If a low-potency topical steroid doesn't work for you, your doctor may prescribe a stronger one for you to apply, says Dr. A nonsteroidal topical medication, such as crisavorol or tacrolimus, can also be added to your treatment. Steroid creams are generally used to reduce skin inflammation caused by conditions such as psoriasis and eczema. They are the cornerstone and first-line treatment of these and many other skin conditions.
Steroid creams have been used for the past 50 years, but they are not a cure because they have no effect on the underlying cause of inflammation. However, they can be very effective in helping to control skin rashes and relieving symptoms, such as itching and irritation. In addition, they help reduce the likelihood of infection that can occur as a result of scratching and trauma to the skin. The National Eczema Association is committed to raising awareness of topical steroid withdrawal (TSW), a potential serious side effect of topical steroid use that patients and providers don't easily recognize.
Much is still unknown about this condition, especially how often it occurs and the amount of topical steroid use that causes it. While we believe that topical steroids have a role to play in treating eczema, it's important for the eczema community to be aware of the TSW. Many people with similar conditions, such as papulopustulose, rosacea and psoriasis, use topical steroids for treatment and should also be aware of TSW. The term “topical steroid withdrawal” (also known as topical steroid addiction, steroid withdrawal syndrome, or red skin syndrome) refers to a constellation of symptoms that may appear in the days and weeks after a person stops using topical corticosteroids.
Because of the lack of research and the lack of clear diagnostic criteria, it is not yet known how many steroids cause TSW, how many people have the condition, and what percentage of people using topical steroids can develop it. Lichen sclerosus (LS) is a chronic skin disorder with a remitting and relapsing clinical course. Women often have severe vulvar itching and an urge to scratch their skin. The recommended treatment is a cycle of topical steroids.
Most women will get better with treatment. However, some will report that “steroids didn't help. Regardless of the concentration, steroid creams “start working within 1 day,” says Dr. Corinna Bowser.
She is an allergist and immunologist at Suburban Allergy Consultants in the Philadelphia area. While topical steroids may be effective in improving skin inflammation in patients with eczema, research has confirmed the need to avoid long-term daily use of topical steroids. For example, a low-potency steroid may be recommended for sensitive skin, such as the face, and a higher-potency steroid on the trunk.
