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Topical steroid withdrawal: a serious, under-recognised skin condition
Fatima N Hamed1, Rhiannon A Bates2, Claire Daley3
1Dermatology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK fatima.hamed@nhs.net.
BMJ Case Reports
|December 16, 2025
Summary
Topical steroid withdrawal (TSW) is a severe skin reaction from prolonged topical corticosteroid (TCS) use. This case report details TSW complexities, emphasizing early diagnosis and clinician awareness for better patient management.
Area of Science:
- Dermatology
- Adverse Drug Reactions
Background:
- Topical corticosteroids (TCS) are widely used for eczema and psoriasis.
- Prolonged TCS use can lead to Topical Steroid Withdrawal (TSW), a condition of skin dependence on steroids.
- TSW symptoms include burning, itching, erythema, and skin thinning after TCS cessation or tapering.
Purpose of the Study:
- To present and analyze a clinical case of TSW.
- To detail a patient's 22-month TSW experience.
- To highlight diagnostic and management complexities of TSW.
Main Methods:
- Clinical case presentation.
- Patient's 22-month self-reported experience.
- Dissection of diagnostic and management challenges.
Main Results:
- TSW diagnosis is challenging due to variable presentations.
- The pathophysiology of TSW is complex and not fully understood.
- Timely recognition is crucial to prevent mismanagement and ensure patient support.
Conclusions:
- Heightened clinician awareness of TSW is essential.
- Accurate diagnosis and tailored interventions are needed for TSW management.
- Further research into TSW pathophysiology and treatment is warranted.
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