Background: Systemic corticosteroids, a mainstay of treatment for severe dermatosis, are associated with systemic complications. Adverse effects of corticosteroids to bone represent a significant adverse effect that, is poorly understood and poorly managed. Objectives: The purpose of this article is to educate dermatologists to the current understanding of the pathogenesis, diagnosis, and treatment options available for bone complications of corticosteroids. Results: Virtually all patients chronically exposed to high-dose corticosteroid therapy lose bone mass and are at risk for osteoporotic fractures. In addition, osteonecrosis is an unpredictable complication of corticosteroid therapy that may occur with even low-dose corticosteroids. Conclusion: Optimal risk management of corticosteroid therapy includes understanding the risk factors associated with bone complications and improving communication with patients.