Skin hypopigmentation and atrophy are the most commonly reported local adverse effects following corticosteroid application. While these changes are typically reversible, the recovery may be delayed or incomplete in older adults due to diminished physiological reserves and age-related reductions in melanocyte function and dermal regenerative capacity. Adipose-derived mesenchymal stem cells (ADMSCs) secretome may offer substantial benefits in reversing the alterations. In this report, we present the clinical evaluation of an elderly patient with steroid-induced cutaneous manifestations receiving ADMSCs secretome administered with intradermal injection and microneedling. Given that corticosteroid-induced atrophy and hypopigmentation may improve spontaneously, this case does not establish treatment efficacy; rather, it describes a clinical observation. The potential mechanisms by which ADMSCs secretome may facilitate improvement are also discussed. Copyright © 2026 Shannaz Nadia Yusharyahya et al. Case Reports in Dermatological Medicine published by John Wiley & Sons Ltd.