Beyond Skin Deep: The Systemic Impact of Topical Corticosteroids in Dermatology.

Abstract

Corticosteroids are widely prescribed for a variety of dermatologic indications. However, since 2020, regulatory bodies from Canada and the United Kingdom, as well as academic and patient advocacy societies, are increasingly calling for limiting topical corticosteroid use due to safety concerns. This article reviews the variety and extent of both cutaneous adverse effects (i.e., steroid-induced damage) and systemic adverse effects from topical corticosteroids and explores alternative therapies. The risk of adverse effects increases with steroid potency, amount, duration, and frequency of use across indications, routes of administration, and prescribers (i.e., cumulative steroid dose). In order to reduce these safety risks, clinicians should prescribe steroids appropriately and counsel patients on appropriate use and consider combination topical corticosteroid therapy or newer alternative steroid-sparing treatments.