Updated 09 July 2014

The dangers of long-term and continuous use of topical steroids

Is continued use of topical steroids dangerous?


Topical steroids are creams, ointments and lotions which contain steroid medications and are most commonly used in the treatment of skin conditions such as eczema to reduce skin inflammation.

They come in different potencies and the greater the strength, the greater the risk of side-effects with continued use.  Which is why many experts advise against the long-term use of topical steroids and many companies are now developing treatments which exclude the use of topical steroids completely.

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Common side-effects from topical steroids

Generally short courses of topical steroids which last under four weeks are considered a safer option. Problems may develop however, if topical steroids are used for long periods, or if short courses of stronger steroids are repeated too often.

Long-term use topical steroids may cause side effects, the most common of which is skin atrophy. This is worsened by factors such as higher potency steroids, occlusion, thinner skin, and older patient age.

The long-term use of strong steroids is most concerning and side-effects can either be ‘local’ or ‘systemic’. Local means just affecting that bit of skin and systemic means affecting the whole person.

Local effects may include:

  • Stinging or burning feeling following the first treatment.
  • Skin thinning – this mostly occurs with the use of high-strength steroids, although it can be reversed when treatment is stopped.
  • Stretch-marks: long-term use has in some cases led to permanent striae on the skin, bruising, discolouration, or thin spidery blood vessels.
  • Topical steroids can also induce rosacea, which may include the eruption of erythema, papules, and pustules.
  • Increased hair growth where the skin is being treated.
  • Allergy: some people have developed an allergy to the contents of the treatment, which in some instances can make the inflammation worse.

Read: Steroids improve eyesight

Systemic effects include:

  • In some cases the topical steroid gets through the skin and into the bloodstream, which is primarily a concern in children who are on strong doses as this can affect their growth.
  • Fluid build-up in the legs
  • Increase in blood pressure
  • Bone damage and thinning
  • Cushing's syndrome: although rare, symptoms include rapid weight gain, skin thinning and mood changes.

Should you be prescribed a treatment which includes a topical steroid, it is important to only use it as directed by your doctor and not to continue use as a ‘preventative’ measure.

Read more:

Are there steroids in dietary supplements?
The scientific side of steroid use and abuse
Steroid medication makes asthmatics depressed

Patient.UK Topical Steroids for Eczema:


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Skin expert

Dr Suretha Kannenberg holds a degree in Medicine and a Masters in Dermatology from the University of Stellenbosch. She is employed as a consultant dermatologist by Stellenbosch University and Tygerberg Academic Hospital, where she is involved in clinical duties and the training of medical students and dermatology residents. Her areas of interest and research include vitiligo, eczema and acne. She also performs limited private practice work in the Northern suburbs of Cape Town in general and cosmetic dermatology.

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