Steroid : Most Common Adverse Effect

Artikel ini ditulis oleh:
Dr. PM Ridzuan
Head of Researcher, Director of Dr.Ridz SkinLabs & Dr.Ridz Manufacturing Sdn Bhd.

Topical steroids, when used as directed, are generally considered safe and effective for treating skin conditions. However, as with any medication, there can be potential side effects. 

Yes, it’s true that long-term use of steroids even only apply on the skin surface can lead to a condition known as steroid addiction or “steroid dependency.” This can cause the body to become dependent on the steroid, leading to withdrawal symptoms such as itching and hives when the steroid is discontinued.

This is because the skin is highly permeable and all steroid can be absorbed into the blood stream especially high-potency and ultra-high- potency corticosteroids , leading to systemic effects throughout the body.

Steroids can suppress the natural production of hormones in the body that regulate inflammation and itching. Over time, the body may become unable to produce enough of these hormones on its own, leading to withdrawal symptoms when the steroid is discontinued. 

To minimize the risk of steroid addiction, it is important to use steroid creams ONLY under the guidance of a doctor and to follow their recommended dosing and frequency of use. We strongly discourage buying any cream that contains steroids directly from pharmacies, clinics, or online store without consulting your specialist first.

Table Of Contents

Steroid Adverse Effect

  • Skin Thinning
  • Systemic Side Effect
  • Adrenal Suppression
  • Topical steroid withdrawal (TSW)
  • Rebound Effect


Skin Thinning:

Skin infections can occur as a result of overuse of topical steroids, which can weaken the skin’s natural defense mechanisms. This can make the skin more susceptible to infections caused by bacteria, fungi, or viruses.

Symptoms of skin infections can include redness, swelling, pain, and discharge from the affected area. To minimize the risk of skin infections from topical steroids, it’s important to use the medication as directed by a healthcare provider and to avoid overuse.

Systemic Side Effects:

Systemic side effects described above can occur as a result of the systemic absorption of topical steroids when applied to the skin. Topical steroids, when absorbed into the bloodstream, can cause hormonal imbalances, adrenal suppression, reduced immune response, eye problems, and stunted growth in children.

However, it’s important to note that these side effects are not very common and can vary based on factors such as the potency, frequency, and duration of use of the topical steroid. Additionally, these side effects can be avoided or minimized by using topical steroids as directed by a healthcare provider and regularly monitoring for any potential side effects.

Adrenal Suppression:

Adrenal suppression refers to the suppression of hormone production by the adrenal glands. Prolonged use of high-potency topical steroids can cause adrenal suppression, leading to adrenal insufficiency. Adrenal insufficiency can cause symptoms such as fatigue, low blood pressure, and weight loss.

If you suspect that you have adrenal suppression from using topical steroids, it’s important to speak to your healthcare provider, who can perform tests to confirm the diagnosis and provide appropriate treatment.

Topical Steroid Withdrawal (TSW)

Topical steroid withdrawal (TSW) also known as “red skin syndrome.” is a condition that can occur when someone has been using topical steroids for a prolonged period of time and then abruptly stops. This can cause a rebound effect, where the skin condition that was being treated with the steroid worsens temporarily.

The symptoms of TSW can include red, irritated, and itchy skin, which can be severe and last for several weeks or months. In some cases, the symptoms can be even more severe than the original skin condition. To prevent TSW, it’s important to follow the instructions of your healthcare provider for using topical steroids and to gradually taper off the treatment if needed.

Hormonal Imbalances

Children are particularly vulnerable to hormonal imbalances from topical steroids because their bodies are still developing, and their endocrine systems are more sensitive to disruption. Long-term use of topical steroids in children can cause growth retardation, delayed puberty, and other developmental problems.

Topical steroids can be absorbed into the bloodstream and inhibit the body’s natural production of cortisol, a hormone produced by the adrenal glands.

When the body is exposed to exogenous sources of steroids, such as topical steroid creams, it can suppress its natural production of cortisol. Prolonged use of topical steroids can cause the adrenal glands to shrink, leading to a reduction in the production of cortisol. This can cause a range of symptoms, such as weight gain, moon face, and skin thinning, and can lead to a condition known as Cushing’s syndrome.


It is important to seek medical attention and properly stop the use of topical steroids, with gradual withdrawal and supportive care also needed. Supportive care may include cold techniques (ice and cool compresses), psychological support, doxycycline, tetracycline, or erythromycin, antihistamines, and calcineurin inhibitors.

Natural treatment is also encouraged as an alternative to steroid use. For example, the use of herbs such as “Sireh” and “Gelenggang” have been scientifically proven to control eczema.

DERMCARE Soothing Cream is specially formulated for eczema using a combination of traditional Chinese and Malay herbal extracts, through over 5 years of research. Steroid-FREE and free from harmful chemicals, this cream has been dermatologically tested to be comparable to steroids, but without side effects.

Further read HERE for more details.


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