No. with Atopic Dermatitis
No. with Psoriasis vulgaris
Mean age (years)
43 (range 22-57)
Mean duration of treatment with Group III or IV topical steroids (years)
16 (range 6-25)
Localization of skin atrophy:
Clinical evaluation of severity of symptoms and signs of skin atrophy at baseline and at end of treatment.
Clinical parameters Mean severity at baseline Mean severity at end of treatment Decreased thickness of skin (range 2-3) Laxity (range 2-3) Purpura/Echymoses (range 1-3) Dryness Teleangiectasia (range 2-3) (range 1-2) Table 3.
Mean epidermal and dermal thickness, skin elasticity, erythemal and moisture indexes at baseline and after 8 months of treatment with Vivida of 40 patients with corticosteroid induced skin atrophy. Parameters Baseline 8 months Epidermal thickness (mm) (-) (-) Dermal thickness (mm) (-) (-) Elasticity Index 44 (39-53) 74 (65-78) Erythemal Index (-) (-) Moisture Index (11-37) (75-97)
Laws and Penalties: Concerns over growing illegal AAS abuse by teenagers, and many of the just discussed long-term effects, led Congress in 1991 to place the whole AAS class of drugs into Schedule III of the Controlled Substances Act (CSA). Under this legislation, AAS are defined as any drug or hormonal substance, chemically and pharmacologically related to T (other than estrogens, progestins, and corticosteroids) that promotes muscle growth. The possession or sale of AAS without a valid prescription is illegal. Since 1991, simple possession of illegally obtained AAS carry a maximum penalty of one year in prison and a minimum $1,000 fine if this is an individual’s first drug offense. The maximum penalty for trafficking (selling or possessing enough to be suspected of selling) is five years in prison and a fine of $250,000 if this is the individual’s first felony drug offense. If this is the second felony drug offense, the maximum period of imprisonment and the maximum fine both double. While the above listed penalties are for federal offenses, individual states have also implemented fines and penalties for illegal use of AAS. State executive offices have also recognized the seriousness of AAS abuse and other drugs of abuse in schools. For example, the State of Virginia enacted a law that will allow student drug testing as a legitimate school drug prevention program (48, 49).
The obvious priority is immediate discontinuation of any further topical corticosteroid use. Protection and support of the impaired skin barrier is another priority. Eliminating harsh skin regimens or products will be necessary to minimize potential for further purpura or trauma, skin sensitivity, and potential infection. Steroid Atrophy   is often permanent, though if caught soon enough and the topical corticosteroid discontinued in time, the degree of damage may be arrested or slightly improve. However, while the accompanying Telangectasias may improve marginally, the Striae is permanent and irreversible.