Side effects of topical steroids
Topical steroid medications may clear psoriasis lesions, but the clearing is usually not complete or very long-lasting. When psoriasis lesions return, some people may be tempted to use a steroid for too long or on inappropriate areas of the skin. Improper use can increase the common side effects associated with topical steroid medications.
Low-strength steroids are ordinarily used to treat thin, sensitive skin, such as the face, groin and breasts. These areas are most prone to steroid side effects; therefore, even weak steroids must be applied with caution. Treating lesions on the face, skin folds or genitals with steroids should only be carried out under the direction of a doctor.
Potent steroids should not be used on or around the eyelids. Cataracts and glaucoma can result when stronger steroids come in contact with the skin around the eyes.
Stronger steroid medications are suitable for thicker skin, such as the knees and elbows. Superpotent topical steroids can be very effective in clearing lesions, but they must be used cautiously. They may cause skin damage if used too often, over a long period of time or under occlusion.
Some of the side effects of topical steroids may go away after the medication is stopped. In other cases, the damage is permanent. It is difficult to recognize the subtle changes in the skin that mark steroid damage–this is why a doctor should be consulted periodically. The following is a list of potential side effects from using topical steroids.
- Skin damage: Skin thinning, changes in skin pigmentation, easy bruising, stretch marks, redness and dilated surface blood vessels may occur.
- Rebounds: Psoriasis may get worse if topical steroids are discontinued suddenly. This is called a psoriasis "rebound." Some doctors attempt to decrease the likelihood of a rebound by slowly reducing, or tapering, the use of steroids after the psoriasis starts to go away. Others prefer to gradually lower the strength of steroid medications to avoid a rebound. Abruptly stopping the use of superpotent topical steroids can potentially, though rarely, cause plaque psoriasis to convert to pustular psoriasis. Pustular psoriasis can be serious and require hospitalization.
- Facial psoriasis: Steroids can be helpful in the treatment of psoriasis on the face; however, using steroids on the face can cause redness, acne or visible blood vessels that appear swollen. Avoid getting steroids in the eyes, for instance, when treating the scalp.
- Internal absorption: Steroids can be absorbed through the skin and affect a person's whole body, including internal organs. This happens if a topical steroid is extremely misused, i.e., applied to widespread areas of skin, used over long periods of time, or with excessive occlusion of potent steroids.
Updated November 2006
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