With long-term use of topical steroids, the skin may develop permanent stretch marks (stretch marks), bruises, discoloration, or thin, arachnid blood vessels (telangiectasia). Topical steroids can trigger or worsen other skin disorders, such as acne, rosacea and perioral dermatitis. Most people with eczema use topical steroids as a treatment option and to control their symptoms without experiencing adverse events. But for some, TSW can arise as a complication of topical steroid use, even causing significantly worse symptoms than their original skin condition.
Allergic contact dermatitis to topical steroids occurs as a lack of response to treatment or as a worsening of dermatitis. It is usually seen in children with atopic dermatitis. In addition, moderately potent steroids commonly used in children, such as desonide and hydrocortisone butyrate, have an allergic property because of their structural instability. Some commonly used potent steroids include rare allergens, such as fluorinated corticosteroids, clobetasol propionate, betamethasone dipropionate, mometasone, etc.
Common side effects of corticosteroids can include stretch marks, as well as thinning, thickening or darkening of the skin. Less commonly, these steroids can cause infected acne or hair follicles or more serious side effects in the eyes, such as glaucoma and cataracts. Steroid-based ointments that work well with other skin conditions may have the opposite effect with perioral dermatitis. If you use that type of cream from the medicine cabinet, the rash may look better initially because the steroid constricts the small blood vessels in the skin.
However, the reduction in redness won't last, as the steroid tends to suppress the skin's natural healing capacity with its continued use. The length of time during which the steroids were initially used determines the length of the withdrawal phase. Kathy Tullos, registered nurse, is the president of ITSAN, The International Topical Steroid Awareness Network, a non-profit organization focused on raising awareness about TSW and supporting those affected. Even so, the findings add to the evidence that phobias prevent many parents in many parts of the world from using corticosteroids to treat their children with eczema, said Dr.
Steroid-induced telangiectasia occurs due to the stimulation of the release of nitric oxide from endothelial cells of the dermal vessels, leading to abnormal dilation of the capillaries. Topical steroids increase the proliferation of Propionibacterium acnes and Demodex folliculorum, causing an acne-like condition rosacea within 6 months. Steroid-induced protein degradation leads to dermal atrophy and loss of intercellular substance, which also causes blood vessels to lose the surrounding dermal matrix, resulting in dermal vessel fragility, purpuric hypopigmentation and scar depression. Patients with atopic and seborrheic dermatitis who take chronic topical steroids develop an outbreak around the eyes 5 to 7 days after they stop taking steroids.
In the second study, 29 percent of people with phobias didn't use their steroid cream, compared to 10 percent of patients who weren't worried. Atrophy causes a burning sensation, and subsequent use of steroids causes vasoconstriction and soothes burning. Many of these steroid creams also contain antifungal and antibacterial drugs, and the labels indicate that they can be used to treat fungal infections. However, in other countries (for example, India), people can buy creams containing strong steroids without needing a prescription.
Five of the studies in the analysis looked at why people had phobias and found that thinning skin was the most common concern, followed by fears that steroids could affect growth and development. Much is still unknown about this condition, especially how often it occurs and the amount of topical steroid use that causes it. Contact sensitization to topical steroids occurs due to the binding to the amino acid arginine as part of certain proteins. .
