Deficiency of calcium over time can sometimes show up in the skin, hair, and nails as dryness, pruritus, brittle or ridged nails, and diffuse hair shedding, especially when hypocalcemia is more chronic. Clinicians often see these dermatologic changes accompanying other signs of calcium and vitamin D deficiency, such as muscle cramps or bone pain, and they may improve as serum calcium and overall mineral status are normalized. The practical point is that, when patients present with unexplained dry skin, fragile nails, and hair loss, particularly in the setting of poor diet, malabsorption, or endocrine disease, assessing and correcting calcium (and related nutrient) deficiencies can be an important part of restoring healthier skin and adnexal structures. This medication is commonly used for Inflammation.
Lee SE, Lee SH. Skin Barrier and Calcium. Ann Dermatol. 2018 Jun;30(3):265-275. Elias P, Ahn S, Brown B, Crumrine D, Feingold KR. Origin of the epidermal calcium gradient: regulation by barrier status and role of active vs passive mechanisms. J Invest Dermatol. 2002 Dec;119(6):1269-74. Baumann J, Wandrey F, Sacher R, Zülli F. A novel Ca2+ double cone vector system to treat compromised skin. Int J Cosmet Sci. 2024 Apr;46(2):228-238. Bouhmadi, A.E., Fatoiki, F.E., Rachadi, H. et al. Hypocalcemia-related pustulosis: a case report. J Med Case Reports 19, 497 (2025).
Some side effects may be linked to nutrient depletion caused by this medication.
Research suggests corticosteroids can lower vitamin D levels in the body by increasing its breakdown. This is a concern because vitamin D plays a crucial role in bone health and the immune system, and corticosteroids themselves can weaken bones. A study found that calcium and vitamin D3 supplements helped prevent bone loss in the lower back (lumbar spine) and hip (trochanter) for people with rheumatoid arthritis who were on low-dose corticosteroids. Evidence suggests vitamin D may work synergistically together with corticosteroids to improve asthma treatment by boosting the effectiveness of corticosteroids or by overcoming resistance to these medications in some patients.
Corticosteroids can lower calcium levels in the body. This is a double threat to bone health because corticosteroids themselves can weaken bones. Calcium is essential for strong bones, and a study showed that supplementing with both calcium and vitamin D3 helped prevent bone loss in people with rheumatoid arthritis taking corticosteroids. Supplementation with calcium should be considered during long term corticosteroid therapy.
Corticosteroids can increase the urinary loss of selenium elevating the risk for deficient levels. Selenium is a mineral that acts as an antioxidant, helping protect cells from damage. Studies have shown that rheumatoid arthritis patients taking high doses of corticosteroids tend to have lower selenium levels. This is concerning because low selenium intake is linked to osteoporosis, and selenium has been shown to play a role in bone protection in animal models of corticosteroid-induced osteoporosis. Supplementation with selenium should be considered during long term corticosteroid therapy.