The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.
Before too long, though, the blister came back, and this time it was worse. My feet wept from the build-up of fluid, and then the blisters began to spread like a rash across my toes, on the bottom of my feet, and finally up the sides of my feet. It was agony. The incessant itch would wake me up at night and my skin bled from my scratching. Any skin I managed not to scratch wasn't much better, and would often fall off in sodden layers as the blisters oozed fluid all over my feet. I needed crutches to get around, making my daily commute a struggle.
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