What are the adverse effects of long-term topical glucocorticoid use on the skin?

Topical glucocorticoids for the treatment of dermatitis and eczema have been the prescribing habit of dermatologists for decades. However, while glucocorticoids exert their anti-inflammatory, anti-allergic and anti-proliferative therapeutic effects to improve the symptoms of skin diseases, they have obvious adverse effects on the skin barrier system. They are mainly reflected in the following aspects: 1. Effects on epidermal function. Glucocorticoids slow down the recovery of skin epidermal function. After 3 days of topical application of glucocorticoids in adults, the recovery rate of skin barrier function is significantly reduced, and if glucocorticoids are used for a long time, the basic water loss can increase nearly 3 times. 2. Effects on lipid metabolism. Glucocorticoids make the skin drier. After 3-4 weeks of local glucocorticoid treatment in normal adult skin, the content of lipids in the stratum corneum is reduced by more than 24%. 3. Effects on cell proliferation and differentiation. Glucocorticoids make the skin thinner. In normal skin, glucocorticoids can inhibit the proliferation and differentiation of epidermis. 4. Effects on the denseness and adhesiveness of the stratum corneum. The degree of effect of glucocorticoids on denseness is proportional to the dose, which can reduce the adhesion between keratin-forming cells and make the skin flake easily. It is clear from the above that glucocorticoids have a temporary clinical effect on dermatitis and eczema, but at the same time aggravate the patient’s already damaged skin barrier function. Therefore, dermatitis and eczema are more likely to recur. Therefore, the use of moisturizing skin care products along with topical glucocorticosteroids can not only enhance the efficacy of the treatment, but also reduce the recurrence of the disease.