It is crazy that there is absolutely nothing on parameters for the time usage of Topical Steroids. It is good that they put in caps DO NOT USE ON FACE!, but he never mentions that using these long term are extremely damaging. Not just the atrophy, but the fact that the body gets dependant on them.
Tyler L. - If they are being used as prescribed, that is, only in the given affected area and during flare ups, there should be minimal systemic absorption that would lead to withdrawal upon discontinuation. Maintenance therapy should be undertaken with the minimal potency effective. Steroid-sparing approaches such as calcineurin inhibitors may be appropriate in cases where long-term steroid use is not desired. This can be done on a case-by-case basis, and those with moderate-to-severe chronic eczema would benefit from dermatology consultation/referral. As usual, it's a matter of balancing benefits and risks, maximizing quality of life.
This is super smart approach. The problem is that many derms just prescribe them long term. I know this because I have a son that has suffered a horrible withdrawal. He was also on protopic. I had to take him off of all drugs cause 5 docs saw him and they were all ok with him being on close to 4 steroids. I started to notice when I tapered odd things were happening to him. I also started to notice that although the drugs were keeping him clear he was having all types of side effects. All of the docs could not make the connection. This is because they are only told it causes atrophy, but there is never a mention of the unique symptoms that are experienced when on these drugs long term. Topical Steroid Withdrawal is real and needs to be addressed by the medical community.
These are unique symptoms that may be misdiagnosed as severe eczema. When my son came of the drugs he had edema of the face, red burning skin, and hives. These symptoms persisted for the first six months and the itch seemed like it was 24/7. Over time the symptoms have decreased. He still experiences shedding and flare cycles. There are many people that have experienced the same thing online and pictures prove it. At first I didn't think this was possible, but researched like crazy and it all made sense. I don't believe it is the steroids themselves that are causing the problem it is the way in which they are being prescribed. This is totally preventable.
