The corticosteroid diffuses across cell membranes and complexes with the cytoplasmic receptors. These complexes then enter the cell nucleus, bind to the DNA, and stimulate transcription of messenger RNA and subsequent protein synthesis of various inhibitory enzymes. The very young and the elderly are particularly predisposed to increased absorption of topical corticosteroids because of less efficient adrenal reserve capacity and thinner skin, and in babies a high surface area to body volume. Corticosteroids can cause changes to sleep patterns, bring about mood changes, and an increase in appetite. Excessive application of corticosteroids often result in suppression of the pituitary-adrenal axis, which translates in reduced adrenal activity and an inability on the part of the body to tolerate stress.
Corticosteroids can cause acne or increased hair growth to appear on the face or elsewhere.
Perioral dermatitis or rosacea may develop after the application of a topical steroid to the face. Corticosteroids should not be used by pregnant women because of possible fetal abnormalities. Topical application of corticosteroid can suppress the body's ability to produce its own hormones which are needed to fight infection or deal with traumatic injury. As such, use of corticosteroids can cause or exacerbate certain types of infections. The use of corticosteroid may cause the more common form of plaque psoriasis to convert to pustular psoriasis.