemic side effects
Systemic side effects are rare and usually occur only if you do not apply topical corticosteroids as instructed.
Systemic side effects occur because the steroids become absorbed into the blood stream and affect other parts of the body, such as the adrenal gland (a gland that produces many of the body’s natural steroids).
Systemic side effects are usually mild but can include:
- swelling of the legs due to a build-up of fluid
- high blood pressure (hypertension)
- a drop in calcium levels in the body (hypocalcaemia) which can cause symptoms such as muscle cramps, shortness of breath and seizures (fits)
- bone damage
- decreased growth in children
- Cushing’s syndrome (see below)
Cushing’s syndrome is a rare condition caused by having high levels of steroid hormones in your blood. Symptoms of Cushing’s syndrome include:
- rapid weight gain
- changes to the skin, such as thinning of your skin
- mood changes, such as feeling depressed or anxious
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