Eczema & Topical Steroid Addiction & Withdrawl

Topical corticosteroid creams are commonly used to treat eczema, dermatitis, and psoriasis.

Some of the dangers of “episodic” care such as walk in clinics and telemedicine (Babylon Telus Health and other telemedicine providers) are overprescribing, repeat refills and no in person follow up.

Patients using corticosteroid creams for long periods of time may develop a tolerance and require a stronger corticosteroids like betamethasone. When used for longer periods of time, people can suffer severe skin withdrawal symptoms. Signs of severe topical steroid withdrawal include redness of the skin which can be a shade of pink or purple (Red Skin Syndrome). Other signs can include burning, stinging, intense itching, peeling or oozing and even open sores. These signs may occur days or weeks after stopping treatment for as little as 2 months.

Corticosteroids are classified by potency levels (1 highest and 7 lowest) and examples are beclomethasone, betamethasone, clobetasol, hydorcortisone, mometasone, and triamcinolone. Many patients rely on corticosteroids to manage their eczema not knowing that withdrawal can be very troublesome as the steroids are easily absorbed by the skin.

Prevention and treatment of mild to moderate eczema:

moisturize skin with ointments and lotions that seal in moisture. Petroleum jelly (Vaseline) works well.
Identify the triggers that worsen the reaction (sweat, stress, soaps, detergents, seasonal or food allergies)
Take shorter showers and baths and use warm rather than hot water.
Gentle moisture bar such as Dove Sensitive Skin bar soap works well as it is unscented and pH balanced.
Bleach baths. American Academy of Dermatology recommends a bleach bath to prevent flares. Diluted bleach decreases the bacteria on the skin and related skin infections. Add 1/2 cup of household bleach to your bathtub. Do not use more than 2x/week.