What is the most common side effect of high-moderate steroid ointment in a child?

The most common side effect of high-moderate potency steroid ointments in children is skin atrophy. This occurs because corticosteroids can have an impact on the skin's structure when used over time, particularly in sensitive populations like children whose skin is thinner and more delicate. Skin atrophy can manifest as thinning of the epidermis, leading to a more fragile appearance, with potential for easy bruising and stretch marks.

High-potency steroids in particular, when absorbed into the skin, can inhibit the normal proliferation of skin cells and affect the collagen and elastin fibers, resulting in decreased skin thickness. Therefore, when using these medications, it is crucial to monitor for signs of atrophy, especially with prolonged use.

Factors such as the duration of treatment, the area of skin being treated, and the potency of the steroid also influence the risk of developing skin atrophy. Children, due to their skin physiology, are at a higher risk of this side effect compared to adults. Hence, when considering the safety and management of high to moderate steroid ointments in pediatric patients, vigilance for skin atrophy is essential.