What is the risk or side effects of using medicines called topical steroids for a long period?

Question

I have been using Dermovate scalp application for my psoriasis for many years by now and this is the only medication that seems to be working on my condition. I only apply it when redness and itchness occur. I have learned lately that using this type of medication which contains steroids may have serious side effects such as the effect on normal production of steroids in the body. What would that exactly mean? What are the symptoms in such cases? Does it have anything to do with methabolism or overweight issues?

Answer 1

Dermovate is a very potent topical steroid.Generally topical steroids side effects are effects at the site they are applied such as thinning of the skin, easy bruising, skin infection,etc. As a very potent topical steroids, Dermovate is more likely to be absorbed through the skin into the body and to cause side effects similar to oral steroids, especially if they are used continuously for long period on large areas of the body such as the back. You are right, it affect normal production of steroids in the body which is the function of the adrenal gland. Side effects would include increase risk of getting infection (takes place with very high doses), reduced calcium absorption through the gastrointestinal tract resulting to bone thinning and an increased risk of osteoporosis amongst others. It can suppress growth in children. Some of the more common side effects include changes in appearance, such as acne, development of a round or moon-shaped face and an increased appetite leading to weight gain. Steroids may also cause a redistribution of fat, leading to a swollen face and abdomen, but thin arms and legs. The side effects usually reversed once the steroids are stopped.

Answer 2

I'm not familiar personally with having psoriasis (but I can empathize as someone with dry skin after living in the desert for several years) or the side effects of the long term use of topical steroids. The best person to ask would be your pharmacist.

I did however find this, I hope it helps :)

Side effects of topical steroids from the Psoriasis Foundation:


Topical steroid medications are capable of clearing psoriasis lesions from the skin, but steroids don't usually produce remissions, and the clearance often doesn't last very long. The early return of psoriasis can contribute to patients using steroids for a longer period of time than is recommended or using a steroid that is too potent for a particular type of skin. (For example, the skin on the face is very different and much more sensitive to steroids than the skin on the bottom of the foot.) This may contribute to the appearance of common side effects associated with topical steroid medications.
Weak, less potent steroids are ordinarily used to treat thin, sensitive skin, such as the face, groin and breasts. These areas are most prone to steroid side effects; therefore, even weak steroids must be applied with caution. Treating lesions on the face, skin folds or genitals should only be carried out under the direction of a doctor. Stronger steroid medications are more appropriately used on thicker skin, such as the knees and elbows.

Superpotent topical steroids can be very effective in clearing lesions, but they must be used cautiously. They can cause serious skin damage if used too often, over a long period of time or under occlusion.

Some of the side effects of topical steroids may go away after the medication is stopped. In other cases, the damage is permanent. It is difficult to recognize the subtle changes in the skin that mark steroid damage–this is why a doctor should be consulted periodically. The following is a list of potential side effects from using topical steroids.

Skin damage: Skin thinning, changes in skin pigmentation, easy bruising, stretch marks, steroid redness and dilated surface blood vessels may occur.

Rebounds: Psoriasis may get worse if topical steroids are discontinued suddenly. This is called a psoriasis "rebound" or "flare." Some doctors attempt to stall a rebound by slowly reducing, or tapering, the use of steroids after the psoriasis starts to go away. Others prefer to gradually lower the strength of steroid medications to avoid a rebound. While it is quite rare, abruptly stopping the use of superpotent topical steroids can potentially cause a common form of plaque psoriasis to convert to pustular psoriasis. Pustular psoriasis can be serious and require hospitalization.

Facial psoriasis: Steroids can be helpful in the treatment of psoriasis on the face; however, using steroids on the face can cause redness, acne or visible blood vessels that appear swollen. Topical steroids should not be used around the eyes or on the face unless specifically directed by a doctor. Avoid getting steroids in the eyes, for instance, when treating the scalp.

Internal absorption: Steroids can be absorbed through the skin and affect a person's whole body, including internal organs. This happens if a topical steroid is grossly misused, i.e., applied to widespread areas of skin, used over long periods of time, or with improper occlusion of potent steroids. For this reason, a doctor should monitor the use of topical steroids.