How steroids affect the skin
Steroids are vital medications for many conditions, including autoimmune diseases like lupus and rheumatoid arthritis, but they do cause side effects, and skin changes are among the most common.
Steroids are powerful medications that can be pretty hard on the skin. Steroids can affect the skin in several ways:
Thinning of the skin (atrophy)
While taking steroids, you might notice that your skin becomes more fragile and tears more easily than normal.
Bruising
Even minor bumps can lead to substantial areas of bruising. People usually notice these on their arms and legs, which tend to be more exposed than other areas of the body.
Delayed wound healing
No, it’s not your imagination. People who take steroids often find that minor cuts and scrapes take longer to heal. Delayed wound healing can pose a big problem for patients who have to undergo surgery.
Stretch marks
Chronic steroid use can also lead to the development of stretch marks (striae). These are often prominent on the abdomen, upper arms, thighs and breasts.
Acne and pimples
Many people find that they develop steroid-induced acne or a rash resembling acne.
Superficial fungal infections
Some patients are more prone than others to fungal infections like athlete’s foot.
Increased hair growth (hirsutism)
Steroids can even affect your hair. Look closely and you may see an increase in the fine hair that grows on your face, back, or other areas. This new hair will not do you any harm, but it can be unwelcome if you don’t like the way it looks.
Why does this happen?
Steroids work by reducing the strength of the immune response. While this makes them effective at treating autoimmune diseases and reducing inflammation (swelling), they can also affect a number of metabolic processes and lead to unwanted side effects:
Collagen breakdown
Steroids reduce the body’s ability to produce collagen, a protein essential for skin structure, causing skin thinning and stretch marks.
Altered sebum (oil) production
Steroids can also increase sebum production in the skin, which can clog pores and lead to acne.
Immune system suppression
Reduced immune function slows wound healing and can lead to infections like folliculitis (inflamed hair follicles).
Growth hormone suppression
Steroids suppress the secretion of growth hormones, which limits skin regrowth. In children, this can even lead to a reduction in their adult height.
With close care and the right strategies, you can help protect your skin.
Top tips for healthy skin
There are a number of practical steps you can take to manage these side effects and protect your skin:
1. Be gentle
Use mild, fragrance-free cleansers and moisturizers. Avoid hot water, harsh soaps and scrubbing, which can make skin thinning worse.
2. Hydration, hydration, hydration!
Apply moisturizers regularly to help maintain the skin's protection barrier. Look for products that contain ceramides or hyaluronic acid for extra hydration.
3. Protect your skin from sun damage
Apply broad-spectrum sunscreen (SPF 30 or higher) every single day, even on cloudy days. Wear protective clothing and seek shade when possible.
4. Track skin changes
Look out for new or worsening bruises, stretch marks, or delayed wound healing. Keep track of any unusual hair growth or acne.
5. Prioritize wound care
Clean cuts or scrapes gently and apply antibiotic ointment to prevent infections. Consult your doctor if wounds take longer than usual to heal.
6. Avoid picking or squeezing acne
Picking at pimples can lead to scarring and increase the risk of infection. Consider using a gentle acne treatment with salicylic acid or benzoyl peroxide.
7. Speak with your doctor
If you're concerned about any changes in your skin, consult your healthcare provider for a consultation with a dermatologist about how you can manage steroid-induced skin problems is often worthwhile.
The bottom line
While steroids are incredibly effective for managing inflammatory and autoimmune conditions, they do affect the skin in a range of ways that can be inconvenient and, at times, uncomfortable. However, with close care and the right strategies, you can help manage and reduce these side effects.
Remember, always consult your doctor before making any changes to your medication or lifestyle to ensure the best care for your specific health needs.