INDIVIDUAL ARTICLE: Cutaneous and Systemic Adverse Events Associated With Topical Corticosteroid Use: A Targeted Literature Review

Background: Topical corticosteroids (TCS) have been used to treat chronic inflammatory skin conditions since initial approval in 1950, which was followed by reports of cutaneous and systemic adverse events (AEs) over the succeeding decades.
Methods: A targeted literature review was performed to identify case-report and observational-study publications from August 2015 to 2025 that reported TCS-associated adverse events (AEs).
Results: The 42 publications included identification of clinically meaningful cutaneous (69.0%) and systemic AEs, including hypothalamic-pituitary-adrenal axis suppression or adrenal insufficiency (40.5%) and Cushing syndrome (47.6%). AEs ranged from mild to severe and nonserious to serious, and reports implicated prolonged (≥12 months, 45.2%) or high-potency (69.0%) TCS use.
Conclusion: Overall, these results identified an opportunity to assess TCS access requirements and the need for additional clinician awareness and education to improve TCS prescribing practices, including monitoring of AEs and cumulative steroid exposure. Improving access to anti-inflammatory therapies that have demonstrated short- and long-term safety and efficacy in clinical trials and are not steroids for patients with chronic dermatoses should be prioritized. Often, gaining access to these alternative treatments requires step-through TCS therapy or other utilization management requirements, which unnecessarily puts patients at risk for steroid-associated AEs and delays positive treatment outcomes.