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Insect bites and stings - Management
What are the adverse effects of topical corticosteroids?
- Topical corticosteroids are associated with localized effects, such as skin atrophy and exacerbation of skin infections (e.g. fungal infection):
- The risk of adverse effects increases with the potency of the topical corticosteroid, duration of use, and area of application (e.g. thin skin on the genitalia). Adverse effects are most likely with potent or super-potent topical corticosteroids when used in large quantities for prolonged periods.
- Mildly and moderately potent topical corticosteroids used for short periods are rarely associated with adverse effects.
- Skin atrophy is much more likely with potent and very potent topical corticosteroids.
- There is little risk of skin thinning with mildly to moderately potent topical corticosteroids when used for up to 4 weeks.
- Contact allergy to topical corticosteroids has also been reported (4–5%). The allergy is normally to preservatives in the preparation (more likely with creams) or, more rarely, to the corticosteroid itself.
- Note: systemic effects, such as hypophyseal-pituitary-adrenal (HPA) suppression which may lead to growth retardation, are extremely rare. HPA has been observed following prolonged application of potent steroids to large areas of skin.
[MeReC, 1999; DTB, 2003]
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