Adverse effects of topical glucocorticosteroids

Area of Science:

• Dermatology
• Pharmacology

Background:

• Topical corticosteroids have been used for 50 years, marking a significant advance in dermatologic therapy.
• Adverse drug reaction reporting and literature on topical corticosteroid safety are often incomplete and neglected.

Purpose of the Study:

• To provide an updated review of the adverse-effect profile of topical corticosteroids.
• To highlight local and systemic adverse effects, including recent FDA reports on pediatric safety.

Main Methods:

• Literature review of adverse effects associated with topical corticosteroid use.
• Analysis of reported local and systemic reactions, considering factors like patient age and application site.

Main Results:

• Common cutaneous adverse effects include atrophy, striae, rosacea, perioral dermatitis, acne, and purpura.
• Less frequent effects include hypertrichosis, pigmentation changes, delayed wound healing, and secondary infections.
• Contact sensitization rates are higher than commonly perceived, and systemic reactions like hyperglycemia and glaucoma can occur.

Conclusions:

• Topical corticosteroids, while effective, present a range of local and systemic adverse effects.
• Children are more susceptible to systemic reactions due to their body surface area to weight ratio.
• Awareness and reporting of adverse effects are crucial for safe and effective use of topical corticosteroids.