Steroid creams reduce inflammation in conditions like eczema and dermatitis. They work well, and two opposite mistakes are common: using a strong one for too long in the wrong place, and being so worried about them that the condition is undertreated.
They come in a range of strengths, from mild through to very potent, and advice about one does not transfer to another. A mild cream used briefly on a small area is a very different proposition from a potent one used for weeks. Know which you have.
Common side effects of this pharmacy medicine or category
- Burning or stinging on application, usually settling
- Skin thinning with prolonged use, most on the face and in skin folds
- Stretch marks, which do not reverse
- Visible small blood vessels, and easy bruising
- Acne or small bumps around the mouth
- Lightening of the treated skin, which can be more noticeable on darker skin
These come from prolonged or inappropriate use, not from a short course as directed. Fear of them leads some people to use too little for too short a time, leaving the condition flaring, which brings its own problems including skin infection and poor sleep. Using an adequate amount for the period advised, then stopping, is the intended pattern.
Interactions and duplicate-ingredient risks
Do not use a steroid cream on an undiagnosed rash, and in particular not on anything that might be a fungal or bacterial infection. Steroids reduce inflammation without treating infection, so the rash may look better briefly while the infection spreads. Ringworm treated with a steroid cream is a classic example of a rash that changes appearance and becomes harder to diagnose.
Some products combine a steroid with an antifungal or antibacterial for exactly this reason, but they are chosen deliberately rather than assumed.
If you also take steroid tablets, or use a steroid inhaler, mention the cream, since the total matters when large areas are treated. See long-term steroid side effects.
Children, pregnancy, older adults and chronic medicine cautions
- Children. Absorb proportionally more. Use only the strength advised for their age and area, and follow the amounts given.
- Face, eyelids, groin and skin folds. Skin is thinner and absorption higher, so weaker preparations and shorter courses apply. Ask before using anything on the face.
- Pregnancy and breastfeeding. Generally acceptable for limited use, but check, and avoid applying where a baby feeds.
- Older adults, whose skin is already thinner.
Warning signs and overdose concerns
Stop and seek advice for skin becoming thin, shiny or fragile; a rash that spreads or worsens despite treatment; signs of infection such as increasing pain, warmth, swelling, pus or crusting; or a rash that keeps returning as soon as you stop.
Get emergency help for difficulty breathing or swelling of the face, lips or throat.
With eczema that flares immediately every time treatment stops, the answer is usually a proper management plan including moisturisers rather than either continuous steroid use or abrupt stopping.
Questions to ask a pharmacist before using it
- What strength is this, and where is it safe to use?
- How much should I apply, and for how many days?
- Could my rash be an infection rather than eczema?
- Should I be using a moisturiser alongside it?
- What do I do when it flares again after stopping?
Related OTC and medicine-safety guides
- Topical medicine side effects
- Skin medicine side effects
- OTC medicine side effects
- When to see a doctor about an OTC medicine
- Report an OTC medicine side effect
See also hydrocortisone cream and corticosteroid side effects.
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.