Duration. The duration of acute topical corticosteroid withdrawal is variable; the skin can take months to years to return to its original condition. The duration of steroid use may influence the recovery factor time, with the patients who used steroids for the longest reporting the slowest recovery.
The duration of acute topical corticosteroid withdrawal and time to peak is variable from days to months, before eventually the skin becomes 'normal'. It can take weeks to years to return to its original condition.
Taking oral corticosteroids for a few weeks can help your body adjust to stopping topical corticosteroids and reduce symptoms of TSW. Using cold compresses. Cold compresses and other skin soothing treatments might also be recommended.
In normal regular use skin thinning is unlikely and, if it does occur, it often reverses when the topical steroid is stopped. With long-term use of topical steroid the skin may develop permanent stretch marks (striae), bruising, discolouration, or thin spidery blood vessels (telangiectasias).
Moisturise Your Skin
Using a facial serum or body oil with natural botanical oils is the good way to keep your skin moisturised without irritating skin further during topical steroid withdrawal.
A standard approach to TSW recovery is to stop using topical steroids and allow skin to heal , though there is great variability in time, response, and symptoms using this approach.
Symptoms seen in TSW include burning pain, severe itch, shedding skin/desquamation (Fig. 1B), edema, serous exudate/ooze, skin sensitivity, insomnia, and depression. Signs that are commonly seen in these patients are discussed in Table 1.
When topical steroid medication is stopped, the skin experiences redness, burning, a deep and uncontrollable itch, scabs, hot skin, swelling, hives and/or oozing for a length of time. This is also called 'red skin syndrome' or 'topical steroid withdrawal' (TSW).
Patients with this type of withdrawal experience swelling, redness, burning, and skin sensitivity usually within 1-2 weeks of stopping the steroid. The papulopustular variant was more often associated with use of topical corticosteroids for cosmetic purposes or for an acne or acne-like disorder.
If taken orally, steroids can show up in a urine test for up to 14 days. If injected, steroids can show up for up to 1 month.
Even low-potency topical steroids can cause slight skin atrophy that often reverses upon discontinuation of the drugs.
Symptoms include fever, swollen lymph glands, sore throat, headache, fatigue, rash, and body aches. Symptoms could last up to 6 months but usually go away within 2 to 4 weeks.
Steroid use cannot be stopped abruptly; tapering the drug gives the adrenal glands time to return to their normal patterns of secretion. Withdrawal symptoms and signs (weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea, abdominal pain) can mimic many other medical problems.
It is true that potent and super potent topical corticosteroids can cause skin atrophy if applied too frequently and for a prolonged time without a break. Although early skin thinning can disappear if the topical corticosteroid is discontinued, prolonged use can cause permanent stretch marks (striae).
Steroid-induced skin atrophy is often permanent, though if caught soon enough and the topical corticosteroid discontinued in time, the degree of damage may be arrested or slightly improve. However, while the accompanying telangiectasias may improve marginally, the stretch marks are permanent and irreversible.
If you've been taking steroid tablets for more than a few days, you usually need to reduce your dose gradually. Stopping suddenly can cause your adrenal gland, which makes important hormones for the body, to stop working. This is known as adrenal insufficiency.
Do not stop taking hydrocortisone without talking to your doctor. Stopping the drug abruptly can cause loss of appetite, an upset stomach, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss.
Fluid retention is one of prednisone's most famous side effects. “'Moon face' is common, which is swelling in the face that can occur after you've been on steroids for a long time,” Dr. Ford notes. “You can also get swelling in the legs and midsection.”
One of two main types of rashes may develop with topical steroid withdrawal at the sites of application. One type is red, swollen, scaly and peeling, and the other is defined by red, pus-filled bumps without scaling or peeling. The skin may also be burning, stinging, or itchy, and you may experience facial hot flashes.
Using creams that contain vitamin A, also known as retinol or retinoids, may help to prevent skin from thinning further. Retinol creams are available in drugstores or online as cosmetic products. Research published in 2018 suggests that in some cases retinol may help to normalize skin thickness.
Ultra-high-potency topical steroids should not be used continuously for longer than three weeks. Low- to high-potency topical steroids should not be used continuously for longer than three months to avoid side effects.
Skin atrophy: Skin atrophy is demonstrated by thin shiny-appearing skin, telangiectasia (small readily visible blood vessels), ecchymoses (bruises), striae (stretch marks), hypertrichosis (increased hair), redness, and pigmentation changes.