BACKGROUND:
Concerns about topical steroid withdrawal (TSW) continue to grow. As a result, many patients now stop long-term topical corticosteroid (TCS) use on their own. However, no diagnostic criteria exist for TSW, which creates confusion for both patients and clinicians.
OBJECTIVE:
This study aims to explore the experiences of adults who believe they are going through TSW after discontinuing chronic TCS overuse. It also aims to identify patterns in patient history, symptoms, and outcomes.
METHODS:
Researchers reviewed patient records from an Australian general practice. The review covered January 2015 to February 2018. During this time, adults presented with concerns that aligned with what they believed to be TSW. Their skin symptoms, treatment history, and examination findings were examined and compared.
RESULTS:
The study included 55 adults. Women made up 56% of the group. Ages ranged from 20 to 66 years, with a mean age of 32.9 and a median of 30.
Furthermore, 76% of the group previously received a diagnosis of atopic dermatitis.
Many patients reported strong steroid exposure. For example, 60% used potent TCS on their face. In addition, 42% had taken oral corticosteroids for skin flares.
Symptoms appeared consistently across the group. Burning pain affected 65% of patients. Every patient showed widespread red skin. In addition, several classic signs often linked to TSW were noted:
“Elephant wrinkles” appeared in 56%
“Red sleeve” appeared in 40%
The “headlight sign” appeared in 29%
These patterns aligned with common TSW descriptions found in clinical discussions and patient reports.
CONCLUSIONS:
This study shows that adults who stop long-term TCS overuse often experience symptoms similar to those described as topical steroid withdrawal. Since no official diagnostic criteria currently exist, TSW remains difficult to recognise and diagnose consistently.
Therefore, this article proposes suggested criteria based on the patterns found in these patients. The goal is to support clearer discussion, guide future research, and improve understanding of TSW in individuals with chronic eczema and atopic dermatitis.
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Information credit goes to Dr Belinda Sheary and you can read more here.
