One of the key side effects of corticosteroid is skin thinning – this is also known as skin atrophy. Thinner skin has increased rate of transepidermal water loss (TEWL), more fragile and prone to irritation. The skin thinning is due to decreased rate of collagen and skin cell growth. The mechanism is from the activation of glucocoricoid and mineralocorticoid (MR) receptors in the epidermis by the corticosteroids.
Researchers in hypertension (high blood pressure) discovered that drugs for hypertension that contain spironolactone works as a MR antagonist by reducing the activation of the MR receptors. Based on a small randomized double-blind controlled trial of 23 individuals for 28 days, it was recorded that there was no skin thinning for those who applied spironolactone. Thus, it was an indication that corticosteroids could possibly be used without the worry of skin thinning effect if it’s applied together with the above hypertension drug.
It is interesting to see if there’s medical advancement in this area – steroid side-effect is a concern of many parents and while generally safe to use, always bear in mind to use as indicated and check with your doctor
- How much to use (finger tip unit)
- How long to use (duration and frequency)
- Where it can be used (especially for thinner areas of skin such as face and neck)
- What appearance of rash you should see after application by week (1,2 and when to stop)
- How it can be used – especially if you are also applying wet or dry wrap, you should not also be using corticosteroids as under occlusion, the side effects are more significant