topical steroid withdrawal: what we tell people who ask

People ask our peer support group about Topical Steroid Withdrawal (TSW) fairly often. It's a genuinely difficult, debated topic, and one we take seriously - which is exactly why this article is careful about what it does and doesn't say. TSW anxiety often sits alongside a wider, more general wariness of topical steroids - see "The Truth About Steroid Phobia" - https://ayreczema.co.uk/#/articles/steroid-phobia-our-peer-groups-real-views for how our group talks about steroid concerns more broadly.

This is not medical advice, and ayr is a peer-support charity, not a clinical service. If you are currently using prescribed topical steroids and have questions or concerns about TSW, please speak to your GP or dermatologist before making any change to your treatment. Nothing in this article is intended to guide a decision about starting, stopping, reducing, or changing steroid use - that conversation needs to happen with a qualified clinician who knows your specific case.

What people in our group actually say and feel

TSW comes up in our sessions as a source of real anxiety and curiosity, and our group treats it as a legitimate concern worth discussing openly, not something to dismiss. People who believe they've experienced it deserve to be heard, and shutting the conversation down doesn't make the concern go away - it just pushes people toward less careful sources of information.

At the same time, our group has directly discussed the risks of one specific approach associated with TSW discourse: reducing or stopping moisture and skincare products entirely, sometimes described as "no moisture treatment," with the stated aim of encouraging skin to produce its own oils. In our sessions, this approach has been raised with clear concern, not endorsement. A facilitator directly cautioned against it, and the group discussed real risks associated with it for the skin barrier and overall skin health. That caution reflects our group's actual position - this is not a practice ayr recommends or presents as safe, and this article does not describe how to do it, for how long, or in what way, because doing so could function as instructions rather than information.

"It's something people bring up because they're scared and looking for answers, not because anyone in our group thinks they've found a solution. What actually helped me was hearing that it was okay to be worried about it and still not have a clear answer."

What's contested and unclear, stated plainly

Topical steroid withdrawal reactions are officially recognised in the UK. The Medicines and Healthcare products Regulatory Agency (MHRA), the UK's medicines regulator, reviewed the evidence in 2021 and again in 2024, and the British Association of Dermatologists (BAD) and National Eczema Society (NES) have issued a joint statement on TSW. The regulator's position has two halves, and both matter equally. First, topical steroids are safe and effective when used as prescribed, and severe withdrawal reactions are considered rare - so TSW is not a reason to be frightened of a steroid cream a clinician has recommended for you. Second, these reactions are real, can be severe and distressing, and are associated mainly with frequent or prolonged use of stronger (moderate-to-high potency) steroids. At the same time, there is still no agreed clinical definition of TSW, and its causes and management remain poorly understood and genuinely debated within dermatology. We're not in a position to adjudicate that debate, and this article doesn't attempt to - but we won't dismiss the experiences people describe either.

Where to go for actual clinical information

If you're worried about TSW, or have questions about your own steroid use, the right next step is a conversation with your GP or dermatologist - not a peer support charity, and not this article. For further reading from clinical authorities on this topic:

• The MHRA (the UK medicines regulator) publishes a patient safety leaflet, Topical corticosteroids and withdrawal reactions, which explains TSW and what to do if you're worried - including the important point that if your skin flares within days to weeks of stopping a steroid, you should speak to a doctor before restarting rather than deciding for yourself.

• The British Association of Dermatologists and National Eczema Society have published a joint statement on topical steroid withdrawal, alongside their wider patient information on topical steroid use.

• The NHS provides guidance on eczema treatment, including topical steroids, from a clinical and patient-safety perspective.

Why we're being this careful

TSW is a sensitive, high-search-interest topic, and getting the framing wrong could genuinely put someone at risk - either by encouraging an unsafe approach to steroid use, or by dismissing a real and distressing experience some of our members report. We'd rather be a source that takes both of those risks seriously than one that offers false certainty in either direction.

This article reflects the shared, anonymised experience of members of the ayr Eczema Circle peer support group - it is peer perspective only, not medical advice, and not a clinical assessment of TSW as a condition. If you are using prescribed topical steroids and have any concerns, including about TSW, please speak to your GP or dermatologist before changing your treatment in any way.

References

1. MHRA, "Topical corticosteroids and withdrawal reactions" (patient safety leaflet), updated May 2024 - https://www.gov.uk/guidance/topical-corticosteroids-and-withdrawal-reactions

2. MHRA, "Topical corticosteroids: information on the risk of topical steroid withdrawal reactions" (Drug Safety Update), September 2021 - https://www.gov.uk/drug-safety-update/topical-corticosteroids-information-on-the-risk-of-topical-steroid-withdrawal-reactions

3. British Association of Dermatologists, National Eczema Society and British Dermatological Nursing Group, joint statement on Topical Steroid Withdrawal (2024) - https://www.bad.org.uk/topical-steroid-withdrawal-joint-statement

4. NHS, "Atopic eczema - Treatment" - https://www.nhs.uk/conditions/atopic-eczema/treatment/

5. National Eczema Society, patient resources on topical steroids - https://eczema.org/

Related reading

"The Truth About Steroid Phobia" - https://ayreczema.co.uk/#/articles/steroid-phobia-our-peer-groups-real-views