Prednisolone foam causing spots/acne

Rectal-route steroids are roughly 10 percent systematic and 90 percent topical. Oral-route (prednisone) is 100 percent systematic (other than delayed-release coated uceris/entocort ec/clipper that mirrors rectal-route). It's the systematic aspect that gives us those awful side effects of which we're all accustomed to. Your Prednisolone foam is likely the equivalent of 7-10mgs of prednisone regarding side effects, so you're likely to get some of the milder but still annoying side effects (e g., acne, some mood swings/irritability, more limited bloating, fatigue, or aching). That's around the prednisone dose where I got horrible acne, hormonal and very hard to treat (I never had substantial acne, even as a teenager, but boy did I breakout on prednisone). Had acne all over my face, neck, shoulders, and back. Went away a few weeks after discontinuing prednisone.

I'd recommend limiting your salt intake to reduce bloating, and increasing your potassium intake, while on corticosteroids. Good luck,

"The Effects of Taking Prednisone on Potassium Levels
Potassium is a critical mineral and electrolyte essential for proper nerve and muscle function. It maintains the cells' electrical potential. Cells with high electrical activity, such as muscle and nerve cells, are particularly affected by changes in potassium levels.

Prednisone's Effects on Potassium Levels
A serious side effect of taking prednisone is that it increases the loss of potassium in the urine. Over time, this can lead to a potassium deficiency known as hypokalemia. Hypokalemia is defined as a serum potassium concentration of less than 3.5mmol/L. The Linus Pauling Institute reports that a moderate deficiency in potassium can cause increased blood pressure, increased salt sensitivity, an increased risk of kidney stones and increased bone turnover. "
www.livestrong.com/article/530581-the-effects-of-taking-prednisone-on-potassium-levels/