Higher cumulative doses of topical corticosteroids may increase the risk of osteoporosis and major osteoporotic fracture, according to a study published by Hsieh et al in the Journal of the European Academy of Dermatology & Venereology. Investigators used the Taiwan National Health Insurance Research Database to analyze the outcomes of 129,682 patients with osteoporosis and 34,999 patients with major osteoporotic fractures compared with 658,724 age- and sex-matched controls. After a follow-up of 5 years, the investigators found that compared with those who didn’t use topical corticosteroids, patients with exposure to low cumulative doses (adjusted odds ratio [OR] = 1.216, 95% confidence interval [CI] = 1.189–1.243), medium cumulative doses (adjusted OR = 1.260, 95% CI = 1.241–1.280), and high cumulative doses (adjusted OR = 1.341, 95% CI = 1.314–1.369) of the agents were more likely to develop osteoporosis. Further, patients who had exposure to low (adjusted OR = 1.118, 95% CI = 1.069–1.170), medium (adjusted OR = 1.191, 95% CI = 1.156–1.227), and high (adjusted OR = 1.288, 95% CI = 1.238–1.340) cumulative doses of the drugs were more likely to experience major osteoporotic fractures after a follow-up of 5 years. The investigators noted that female patients had a higher risk of osteoporosis and major osteoporotic fractures, and younger patients had a higher risk of osteoporosis compared with male patients and other age groups, respectively. The investigators concluded that physicians should be cautious when prescribing topical corticosteroids for long-term use—particularly in patients who may be susceptible to bone-related complications.