Side-effects of using topical steroids.  

Side-effects of using topical steroids incorrectly or continuously over a prolonged period and on areas of skin that are thinner, such as eyes, eyelids and face, or on very young babies and children includes:

  • Skin thinning and slower wound healing.
  • Increases risk of other types of bacterial, fungal or viral infections.
  • Over time, absorption of topical steroids can start to affect the body and skin's ability to make it's own cortisol,
  • this can lead to adrenal dysfunction and an inability to naturally suppress inflammation.

Side-effects can be minimised if the amount used is decreased, the potency used is the lowest that is required and the frequency only when absolutely needed.

Natural alternatives when used as an alternative can help to prevent unwanted side-effects in the long run.

Know the potency of the topical steroid you are using.

Very Potent

Up to 600 times as potent as Hydrocortisone
- Clobetasol Proionate

Potent

100-150 times as potent as Hydrocortisone
- Betamethasone Valerate
- Betamethasone Dipropionate
- Hydrocortsine 17-butyrate
- Mometasone Furoate
- Methylprednisolone Aceponate

Moderate

2-25 times as potent as Hydrocortisone
- Clobetasone Butyrate
- Triamciniolone Acetonide

Mild

- Hydrocortisone
- Hydrocortisone Acetate

There is little point in diluting a topical steroid, as their potency does not depend much on concentration and diluting the product does not reduce the risk of adverse effects.
After the first 2 or 3 applications, there is no additional benefit to applying a topical steroid more than once daily.
A potent topical steroid applied for weeks to months or longer can lead to periorificial dermatitis (common in children), steroid rosacea, symptoms due to topical corticosteroid withdrawal, and pustular psoriasis.