Side effects of topical corticosteroids

Commonly, side effects with topical corticosteroids are only encountered with the potent, e.g. betamethasone 0.1%, and very potent, e.g. clobetasol propionate 0.5%, groups.

The possibility of adverse effects depends on the following factors:

• potency of the steroid used
• duration of use
• surface area of the skin treated - treating large areas of skin increases risk
• skin condition and the site of application – risk is increased when applied to areas with thin skin (face, the backs of the hands, intertriginous areas) and to raw surfaces
• occlusion – increases skin absorption (1,2,3)
• age of the patient – paediatric and geriatric patients are at an increased risk (4)

Particular care must be taken with corticosteroids in children. Very potent agents are contraindicated in children under one year-of-age and potent agents should be avoided. Growth retardation and cosmetic deformation may result.

Reference:

• (1) MeReC. Using topical corticosteroids in general practice. MeReC Bulletin 1999;10(6), 21-24.
• (2) Tadicherla S et al. Topical corticosteroids in dermatology. J Drugs Dermatol. 2009;8(12):1093-105
• (3) Ference JD, Last AR. Choosing topical corticosteroids. Am Fam Physician. 2009;79(2):135-40
• (4) Lee NP, Arriola ER. Topical corticosteroids: back to basics. West J Med. 1999;171(5-6):351-3.