Oral steroid medications are frequently used to treat medical problems associated with inflammation. Conditions such as a severe allergic reaction, autoimmune disease, asthma, or inflammatory bowel disease where inflammation is a problem often respond to oral steroids. Unfortunately, oral steroids are associated with a long list of side effects that are more common when these drugs are used at high doses for long periods of time. In cases where inflammation is a prominent feature, but the problem is superficial such as a bad case of poison ivy, there are over-the-counter steroid creams available to treat the itching and reduce the inflammation. Over-the-counter steroid creams found in drugstores have lower concentrations of the active steroid ingredient than do prescription strength topical steroid creams.
Over-the-counter steroid creams are sold for treatment of skin conditions such as eczema and contact dermatitis. Most people assume because they’re sold without a prescription that they must be safe. Although the concentrations of active steroids in drugstore creams is much lower than those available by prescription, over-the-counter steroid creams can still have side effects.
When an over-the-counter steroid cream is applied to the skin, a certain amount of it is absorbed, although the amount is usually quite low. If there are breaks in the skin, as might be the case with a bad contact dermatitis or eczema, absorption will likely be higher. Despite this, the more serious side effects seen with oral steroid medications are usually not seen with over-the-counter steroid creams and they’re generally deemed to be safe in terms of the risk of serious health problems.
Use of over-the-counter steroid creams can cause local skin problems. If they’re used for prolonged periods of time, side effects can include thinning of the skin and an increased risk of telangiectasia, a condition where tiny, superficial blood vessels develop. There can also be changes in skin pigmentation and hair growth as well as easy bruising. In children, there’s the concern that use of steroids could affect growth patterns. This could potentially be a problem if excessive amounts are used for a prolonged period of time.
The way to avoid the side effects of over-the-counter steroid creams is to use the lowest dose for the shortest period of time possible, preferably seven days or less. Any condition that doesn’t respond to treatment in that period of time should be seen by a doctor. Although over-the-counter steroid creams are generally safe, they’re not recommended for long-term use.