British health authorities have issued a drug safety update saying that while topical steroid products are safe and highly effective treatments for managing various inflammatory skin diseases, they have some risks, especially with prolonged use at high potency – and in rare instances, adverse reactions and withdrawal symptoms have been reported.
As a result, these products will, over the next year, be labelled with information on their potency to simplify advice for patients.
These will be labelled ‘mild steroid’, ‘moderate steroid’, ‘strong steroid’, and ‘very strong steroid’.
The reported adverse reactions – Topical Steroid Withdrawal Reactions’ (TSW) –
have been linked to long-term (generally six months or more) use of moderate or stronger potency products, particularly when used for eczema treatment.
When stopping treatment, long-term users have reported skin reactions, including intense redness, stinging, and burning of the skin that can spread beyond the initial treatment area.
Topical steroids can rarely lead to serious side effects such as thinning of the skin, adrenal suppression or very rarely Cushing’s syndrome, due to systemic absorption.
The incidence of these more serious side effects is linked to the amount, potency and duration of use of the topical steroid.
Given the lack of new information on possible withdrawal reactions in the scientific literature since the previous review, further research is required to fully understand the characteristics and reasons for these reactions.
More than 11m prescriptions are issued for topical steroids each year, and the number of reports of adverse reactions received must be put into context of the millions of people who have benefitted from these treatments without experiencing any problems, added the authorities.
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