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Topical steroid withdrawal, also known as red burning skin and steroid dermatitis, has been reported in people who apply topical steroids for 2 weeks or longer and then discontinue use. [ 4 ] [ 5 ] [ 2 ] [ 1 ] Symptoms affect the skin and include redness, a burning sensation, and itchiness, [ 2 ] which may then be followed by peeling.
Steroid-induced skin atrophy is thinning of the skin as a result of prolonged exposure to topical steroids. In people with psoriasis using topical steroids it occurs in up to 5% of people after a year of use. [5] Intermittent use of topical steroids for atopic dermatitis is safe and does not cause skin thinning. [6] [7] [8]
Adrenal crisis can be triggered by abrupt, and frequently unintentional, steroid withdrawal. The hypothalamic–pituitary–adrenal axis is suppressed by the use of glucocorticoids in rectal preparations, spinal injections, injections into the dermis, injections into the joint, nasal, inhaled, or steroids applied to the skin.
Abrupt termination of the drug commonly causes transient non-specific symptoms such as loss of appetite, upset stomach, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss. [29] [30] These symptoms can be attributed to steroid withdrawal syndrome, adrenal insufficiency, or disease relapse. [29]
When topical steroid medication is lost, the skin experiences redness, burning, itching, hot skin, swelling, and/or oozing for a length of time. This is also called 'red skin syndrome' or 'topical steroid withdrawal' (TSW). After the withdrawal period is over the atopic dermatitis can cease or is less severe than it was before. [40]
Despite their side effects, some tricyclic antidepressants may be effective for improving depression symptoms when other, newer medications aren’t effective. Atypical antidepressants.
Antidepressants with a lower half-life, such as paroxetine, duloxetine, and venlafaxine, have been implicated in higher incidences of withdrawal symptoms and more severe withdrawal symptoms. [25] With SSRIs, duration of treatment does not appear associated with the severity of withdrawal symptoms. [24]
The steroid creams should generally be of mid-to high strength and used for less than two weeks at a time, as side effects can occur. [8] Antibiotics may be required if there are signs of skin infection. [2] Contact dermatitis is typically treated by avoiding the allergen or irritant.