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.