The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.
The side effects of Nebido can include those of an androgenic nature. The androgenic side effects of Nebido are, however, highly dependent on genetic predispositions and will not affect all men. The possible androgenic side effects of Nebido include accelerated hair loss in those predisposed to male pattern baldness, acne in sensitive individuals and body hair growth.
While by no means always necessary, some men may find the use of a 5-alpha reductase inhibitor to be useful. The testosterone hormone is metabolized by the 5-alpha reductase enzyme, which reduces the testosterone hormone to dihydrotestosterone (DHT). The DHT is what leads to the androgenic related effects. By incorporating a 5-alpha reductase inhibitor, you will reduce the hormones androgenicity. It will not be a complete reduction, but it will be significant. However, such inhibitors are not always recommended and should only be used as needed as they can hinder the potency of the testosterone hormone.