Aim: The aim of this study was to evaluate the prevalence, types, and predictors of dermatological changes in patients receiving long-term corticosteroid therapy. Material and Methods: This prospective observational study included 120 patients receiving corticosteroids for chronic conditions for a minimum of six months. Data collection involved detailed clinical histories, dermatological examinations conducted at baseline and 3-month intervals, and laboratory investigations to assess systemic effects. The prevalence of dermatological changes was evaluated, and associations with corticosteroid dosage, duration, and systemic markers were analyzed using statistical methods, including chi-square tests, Pearson’s correlation, and logistic regression. Results: The study revealed a high prevalence of dermatological changes, with skin thinning (60.00%), striae (46.67%), and easy bruising (36.67%) being the most common manifestations. Patients on corticosteroid therapy for ≥12 months showed significantly higher rates of skin thinning (84.21%) compared to those on therapy for ≥6 months (48.78%) (p < 0.01). High-dose therapy (≥10 mg/day) was associated with a greater prevalence of dermatological changes, including skin thinning (79.31%) and striae (62.07%) (p < 0.001). Laboratory findings demonstrated significant correlations, with low serum cortisol (r = -0.45, p < 0.01) and hypoalbuminemia (r = -0.38, p < 0.05) being strongly associated with severe dermatological changes. Logistic regression identified long therapy duration, high dosage, and low cortisol levels as significant predictors of severe dermatological changes. Conclusion: This study underscores the high prevalence and dose- and duration-dependent nature of corticosteroid-induced dermatological changes. Proactive monitoring, individualized corticosteroid regimens, and early management are critical to minimizing these adverse effects and improving patient outcomes.