Topical steroid withdrawal reactions: a review of the evidence

Topical steroid withdrawal reactions: a review of the evidence

The authors stated that by this point, the initial limited areas of dermatitis had expanded significantly. The itch had mostly disappeared but had been replaced by severe burning, which was only relieved by further topical corticosteroid application. The appearance of the dermatitis changed and was more of a hyperaemia. There are difficulties in identifying information on topical steroid withdrawal reactions within the published literature due to different terminologies being used and a lack of recognition of the issue.

‘I remember once having a lesson from the doctor on how to apply my creams when I was very, very young. ‘Following application instructions are key – using too little can result in long-term use and a prolonged flare because the inflammation is never properly controlled,’ says Dr Vyas. Anything that causes more irritation or discomfort to the skin must always be stopped as it will worsen inflammation.

  • The vast majority of people who abuse anabolic steroids do so for body image reasons, other drugs may be abused at the same time.
  • If your treatment involves tapering you off steroids, it can make your withdrawal last even longer, but the likelihood of severe symptoms will be reduced.
  • You can use a rubber comb to relieve itching, and it will not break the skin, especially when you scratch with only light pressure.
  • However, stopping steroid use cold turkey can significantly increase the severity of your withdrawal symptoms.
  • All Yellow Card reports received are entered onto the MHRA’s adverse drug reaction database so that they are available for signal detection.

We also considered information to prescribers or patients on topical steroid withdrawal reactions from other regulators. Topical corticosteroids are safe and highly effective treatments when used correctly. As with any medicine, topical corticosteroids can cause side effects, although not everybody gets these. We considered data from Yellow Card reports, in addition to information from the published literature and other medicines regulators.

Reason for the review

Your response to home detox will depend on how long you’ve used the drug, the dosage used, your unique metabolism, and other health factors. There are several benefits of using the tapering method in the steroid abuse detox process. It allows you to gradually reduce your dose over time so as to avoid a sudden shift in your hormone balance.

  • If you develop symptoms months after ceasing treatment, or they appear elsewhere on your body, then you’re not suffering from topical corticosteroid withdrawal.
  • Read about other types of corticosteroids, including tablets, capsules, inhalers and injected corticosteroids.
  • Elevated IgE levels during RSS are normal, and they are expected to gradually return to normal with recovery.
  • While Pyramiding means gradually building up the steroid dose to a peak and then slowly tapering off.
  • We considered side effects reported to us by patients and healthcare professionals, in addition to information published by researchers and other medicines regulators.

The Medicines and Healthcare products Regulatory Agency (MHRA) is the government agency responsible for regulating medicines in the UK and ensuring their safety, quality and effectiveness. It is very important that you follow instructions from healthcare professionals. You should also read the patient information leaflet included with your medicine. Different topical corticosteroids have different strengths, or potencies.

Chloe’s skincare routine for dealing with TSW

When used continuously over long periods of time, the body can become dependent. Most topical corticosteroids are considered safe to use during pregnancy or breastfeeding. Your doctor will consider the area of skin where you need to use it, how often you’ll use it and the condition of your skin. You should wash off any steroid cream applied to your breasts before feeding your baby.

Yellow Card scheme

If you’ve been using topical corticosteroids for a long time, it’s a good idea to ask your doctor to review your treatment. If you’re using a potent or very potent topical corticosteroid for several weeks or more, you may be given a steroid treatment card that explains how you can reduce the risk of side effects. Very potent topical corticosteroids are not usually prescribed for pregnant or breastfeeding women, or for very young children. Sometimes you may be prescribed them under the supervision of a skincare specialist (dermatologist).

Our Stop Start Grow model is a refreshing approach to treatment and is what makes recovery at Delamere different. Our goal is always to give you the mindset and tools to grow beyond addiction and live life on your terms once you leave us. Thanks to the pressure of social media, more people are worried about the way they look than ever before. Images of toned muscles and perfect bodies are an unachievable goal for many, and this is leading to an increase in steroid addiction, especially among young men.

This can make your eczema sorer but can also trigger other inflammatory skin issues like rosacea and acne, amongst others. As my skin started to clear, I stared to use the Celluma which was so amazing for my face where I had a lot of skin damage. At first, I bought 10 sessions and then I bought an unlimited pass and have done that for the past 3 months. My skin is so much stronger and stable and is learning to function by itself.

What should the patient be told?

Read more to learn about the two main types of steroids, the effects of steroids, steroid addiction, and more importantly, how steroid addiction is treated. Patients on long-term corticosteroid treatment should carry a steroid treatment card which gives guidance on minimising risk and provides details of prescriber, drug, dosage and duration of treatment. Systemic corticosteroids may be stopped abruptly in those whose disease is unlikely to relapse and have received treatment for 3 weeks or less and are not included in the patient groups described above.

The optimum daily dose is determined on the basis of clinical and biochemical response. If you need to take both medications, you may be given a medication called a proton pump inhibitor (PPI). Corticosteroids can decrease the effectiveness of medications used to treat diabetes. Steroids that are injected into muscles and joints may cause some pain and swelling at the site of the injection.

Help and Advice on Managing Your Condition

This occurs because steroid abuse causes hormonal imbalance in the body. Steroid withdrawal rarely causes dangerous physical effects, but you might experience severe depression and suicidal thoughts. We identified 55 reports in the Yellow Card database that are probable reports of topical steroid withdrawal reactions and 62 further reported reactions potentially indicative of topical steroid withdrawal reactions. This was a retrospective cohort study of patients in an Australian general practice presenting with this clinical scenario between January 2015 and February 2018.