Home Remedies for Topical Steroid Withdrawal
Whether you’re treating dermatitis or looking to minimise eczema rashes, topical steroids are a common way to manage the symptoms of skin conditions.
However, it’s possible to develop a reliance on topical steroids, which can cause uncomfortable withdrawal symptoms, such as cracked and inflamed skin.
In this article, we’ll provide more detail on topical steroid withdrawal, as well as how to manage the withdrawal symptoms at home.
What are topical steroids?
Topical steroids are a group of medicinal creams, applied directly to the skin, to speed up the healing process of skin conditions, such as eczema, psoriasis, and forms of dermatitis.
Different forms of topical steroids work best for different skin conditions. For example, a more hydrating, thicker cream might help tackle eczema, while an emollient is more softening and soothing for cases of dermatitis, where the skin may be weeping.
While many skin conditions can’t be cured, they can be managed. As such, topical steroids are best used as a temporary treatment for flare-ups of skin conditions, as opposed to trying to clear up your skin completely.
What is topical steroid withdrawal?
When used safely, topical steroids provide short-term relief for symptoms of skin conditions. However, improper use, such as applying too liberally, can lead to a condition called topical steroid withdrawal (TSW).
Although there’s not yet a lot known about TSW, a study by the American Academy of Dermatology suggests overusing topical steroids is what causes TSW skin. This is because applying steroid creams in an excessive amount or using them for too long can cause your skin to become dependent on them.
Once your skin is dependent on the steroid cream, it can make it react negatively when you stop using the cream. As a result, you may notice signs of steroid withdrawal skin after just a couple of weeks of not using the cream.
Typically, your prescribing clinician will recommend using steroid creams only once or twice a week, for no longer than a week. Additionally, it’s best not to use them on areas where the skin is already quite thin or sensitive – eyes, eyelids, or genitals – unless you’re specifically advised otherwise by the clinician prescribing the cream.
What are the most common topical steroid withdrawal symptoms?
Symptoms of TSW skin can vary depending on whether it’s a severe or mild topical steroid withdrawal.
If you’re dealing with a mild case of TSW, then you may experience symptoms like flaky skin, rashes, and spot-like bumps on the surface of your skin. You may also notice:
Painful skin.
Dry skin.
Itchy skin.
Swelling.
Wrinkles.
While more severe cases of TSW are likely to include the above symptoms as well, you might also experience other topical steroid withdrawal symptoms, such as:
Pus-filled bumps.
Papules or nodules.
Burning sensation.
Peeling or shedding.
Insomnia.
TSW symptoms usually only occur in the area you applied the cream, but they can start to spread further around the face and body. However, this typically only happens in more severe cases of steroid cream withdrawal.
How to treat topical steroid withdrawal?
1. Stop using the topical steroid cream
While it may seem contradictory to the name of the condition, topical steroid withdrawal can sometimes occur when using the cream, as well as after stopping usage.
If you’re still using the topical steroid and notice you have symptoms of TSW, you should stop using the cream straight away. While this can be difficult, especially if it was helping your skin condition, continuing to use the cream in this instance can worsen the TSW.
However, if you aren’t showing signs of TSW, then the National Eczema Society suggests weaning yourself off the steroid cream as you approach the end of the usage time. This may help prevent TSW occurring when you do stop using the steroid cream.
Your body needs time to heal itself from a dependency on steroid creams and it may be a couple of months before you notice TSW skin start to heal. This period can be debilitating and stressful, but it’s important not to go back to using the cream, as this can worsen symptoms in the long run.
2. Take an antihistamine
You can take an antihistamine tablet to treat the steroid cream withdrawal symptoms, while an antihistamine cream can both treat and soothe TSW skin directly.
For the tablet, it’s best to take only one a day, while you can apply an antihistamine cream up to four times a day. The NHS suggests oral and topical antihistamines can be taken together, but don’t use more than the daily recommended amount of either, unless advised by a medical professional.
A pharmacist will be able to give you stronger forms of antihistamine than those available in the supermarket. Antihistamines from a pharmacist could help treat the symptoms of TSW a bit faster and may be useful for more severe cases of TSW.
3. Apply a cold compress
A cold compress can help soothe the burning and itching sensations that come with steroid cream withdrawal, as well as reduce the appearance of red and inflamed skin.
Cold compresses are available in most pharmacies and supermarkets, but they are also easy to make yourself at home. To make a cold compress, simply wrap some ice in a clean and dry cloth.
You can leave a cold compress on your skin for around 10 to 15 minutes in one sitting. For the best results, apply the cold compress three times a day – in the morning, around lunchtime, and then again before you go to bed.
4. Use gentle moisturisers or emollients
Dry skin is common with TSW, though you may also experience dry skin that’s cracked and weeping. However, there are creams you can use in your daily skincare routine that soothe both dry and wet skin.
For dry skin, it’s best to apply a moisturiser that’s fragrance-free and suitable for sensitive skin. Apply the moisturiser as frequently as possible to help provide a skin barrier and promote healing.
If your skin is weeping, then you might find better results from gels and emollients. You can speak to a pharmacist about suitable creams for treating dry or cracked TSW skin.
5. Don’t use cosmetics when showing TSW symptoms
While applying makeup may be part of your daily routine, it’s best to stop using cosmetics while you are showing symptoms of TSW.
Harsh chemicals in cosmetics like concealer, mascara, and foundation can irritate TSW skin, making the symptoms worse. However, not using makeup is only a temporary measure while you’re experiencing TSW symptoms, and you can use makeup again once the TSW clears up.
You should also look to replace face washes and cleansers with ones more suitable for sensitive skin as well. Instead of bars of soap, for example, try an emollient-based wash product, as these are better for soothing dry and irritated skin.
However, if rubbing your skin is painful, then a simple splash of lukewarm water is enough to clean your face. Just make sure to gently pat your skin dry with a soft towel to avoid any pain or irritation from rubbing with rough materials.
When to see a GP about topical steroid withdrawal
Symptoms of TSW can take a couple of months to go away with at-home treatments, but there are occasions where it might be best to see a medical professional.
For example, if your symptoms aren’t going away and are getting worse despite treating them at home, then you should see your GP. Additionally, if your symptoms are recurring – meaning they leave completely, only to return again later down the line – then you also may want to speak to your GP.
A GP can refer you to a dermatologist who will be able to provide more detailed advice on how to care for TSW skin when it flares up, as well as how best to treat it to stop it from returning.
If you’re experiencing the more severe symptoms of TSW, such as hair loss, difficulties sleeping, or you’re showing signs of an infection, then try to see a medical professional as soon as possible.
How can Benenden Health help with topical steroid withdrawal
Symptoms of steroid cream withdrawal can be debilitating, leading to stress and anxiety.
As a Benenden Health member you can get access to our 24/7 GP Helpline, so you can speak to a doctor about help with TSW at any time, without having to wait for an appointment.
From day one of joining, you will be able to access over the phone GP consultations anytime, as well as video call consultations between 8am and 10pm - helping you receive initial TSW advice that bit sooner.
We also have a 24/7 Mental Health helpline. If your symptoms are causing you distress and you’re struggling to go about your daily activities, you can talk to our dedicated team about the mental toll of TSW.
Alternatively, if you’re looking for more advice on treating skin conditions such as eczema or rosacea, or you’d like tips on dealing with stress, check our Be Healthy hub.
Medically reviewed by Cheryl Lythgoe in September 2024.
