Abigail Stein developed severe, widespread skin worsening after topical corticosteroids for hand dermatitis, with redness spreading to arms, torso and belly. Stopping steroids caused extreme dryness, cracking, stabbing nerve pain and recurrent infections, and social withdrawal. Online reports identified topical steroid withdrawal (TSW) characterized by rebound redness, intense burning, itching, stinging, oozing, swelling and flaking; severe cases include nerve pain and suicidal ideation. Physicians escalated steroid potency with worsening outcomes. Recognition of TSW as distinct from eczema is contested within dermatology, complicating diagnosis and management and leaving patients facing prolonged suffering and uncertainty.
When 28-year-old Abigail Stein from London was prescribed a topical corticosteroid to treat her eczema, she trusted that her skin condition would start to settle. Instead, it erupted. What had begun as a stubborn patch of hand dermatitis spread aggressively across her body. Physicians prescribed stronger and stronger steroid creams, but things only worsened. Stein has had eczema since she was a child and is used to periods of flare-ups and remission.
It was on a stranger's blog that Stein first came across a condition called topical steroid withdrawal (TSW). What she read scared her. "It was terrifying. People were talking about being bedridden for months," she says. Symptoms include rebound redness between treatment applications and intense burning, itching and stinging. Some people report that when they try to stop using topical steroids, their skin oozes, swells and flakes.
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