If too much corticosteroid cream becomes absorbed through the skin, serious complications can result, including adrenal gland suppression and Cushing's syndrome. In adrenal gland suppression, the body stops manufacturing its own steroids, so the patient may become dependent on the drug. Cushing's syndrome causes symptoms including diabetes, high blood pressure , and muscle weakness. Local side effects are also possible due to misuse of corticosteroid cream. These can include skin atrophy, stretch marks , susceptibility to infection, allergy , easily bruised or injured skin, and enlarged blood vessels.
The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.