Topical corticosteroids are frequently prescribed for pruritic conditions (e.g., dermatitis, pruritus ani). Is there any danger of systemic effects from chronic use of OTC steroid creams and/or ointments? — James May, PA-C, Macon, Ga.

OTC topical corticosteroid creams and ointments typically include preparations that contain hydrocortisone acetate in concentrations ranging from 0.5% to 1.0%. Chronic use may result in cutaneous atrophy, pigment changes, or both at the site of application.

Systemic adverse effects from localized application of these preparations would be unexpected. Even if the OTC corticosteroid preparation was applied over larger areas of the body, systemic effects would be unlikely since the potency of these creams and ointments is low. — Philip R. Cohen, MD (171-2)

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