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West J Med. 1995 February; 162(2): 123–126.
PMCID: PMC1022645

Adverse effects of topical corticosteroid use.


Topical corticosteroid use, a common and often efficacious therapy for a wide variety of cutaneous conditions, may have substantial adverse effects. These range from the notable nondermatologic side effects of hypothalamic-pituitary-adrenal axis suppression, Cushing's disease, femoral head osteonecrosis, and cataracts to a variety of less serious skin effects such as cutaneous tinea and contact dermatitis. The broad availability, efficacy, relative low cost, and ease of applying topical corticosteroids should not induce complacency or a cavalier attitude in prescribers. Physicians should have the same awareness of the possible side effects of topical steroid use as when prescribing parenteral medication.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Nachman RL, Esterly NB. Increased skin permeability in preterm infants. J Pediatr. 1971 Oct;79(4):628–632. [PubMed]
  • Olsen EA, Cornell RC. Topical clobetasol-17-propionate: review of its clinical efficacy and safety. J Am Acad Dermatol. 1986 Aug;15(2 Pt 1):246–255. [PubMed]
  • Pascher F. Systemic reactions to topically applied drugs. Int J Dermatol. 1978 Dec;17(10):768–775. [PubMed]
  • Keipert JA, Kelly R. Temporary Cushing's syndrome from percutaneous absorption of betamethasone 17-valerate. Med J Aust. 1971 Mar 6;1(10):542–544. [PubMed]
  • Walsh P, Aeling JL, Huff L, Weston WL. Hypothalamus-pituitary-adrenal axis suppression by superpotent topical steroids. J Am Acad Dermatol. 1993 Sep;29(3):501–503. [PubMed]
  • Feldmann RJ, Maibach HI. Regional variation in percutaneous penetration of 14C cortisol in man. J Invest Dermatol. 1967 Feb;48(2):181–183. [PubMed]
  • Turpeinen M. Influence of age and severity of dermatitis on the percutaneous absorption of hydrocortisone in children. Br J Dermatol. 1988 Apr;118(4):517–522. [PubMed]
  • Turpeinen M, Mashkilleyson N, Björkstén F, Salo OP. Percutaneous absorption of hydrocortisone during exacerbation and remission of atopic dermatitis in adults. Acta Derm Venereol. 1988;68(4):331–335. [PubMed]
  • Johns AM, Bower BD. Wasting of napkin area after repeated use of fluorinated steroid ointment. Br Med J. 1970 Feb 7;1(5692):347–348. [PMC free article] [PubMed]
  • Stevanović DV. Corticosteroid-induced atrophy of the skin with telangiectasia. A clinical and experimental study. Br J Dermatol. 1972 Dec;87(6):548–556. [PubMed]
  • Colomb D. Stellate spontaneous pseudoscars. Senile and presenile forms: especially those forms caused by prolonged corticoid therapy. Arch Dermatol. 1972 Apr;105(4):551–554. [PubMed]
  • Sibenge S, Gawkrodger DJ. Rosacea: a study of clinical patterns, blood flow, and the role of Demodex folliculorum. J Am Acad Dermatol. 1992 Apr;26(4):590–593. [PubMed]
  • Plewig G, Kligman AM. Induction of acne by topical steroids. Arch Dermatol Forsch. 1973;247(1):29–52. [PubMed]
  • Shelley WB, Shelley ED, Burmeister V. Unilateral demodectic rosacea. J Am Acad Dermatol. 1989 May;20(5 Pt 2):915–917. [PubMed]
  • Tsuji T, Kadoya A, Tanaka R, Kono T, Hamada T. Milia induced by corticosteroids. Arch Dermatol. 1986 Feb;122(2):139–140. [PubMed]
  • Nielsen NV, Sørensen PN. Glaucoma induced by application of corticosteroids to the periorbital region. Arch Dermatol. 1978 Jun;114(6):953–954. [PubMed]
  • Ive FA, Marks R. Tinea incognito. Br Med J. 1968 Jul 20;3(5611):149–152. [PMC free article] [PubMed]
  • Smith EB, Breneman DL, Griffith RF, Hebert AA, Hickman JG, Maloney JM, Millikan LE, Sulica VI, Dromgoole SH, Sefton J, et al. Double-blind comparison of naftifine cream and clotrimazole/betamethasone dipropionate cream in the treatment of tinea pedis. J Am Acad Dermatol. 1992 Jan;26(1):125–127. [PubMed]
  • Macmillan AL. Unusual features of scabies associated with topical fluorinated steroids. Br J Dermatol. 1972 Nov;87(5):496–497. [PubMed]
  • Kestel JL., Jr Hypopigmentation following the use of Cordran tape. Arch Dermatol. 1971 Apr;103(4):460–460. [PubMed]
  • Wilkinson SM, Cartwright PH, English JS. Hydrocortisone: an important cutaneous allergen. Lancet. 1991 Mar 30;337(8744):761–762. [PubMed]
  • Wilkinson SM, English JS. Hydrocortisone sensitivity: clinical features of fifty-nine cases. J Am Acad Dermatol. 1992 Nov;27(5 Pt 1):683–687. [PubMed]
  • Dooms-Goossens A, Morren M. Results of routine patch testing with corticosteroid series in 2073 patients. Contact Dermatitis. 1992 Mar;26(3):182–191. [PubMed]
  • Fisher AA, Pascher F, Kanof NB. Allergic contact dermatitis due to ingredients of vehicles. A "vehicle tray" for patch testing. Arch Dermatol. 1971 Sep;104(3):286–290. [PubMed]
  • du Vivier A. Tachyphylaxis to topically applied steroids. Arch Dermatol. 1976 Sep;112(9):1245–1248. [PubMed]

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