Topical steroid withdrawal syndrome: time to bridge the gap.

Abstract

Since their introduction in the 1950s, topical corticosteroids (TCSs) have improved the lives of many dermatology patients. In 2020–2021, over 10·5 million tubes of TCSs were prescribed in England alone1 and in addition, many more were purchased over the counter. Yet in 2021 the Medicines and Healthcare products Regulatory Agency issued a new warning on TCSs, advising patients to seek medical advice if skin burning or redness occurs after discontinuing treatment.2 What has led to this new caution surrounding one of dermatology’s most relied resources? There is growing public awareness and concern about Topical Steroid Withdrawal Syndrome (TSWS), also known as Topical Steroid Addiction or Red Skin Syndrome. A systematic review by Hwang and Lio 3 describes TSWS as a distinct clinical entity of skin burning and erythema, which occurs most frequently in women, sometimes in under 18‐year‐olds, after discontinuation of prolonged application of moderate‐to‐high potency TCSs.3 This review also highlights the poor quality of research that has been completed in TSWS.