Topical steroids are a common treatment for various skin conditions, offering relief from inflammation and discomfort. A frequent concern regarding potential side effects is weight gain.
What Topical Steroids Are
Topical steroids, also known as topical corticosteroids, are anti-inflammatory medications applied directly to the skin. They are prescribed to control conditions like eczema, psoriasis, and dermatitis, reducing redness, itching, and swelling. These preparations come in various forms, including creams, ointments, lotions, and gels.
These steroids work by mimicking natural hormones, primarily cortisol, to suppress the immune system’s inflammatory response. Unlike oral or injectable steroids, which affect the entire body, topical steroids are designed for localized action. Their effects are primarily concentrated where they are applied, minimizing widespread systemic impact. Their potency varies from mild to very strong, chosen based on the specific skin condition, its severity, and application area.
Do Topical Steroids Cause Weight Gain?
Systemic steroids, taken orally or by injection, are known for causing weight gain due to their effects on metabolism, fluid balance, and appetite. They can lead to increased appetite, fluid retention, and fat accumulation in the face, neck, and abdomen, sometimes called Cushingoid features. In contrast, topical steroids are far less likely to cause significant weight gain. Weight gain from topical steroid use is rare and typically only occurs if a substantial amount is absorbed into the bloodstream.
When significant systemic absorption occurs, topical steroids can mimic the effects of oral steroids, potentially leading to increased appetite, fluid retention, or a redistribution of fat, which can contribute to weight gain. This rare occurrence is more likely with prolonged use of high-potency steroids over large body areas or on compromised skin. For most users who follow proper application guidelines, weight gain is not a common side effect.
How Topical Steroids Enter the Body
The absorption of topical steroids into the bloodstream is influenced by several factors. Higher-strength formulations have a greater potential for absorption. Larger surface areas of application also increase the total amount of medication available for absorption.
Prolonged application increases the likelihood of systemic absorption. The integrity of the skin barrier significantly affects how much steroid enters the body; damaged, inflamed, or thin skin (like on the face, armpits, or groin) allows for greater absorption. Additionally, using occlusive dressings, such as bandages or wraps, over the applied area can significantly boost absorption.
Safe Use and When to Talk to Your Doctor
To minimize systemic absorption and side effects, follow a doctor’s instructions precisely. Apply only a thin layer to affected areas. Avoid prolonged use on sensitive skin, such as the face, eyelids, or groin, to reduce absorption.
Unless specifically instructed, avoid occlusive dressings over treated areas, as this greatly increases steroid absorption. Monitor for unusual side effects, including unexpected weight changes or other signs of systemic absorption like skin thinning, stretch marks, increased hair growth, or changes in blood pressure or sugar levels. If concerns about weight gain arise, or if symptoms worsen or new side effects appear, consult a healthcare professional for proper evaluation and guidance.