Skin Health Common Side Effects of Topical Steroid Use By Heather L. Brannon, MD Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years. Learn about our editorial process Heather L. Brannon, MD Medically reviewed by Medically reviewed by Leah Ansell, MD on May 20, 2020 linkedin Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University. Learn about our Medical Review Board Leah Ansell, MD Updated on September 17, 2020 Print Table of Contents View All Table of Contents Tachyphylaxis Steroid Rosacea Skin Atrophy Stretch Marks Alteration of Infection Topical Steroid Allergy Glaucoma While topical steroids have enormous benefit in reducing inflammation, they can also come with certain side effects. Many of these effects are related to long-term use, but others can occur within days of starting therapy. The 7 most common side effects range in severity from mild and transient to long-lasting and permanent. AntonioGuillem / Getty Images Tachyphylaxis Tachyphylaxis is the rapid decrease in response to a topical steroid due to repeated use. Overuse of steroids can cause the skin to develop a tolerance to the drug, rendering them useless. When this happens, people will often increase the dosage or apply the steroid more frequently, which only increases a person's tolerance to the drug. The effect can usually be reversed by stopping treatment for seven days and then restarting. The Safe Way to Use Topical Steroids Steroid Rosacea Prolonged use of a topical steriod on the face can cause rosacea. Often, any attempt to use a lower-strength steroid (or to cut back or stop altogether) can result in intense facial redness and the formation of fluid-filled bumps (called pustules). Skin Atrophy Repeated use of topical steroids in the same area can cause the thinning of the epidermis (outer layer of skin) and changes in the connective tissue of the dermis (middle layer of skin). When this happens, the skin can degenerate and become lax, wrinkled, and shiny. Affected areas can be noticeably thinner than surrounding skin with visible spider veining (telangiectasias), hypopigmentation, and the sudden prominence of underlying veins. Atrophy is usually reversible once steroid use is stopped, but it may take months for the skin to thicken to normal. Stretch Marks Repeated use of topical steroids in areas where skin touches skin, such as the groin and armpits, can result in stretch marks (striae). Stretch marks from topical steroid use are permanent and irreversible. They can be very itchy and may require a lower strength steroid to treat the underlying itch. Alteration of Infection Because topical steroids change the way the immune system work, they can inhibit the skin’s ability to fight off bacterial and fungal infections. A typical example of this is seen when someone applies a topical steroid to an itchy groin rash. If the cause is fungal, the rash will get redder and itchier and spread more extensively than a typical fungal infection. This can lead to a condition called tinea incognito wherein the rash is inflamed with visible pustules. Topical Steroid Allergy Some people are allergic to the non-active component of a topical steroid (also known as the vehicle). People who have a chronic skin condition and use multiple prescriptions (including over-the-counter topical steroids) are at higher risk of developing these allergies. Glaucoma Glaucoma is a disease in which the pressure inside the eye increases to the point of damaging the optic nerve. There are isolated reports of people developing glaucoma after long-term use of topical steroids around the eyes. How this happens is not completely understood, but it is believed that enough of the steroid can be absorbed in the surrounding tissue to leech into the eye itself. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Abraham A, Roga G. Topical steroid-damaged skin. 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