Skin Care Decoded!

While there isn’t any doubt that topical steroids have tremendous benefits in reducing inflammation, you should know that topical steroids have their side effects as well. Side effects of topical steroids can sometimes be seen within days of starting therapy but for some people, the side effects of topical steroid may only be seen with long term usage.

For those using topical steroid, you will need to know what are the different types of side effects of using topical steroids so you will not be confused between your skin allergy and the side effects.

One of the known side effects of using topical steroid is Tachpyhlaxis. Tachphylaxis is a symptom whereby your skin develops a difficulty in constriction of blood cells. The capillaries in your skin will not constrict as well in return will require higher doses and more frequent application of steroid. There are cases where a high potent steroid used 4 times a day creates tachpyhlaxis after just 4 days of application. However, the ability of blood vessels to constrict returns back to normal just after 4 days of stopping the usage of topical steroids

Another side effects of using topical steroids is the steroid rosacea. This side effect is commonly found on people with fair skin whom already have rosacea. A common example is when a person using mild steroid on face to counteract facial flushing ends up having intense facial redness and pustules. Usually the person might have found the results effective in the beginning but as tolerance level develops, the person may need to use a higher strength of steroid which any attempt to cut down or stop the steroid application will cause steroid rosacea.

Skin atrophy is another side effect of using topical steroids. Skin atrophy happens when the repeated use of topical steroid in the same area causes thinning of the epidermis which then changes the connective tissues of the dermis. Skin would then become wrinkled, lax and shiny. The affected areas are usually depressed below level of normal skin with visible underlying veins, hypopigmentation and telangiectasias. In most cases, skin atrophy is only reversible when usage of topical steroid is stopped. However, it may take months for skin to be back to as before.

Usage of topical steroids in areas where skin touches skin such as groin or armpits can also cause stretch marks which are permanent and irreversible. These stretch marks are itchy and requires a lower potent steroid to relieve the itch. It is usually recommended that you should progressively decrease the steroid potency until the therapy in the affected area is terminated.

Another side effect to using topical steroid is when topical steroids change the way our immune system functions. Topical steroids are able to inhibit the skin’s ability to fight off bacterial or fungal infections causing the skin a more serious problem. One of the common example is when one applies topical steroid to a fungal infection thinking its a rash. The rash will get redder, itchier and spreads more intensively than a typical fungal infection.

Apart from that, some people may also be allergic to a certain component of the topical steroid. People that usually have chronic skin conditions and use multiple prescription of over-the-counter topical steroids are the ones that have a higher risk of developing topical steroid allergy.

There is also a risk of glaucoma where people after the long term use of topical steroid around the eyes develop them. Glaucoma happens when the pressure inside the eye increases to a point of damaging the optical nerve. Although it is never understood how topical steroid applied around the eyes causes glaucoma, but it is believed that the steroid is absorbed into the eyes.

Images from nhs.uk