Glucocorticoids: an enemy or a friend for the dermatologist? recommendations for proper use and safe discontinuation

Glucocorticoids (GCs) are steroid hormones produced by the adrenal cortex with anti-inflammatory and immunoregulating effects, thus essential for the management of numerous inflammatory and autoimmune disorders, including a wide range of dermatological conditions. The aim of our review is to summarize current data about the indications for GCs in dermatology, present the dermatological and endocrinological adverse effects and summarize current recommendations about the proper use and safe discontinuation of GCs, creating a practical guide for dermatologists.

A narrative review of the literature on PubMed/MEDLINE was conducted and included articles in English, published until July, 2026. A combination of the keywords "glucocorticoids", "dermatology", "adrenal insufficiency", "HPA axis", "adverse effects" and "monitoring" was used to identify relevant literature for this review, with emphasis on recent recommendations and guidelines. The reference lists of the selected publications were also reviewed.

Although GCs are commonly prescribed medications in dermatology, their use is associated with numerous adverse effects, extending beyond the skin to multiple organ systems. However, some side effects, such as adrenal insufficiency and withdrawal syndrome, may even be life-threatening.

Due to the expanded use of GCs, careful prescription and safe discontinuation is required. For this reason, we have created a practical clinical guide, summarizing the relevant recommendations to ensure proper use of GCs as well as safe discontinuation of the treatment. Optimal GC use requires individualized and careful selection of potency, duration, and route of administration to prevent any side effects and ensure the best outcome for the patient.