Topical steroid creams are commonly prescribed medications for a variety of skin conditions. They are primarily used to reduce inflammation and relieve symptoms like itching and redness. While topical steroids are designed to act locally on the skin, some systemic absorption can occur, potentially leading to side effects.
Understanding Topical Steroids
Topical steroids are corticosteroids applied directly to the skin. They mimic natural hormones, reducing inflammation and suppressing immune responses at the application site. These medications are widely used for conditions like eczema, psoriasis, and dermatitis, alleviating discomfort and promoting healing. Available as creams, ointments, lotions, and gels, they come in various strengths, or potencies, which determine their effectiveness. The goal is localized relief without widespread effects.
How Topical Steroids Can Lead to Weight Gain
Although topical steroids are intended for local action, a small amount can enter the bloodstream through the skin, especially under certain conditions. This systemic absorption can lead to effects typically associated with oral or injected corticosteroids, including weight gain. The likelihood of systemic effects increases with higher potency creams, prolonged use, or application over large areas of the body.
One way systemic corticosteroids contribute to weight gain is through fluid retention. These medications can cause the body to hold onto more sodium and water, leading to increased body weight and a swollen or puffy appearance. This fluid accumulation can particularly affect the face, making it appear rounder, a phenomenon sometimes referred to as “moon face.”
Another mechanism involves changes in fat distribution. Prolonged systemic exposure to corticosteroids can lead to fat accumulation in specific areas, such as the face, the back of the neck, forming a “buffalo hump,” and around the abdomen. This altered fat distribution, known as Cushingoid appearance, results from the body’s altered metabolism of carbohydrates, proteins, and fats.
Systemic corticosteroids can also stimulate appetite, which may lead to increased food intake. This increased caloric consumption, combined with fluid retention and fat redistribution, can contribute to overall weight gain. While these effects are more pronounced with systemic steroid use, they can manifest with topical application if significant absorption occurs.
Minimizing Risk and When to Seek Advice
Several factors can increase the systemic absorption of topical steroid creams, raising the potential for side effects like weight gain. These include using high-potency creams, applying medication over large body surface areas, or prolonged duration of use. Application to thin or damaged skin, such as broken skin or skin folds, also increases absorption. Additionally, using occlusive dressings, like bandages or plastic wrap, over the treated area can significantly boost absorption. Young children and infants are particularly susceptible due to their larger skin surface area to body weight ratio and thinner skin.
To minimize the risk of systemic absorption and potential weight gain, use topical steroid creams as directed by a healthcare professional. Always follow instructions regarding quantity and frequency of application. Applying the thinnest effective layer to the affected area is recommended, and prolonged use should be avoided unless specifically advised by a physician.
Avoid using occlusive dressings unless prescribed by your doctor, as they can intensify the medication’s effect and absorption. Do not apply topical steroids to broken or infected skin without medical guidance. If you experience unexplained weight gain, notice other potential systemic side effects such as easy bruising, skin thinning, stretch marks, or changes in blood sugar, or have any concerns, consult your healthcare provider promptly. They can assess your situation and adjust your treatment plan if necessary.