What is a common adverse effect of topical corticosteroids?

• A. Infection
• B. Skin Atrophy
• C. Hyperpigmentation reversal
• D. Hypertension

Answer: (B)

Topical corticosteroids most often cause thinning of the skin. This happens because these drugs suppress collagen synthesis in the dermis and reduce fibroblast activity, leading to skin atrophy with prolonged or potent use. The thinning makes the skin more fragile, prone to easy bruising, and can be accompanied by stretch marks or visible blood vessels, especially on areas of repeated rubbing or where occlusion increases absorption. This is the classic local adverse effect clinicians monitor for in practice.

While infection can occur if the skin barrier is compromised and the area is heavily treated or occluded, it’s not as common as atrophy. Hyperpigmentation changes aren’t typically described as a reversal effect, and hypertension would require significant systemic absorption, which is uncommon with standard topical therapy.