Topical steroid withdrawal

This article is about the consequences of topical steroids. For other uses, see Burn and Sunburn.
Topical steroid withdrawal
Other namesTopical steroid addiction, steroid dermatitis, red burning skin syndrome, red skin syndrome, iatrogenic exfoliative dermatitis (idiopathic erythroderma)[1]
Red burning skin syndrome from topical steroids. Face pattern with nose sign and spared palms (soles also spared)
SpecialtyDermatology
SymptomsRed skin, burning sensation, desquamation, itchiness[2]
CausesStopping topical steroids after frequent long-term use[2]
PreventionUsing steroid creams for less than two weeks[2][3]
FrequencyNot known[2]

Topical steroid withdrawal, also known as red burning skin and steroid dermatitis, has been reported in people who apply topical steroids for 2 weeks or longer and then discontinue use.[4][5][2][1] Symptoms affect the skin and include redness, a burning sensation, and itchiness,[2] which may then be followed by peeling.[2]

This condition generally requires the daily application of a topical steroid for more than 2 weeks but sometimes can occur with even less steroid use. It appears to be a specific adverse effect of topical corticosteroid use.[6] People with atopic dermatitis are most at risk.[3]

Treatment involves discontinuing the use of topical steroids,[2] either gradually or suddenly.[2] Counselling and cold compresses may also help.[2] Thousands of people congregate in online communities to support one another throughout the healing process, and cases have been reported in both adults and children.[2][1] It was first described in 1979.[3]

  1. ^ a b c Juhász ML, Curley RA, Rasmussen A, Malakouti M, Silverberg N, Jacob SE (September–October 2017). "Systematic review of the topical steroid addiction and topical steroid withdrawal phenomenon in children diagnosed with atopic dermatitis and treated with topical corticosteroids". Journal of the Dermatology Nurses' Association. 9 (5): 233–240. doi:10.1097/JDN.0000000000000331. S2CID 80154596.
  2. ^ a b c d e f g h i j k "Topical corticosteroid withdrawal". DermNet NZ. Retrieved 19 July 2016.
  3. ^ a b c Sheary B (June 2016). "Topical corticosteroid addiction and withdrawal - An overview for GPs". Australian Family Physician. 45 (6): 386–388. PMID 27622228.
  4. ^ Nnoruka EN, Daramola OO, Ike SO (2007). "Misuse and abuse of topical steroids: implications". Expert Review of Dermatology. 2 (1): 31–40. doi:10.1586/17469872.2.1.31. Retrieved 2014-12-18.
  5. ^ Rathi SK, D'Souza P (July 2012). "Rational and ethical use of topical corticosteroids based on safety and efficacy". Indian Journal of Dermatology. 57 (4): 251–259. doi:10.4103/0019-5154.97655. PMC 3401837. PMID 22837556.
  6. ^ Hajar T, Leshem YA, Hanifin JM, Nedorost ST, Lio PA, Paller AS, et al. (March 2015). "A systematic review of topical corticosteroid withdrawal ("steroid addiction") in patients with atopic dermatitis and other dermatoses". Journal of the American Academy of Dermatology. 72 (3): 541–549.e2. doi:10.1016/j.jaad.2014.11.024. PMID 25592622.