Corticosteroids (topical) - Side effects of topical corticosteroids

Topical corticosteroids rarely cause serious side effects if they are used as instructed.

Things that increase your risk of experiencing side effects include:

• the potency (strength) of the topical corticosteroid 
• the length and frequency of treatment – you are more likely to have side effects if you use a topical corticosteroid frequently over a long period of time
• the area of skin being treated – the larger the area you are treating with a topical corticosteroid, the greater the risk; certain areas of skin, such as the face, groin and armpits, are also more sensitive to the medication
• your age – young children and elderly people are at a greater risk because their skin tends to be thinner

Types of side effects

Side effects can affect the patch of skin being treated, known as local side effects or, less often, they can have a wider effect on the body, known as systemic side effects.

Local side effects

Local side effects are the main side effects associated with topical corticosteroids. They usually affect the face, folds of skin and areas that have been treated many times during the past months or years.

Local side effects can include:

• burning or stinging of the skin – this is a common side effect that usually occurs when you start treatment; it tends to improve after a few days as your skin gets used to the medication
• worsening of a pre-existing skin infection
• folliculitis – inflamed hair follicles
• thinning of the skin – this can make the affected skin more vulnerable to damage; for example, you may bruise more easily 
• stretch marks
• contact dermatitis – skin irritation caused by a mild allergic reaction to the substances in a particular topical corticosteroid
• 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 dark skin
• excessive hair growth on the area of skin being treated 

Besides a burning or stinging sensation, most of these side effects are uncommon and should disappear after you stop using the medication. Stretch marks are likely to be permanent, although 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.

They can occur if the medication is absorbed into the bloodstream and affects other parts of the body, such as the adrenal gland (a gland that produces many of the body’s natural steroids).

Possible systemic side effects include decreased growth in children and a rare condition called Cushing’s syndrome that is 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 skin thinning) and mood changes (such as feeling depressed).

For information on the side effects of the particular topical corticosteroid you are using, check the information leaflet that comes with it or search for your medication in the medicines A-Z.