Key takeaways:
Skin thinning can make your skin look and feel older faster, and make skin more prone to bruising and tearing. Medications that can cause skin thinning include prednisone, some inhalers, and steroid creams.
If you’re taking a medication that can thin your skin, protect it by using sunscreen daily and keeping it hydrated with a good-quality moisturizer.
Prescription treatments that may improve thinning skin include hyaluronic acid fillers, retinol treatments, and saline injections.
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Skin damage can make your skin look and feel older. It can also keep your skin from doing its job. You can take steps to protect your skin, like wearing sunscreen and not smoking. But what happens when things that are supposed to keep you healthy, like your daily medications, start to damage your skin?
Some medications can cause skin thinning. This is a type of skin damage that can change how your skin looks and feels, including making your skin look older.
Can medications speed up signs of aging?
Yes. Some medications can contribute to signs of skin aging.
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When it comes to how your skin changes as you get older, there are a lot of things you may know about, like wrinkles and sagging skin. You may also know that genetics and even your daily habits can affect how quickly your skin changes as you get older.
But what many people may not know is that medications can cause skin damage, too. This is especially true for medications that cause skin thinning. Thin skin has less collagen, which can make fine lines and wrinkles more noticeable.
These medications also put you at risk for other skin changes, like:
Color and tone changes
Below is a list of medications that cause skin thinning. But before diving in, keep in mind that not everyone responds in the same way to medications. This means that not everyone develops skin thinning. Regardless, it’s important to know if your medication puts you at risk so you can take steps to protect your skin.
What medications cause skin thinning?
Steroids are the medications most likely to cause skin thinning. Millions of people depend on steroids to treat a wide range of medical conditions. While they can be lifesaving, steroids can also cause a wide range of side effects.
For example, steroids reduce collagen production in your skin. Collagen is a protein that keeps skin, hair, and nails healthy, strong, and resilient. With decreased collagen, skin becomes thinner and is more likely to stretch or tear.
All forms of steroids can lead to skin thinning and damage, including those listed below.
Prednisone
Prednisone is a steroid that people take by mouth. It can be used to treat flare-ups from asthma and chronic obstructive pulmonary disease (COPD). It’s also used to treat flares from autoimmune conditions like lupus and rheumatoid arthritis. The longer you take prednisone, the more likely you are to develop side effects, like skin thinning.
Prednisone is one of the most commonly prescribed oral steroids. But it isn’t the only one that causes skin thinning. These other oral steroids can also cause skin thinning when used too long:
Betamethasone
Dexamethasone
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Asthma and COPD inhalers
Daily asthma and COPD inhalers are called “controller medications.” They’re meant to be used every day to control symptoms and prevent flares.
Some daily inhalers contain steroids to reduce lung inflammation. Inhaled steroids can also cause skin thinning and easy bruising, especially at higher doses and with longer use. Older adults may be more likely to develop these side effects.
Some examples of inhaled steroids are:
Budesonide (Pulmicort)
Fluticasone (Flovent, ArmonAir Digihaler, Arnuity Ellipta)
Beclomethasone (Qvar)
Mometasone (Asmanex HFA, Asmanex Twisthaler)
Fluticasone / salmeterol (Advair Diskus, Wixela Inhub)
Budesonide / formoterol (Symbicort)
Fluticasone / vilanterol (Breo Ellipta)
Mometasone / formoterol (Dulera)
Trelegy Ellipta (fluticasone / umeclidinium / vilanterol)
Steroid creams and ointments
Steroid creams and ointments are an important part of many people’s treatment plans.
Topical steroids help treat many skin conditions including eczema and psoriasis. But they can also calm skin inflammation and irritation, like from a nickel allergy or poison ivy.
But before you reach for that over-the-counter (OTC) hydrocortisone cream, keep in mind that topical steroids can cause skin thinning and other changes like skin discoloration. These changes are more common with higher-potency steroid creams, prolonged use, and use on thinner skin. But even low-strength steroid creams sold OTC can cause skin changes if used for too long.
Examples of topical steroids include:
Steroid injections
If you have any type of arthritis or chronic joint or back pain, you may be familiar with steroid injections. Steroid injections are medical treatments where a healthcare professional uses a needle to inject steroids directly into your joint space. This calms inflammation and relieves pain and swelling.
Even though the steroid goes directly into your joint, it can still affect the nearby skin. For example, steroid injections can lead to changes like skin thinning around the injection site.
Dr. Maria Hannaway, a board-certified dermatologist, notes that steroid injections can even cause indentations in the skin.
Can you reverse skin thinning caused by steroid medications?
No. But there’s some promising research on treatments that can help support thin skin:
One research study found that a topical medication similar to spironolactone was able to help improve skin thinning from steroid use.
Other studies have found hyaluronic acid fillers or even retinol treatments can help improve the appearance of thin skin. There’s also some evidence that collagen supplements can help, too.
Dr. Hannaway notes that for those with steroid indentations to the skin, saline injections can help even out skin.
There are other steps you can take to support and protect your skin like:
Always wear sunscreen and try other measures to protect yourself from the sun.
Consider taking a supplement containing polypodium leucotomos extract, which may help lower your risk of sun-related skin damage when used with sunscreen.
Protect yourself from falls and injuries, since thin skin is more prone to bleeding and bruising.
Keep your skin hydrated with a good moisturizer and look for ingredients like petroleum, glycerin, and ceramides. These help support your skin’s protective barrier, prevent dryness, and improve the appearance of fine lines and wrinkles.
The bottom line
Skin thinning is a type of skin damage that can speed up the changes in your skin that naturally happen as you get older. It also makes your skin more prone to bruising. Steroid-containing medications can cause skin thinning, including pills, inhalers, injections, and creams. There’s no effective way to reverse steroid-induced skin thinning, but prescription treatment can help. You can also protect your skin by wearing sunscreen every day and using a good-quality moisturizer.
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References
Barklund, S., et al. (2020). Treatment of steroid atrophy with hyaluronic acid filler. JAAD Case Reports.
Guillot, B. (2000). Skin reactions to inhaled corticosteroids. Clinical aspects, incidence, avoidance, and management. American Journal of Clinical Dermatology.
Howell-Morris, R. (2020). Oral collagen for the treatment of dermal atrophy: A systematic review of human trials. medRxiv.
Maubec, E., et al. (2015). Topical mineralocorticoid receptor blockade limits glucocorticoid-induced epidermal atrophy in human skin. The Journal of Investigative Dermatology.
MedlinePlus. (2022). Aging changes in the skin.
Niculet, E., et al. (2020). Glucocorticoid-induced skin atrophy: The old and the new. Clinical, Cosmetic and Investigational Dermatology.
Oikarinen, A., et al. (1991). New aspects of the mechanism of corticosteroid-induced dermal atrophy. Clinical and Experimental Dermatology.
Pace, C. S., et al. (2018). Soft tissue atrophy related to corticosteroid injection: Review of the literature and implications for hand surgeons. The Journal of Hand Surgery.
Parrado, C., et al. (2016). Fernblock (polypodium leucotomos extract): Molecular mechanisms and pleiotropic effects in light-related skin conditions, photoaging and skin cancers, a review. International Journal of Molecular Sciences.
Quan, T., et al. (2015). Role of age-associated alterations of the dermal extracellular matrix microenvironment in human skin aging: A mini-review. Gerontology.
Shumaker, P. R., et al. (2005). Treatment of local, persistent cutaneous atrophy following corticosteroid injection with normal saline infiltration. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery.
Stacey, S. K., et al. (2021). Topical corticosteroids: Choice and application. American Family Physician.
