I think that topical steroid withdrawal is something to empathise about, because that is probably a thing that makes people more fearful, thinking that I am going to be applying something that I am going to be addicted to and never get off.
But I do think that the majority of people who use topical steroids do not get it, everyone has a certain baseline and some people have a higher baseline and others have a milder baseline, when they tend to have a higher baseline and they use topical steroids and stop it, eczema can come back because the genetic factors are there, the immunological factors are there.
So it's not really a rebound because you are off the steroids, but there are some patients that I do believe when they stop it, it becomes even worse than the original condition, and even areas they don’t apply, they may have flare-ups, so there are a small proportion of patients with this steroids withdrawal.
However, the majority of patients do not actually have that. So, we have to recognise who may have it and tailor the treatment accordingly. The side effects of steroids are really:
- The thinning of the skin
- You get stretch marks
- Your skin becomes very fragile
- Your blood vessels become visible
- When you knock yourself, the skin bruises very easily
So I think that is the main side effect we worry about when using prolonged topical steroids.
