Do local steroid creams affect bone health?

New research indicates that higher doses of topical corticosteroids, which are commonly used to treat inflammatory skin conditions, are linked with elevated risks of osteoporosis and bone fractures associated with osteoporosis. The findings are published in the Journal of the European Academy of Dermatology and Venereology and are based on information from the Taiwan National Health Insurance Research Database.

Investigators selected 129,682 osteoporosis cases and 34,999 major osteoporotic fracture (MOF) cases and matched them with 518,728 and 139,996 controls (without osteoporosis or MOF) by sex and age.

The team found clear dose-response relationships between long-term use of topical corticosteroids and osteoporosis and MOF. For example, compared with no doses, low, medium, and high cumulative of doses topical corticosteroids were associated with 1.22-, 1.26-, and 1.34-times higher odds of developing osteoporosis over five years. These respective doses were linked with 1.12-, 1.19-, and 1.29-times higher odds of experiencing MOF. Women had higher risks of osteoporosis and MOF than men. Also, younger people (<50 years) had a higher risk of osteoporosis compared with other age groups.

“This study emphasizes that using topical corticosteroids to treat inflammatory skin conditions should be done very carefully and clinicians should be aware of these potential side effects,” said corresponding author Chia-Yu Chu, MD PhD, of National Taiwan University Hospital and National Taiwan University College of Medicine.

Reference:

Bing-Jun Hsieh, Dereck Shen, Tom C. Chan, Yung-Tsu Cho, Chao-Hsiun Tang, Chia-Yu Chu, Higher cumulative dose of topical corticosteroids is associated with osteoporosis and major osteoporotic fracture: A nationwide case–control study, Journal of the European Academy of Dermatology and Venereology, https://doi.org/10.1111/jdv.19697.