What can happen with prolonged use of topical steroids?

Question

Hi doctor,

Two years back I had the problem of ringworm on my upper leg near both sides of the testes and I used antifungal cream Betnovate C and Quadriderm. By using this cream my ringworm are gone but skin becomes very thin with rashes marks. Now there is no problem with ringworm but the skin looks very ugly.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Looking at the history and the picture (attachment removed to protect patient identity) there seems to be a clear correlation. Betnovate-C (a combination of Betamethasone valerate and Clioquinol) is a steroid cream and Quadriderm is a very nonspecific kind of cream. With prolonged use of steroid cream, you tend to have atrophy of the skin which means the upper layer of the skin becomes very thin and paper-like. There is a loss of subcutaneous collagen leading to the appearance of marks which you described in your problem. All these are collective side effects of using a steroid for a long time. I am sorry to tell you that the side effects are having a very bad prognosis. However, you can start using Silicone-based creams like Contractubex cream three or four times a day and massage properly in the area for the marks. You may find some relief after using it for a long time. But, the result will not be very satisfactory. Since you asked me, next time you have a fungal infection, apply Candid cream (Clotrimazole) and go to a dermatologist immediately. Alternatively, you can also go in for silicon-based mesotherapy.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

The skin damage has assumed the appearance of stretch marks, same kind of damage in both cases except the superficial skin damage in terms of steroid cream. Mesotherapy should be followed by a CO2 laser (carbon dioxide laser) in the end to promote collagen. Do not worry; it will not spread. But, to reverse is a challenge, so be patient. Only precaution you need to take is not to ever apply a steroid cream without prescription. This is like a two edged sword, you can end up injuring yourself if you do not use it wisely.

Thank you.