![]() Other local adverse effects: These include facial hypertrichosis, folliculitis, miliaria, genital ulcers, and granuloma gluteale infantum.This has led to therapies such as 3 days on, 4 days off or one week on therapy, and one week off therapy. Recovery usually occurs after 3 to 4 days' rest. Significant tachyphylaxis can occur by day 4 of therapy. Tachyphylaxis: The acute development of tolerance to the action of a drug after repeated doses.Ocular effects: Topical steroid drops are frequently used after eye surgery but can also raise intraocular pressure (IOP) and increase the risk of glaucoma, cataract, retinopathy as well as systemic adverse effects.Perioral dermatitis: This is a rash that occurs around the mouth and the eye region that has been associated with topical steroids.Allergic contact dermatitis (see steroid allergy).Hypothalamic–pituitary–adrenal axis (HPA) suppression.The use of the finger tip unit may be helpful in guiding how much topical steroid is required to cover different areas of the body. Long-term use of topical steroids can lead to secondary infection with fungus or bacteria (see tinea incognito), skin atrophy, telangiectasia (prominent blood vessels), skin bruising and fragility. Some recommend using the topical steroid for 3 consecutive days on, followed by 4 consecutive days off. To prevent tachyphylaxis, a topical steroid is often prescribed to be used on a week on, week off routine. Strong steroids are used for psoriasis, lichen planus, discoid lupus, chapped feet, lichen simplex chronicus, severe poison ivy exposure, alopecia areata, nummular eczema, and severe atopic dermatitis in adults. Moderate steroids are used for atopic dermatitis, nummular eczema, xerotic eczema, lichen sclerosis et atrophicus of the vulva, scabies (after scabiecide) and severe dermatitis. ![]() Weaker steroids are used on the face, eyelids, diaper area, perianal skin, and intertrigo of the groin or body folds. Weaker topical steroids are utilized for thin- skinned and sensitive areas, especially areas under occlusion, such as the armpit, groin, buttock crease, and breast folds. ![]()
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