Topical Steroid Withdrawal TSW

TSW, or topical steroid withdrawal is a painful skin condition that can affect anyone who uses topical steroids. Topical steroids are normal treatments for skin conditions like eczema. They can help relieve itching, scaling, and inflammation. Topical steroids should be prescribed for short term use to avoid dependence or withdrawal. In some cases when treating eczema the dosages of the topical steroids will need to be increased, because your skin may stop responding to the medication. This can prolong the use and need for the topical steroids.

Topical steroids can come in forms of ointments, creams, lotions, gels, sprays, foams, tape, shampoo, or solutions. Topical steroid withdrawal is a rare reaction when stopping using the topical steroids. You are at a higher risk of TSW if you are female, have other allergies, or apply topical steroids to sensitive areas such as face or genitals.

Symptoms

The first symptom that presents is a painful rash. The rash will appear in the area where the topical steroid was first used. Over time the rash may spread. The rash can occur anywhere on the body. The rash will have inflamed skin, be very painful, and may have a burning sensation. Other symptoms can include skin flaking, skin peeling, spreading rash, pus-filled bumps, hard bumps under the skin, swelling, deep wrinkling, temperature sensitivity, itching, trouble sleeping, hair loss, shivering, tiredness, and depression. Symptoms may seem to get better than flare up. Symptoms can last for a few months to years depending on the severity. Severe symptoms can affect normal work and social life.

Sometimes it can be hard to tell if symptoms are caused from an eczema flare up or from topical steroid withdrawal. You should seek medical attention if you experience any of the following. Any persistent or worsening symptoms. Skin thinning. Sudden skin appearance changes. Emotional distress or sleep problems. A dermatologist can help diagnose.

Diagnosis

A dermatologist will take your medical history. They will ask if you were using any topical steroids and for how long you had been using them. They will also want to know when you stopped using the topical steroids, if it has been in the last few months it can be a sign of topical steroid withdrawal. Your dermatologist will examine you looking for a rash that has a burning, stinging, or painful sensation. Another sign of TSW instead of eczema flare up is if the rash in other areas that had not been previously infected by eczema. Widespread redness and swelling on arms and legs can also be a clear sign of topical steroid withdrawal.

Treatment

Treatment is dependent on severity and individual needs. There is no one course treatment for topical steroid withdrawal. One treatment option is to gradually taper off the use of the topical steroids. In some cases your doctor may want to put you on an oral corticosteroid to help slowly taper you off easier. Other doctors may suggest that you immediately stop using any topical steroids. Symptom relief treatment can help you get back to being able to sleep normally. Keeping skin moisturized can help alleviate extra itching, or flaking. Using an antihistamine can also help your skin become less inflamed. Cool compresses or oatmeal baths can give your skin some relief. Over the counter pain relievers can also be helpful. In some cases the rash from TSW can cause your skin to become infected. If your skin gets infected you may need antibiotics. Phototherapy can also give some relief from the rash and symptoms.

It is important to follow the directions of application for any topical steroid. This may not always work for preventing TSW. Since there is no way to know if you are at risk until you stop using topical steroid creams. To help prevent TSW it is important to only use topical steroid creams for a short period of time. Avoid using strong steroids on your face, underarms, or groin areas where skin is more sensitive. When using topical steroids gradual tapering can help reduce the risk of dependence and withdrawal.

Topical steroid withdrawal is a rare reaction when stopping usage of topical steroids. This usually occurs when you have been using topical steroids for a long period of time. This condition can be very painful. It can interfere with your daily life or activities. Symptoms of TSW can last for a few months or even for years.