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Although topical steroids have a good safety profile overall, possible adverse effects include skin atrophy and discoloration, purpura, telangiectasia, striae, hypopigmentation, and acneiform eruptions. Many of these adverse effects resolve after topical steroid discontinuation, but it may take months. Topical steroid–induced suppression of the hypothalamic-pituitary-adrenal axis is uncommon with continuous mild or moderate topical steroid use. If there is a concern, a cortisol stimulation test can check for appropriate adrenal response.