Topical Steroid Withdrawal: The Challenging Transition from Patient Self-Diagnosis on Social Media to Medical Science and Care

Sneddon I. Adverse effect of topical fluorinated corticosteroids in rosacea. Br Med J 1969; 1: 671–673.

https://doi.org/10.1136/bmj.1.5645.670 DOI: https://doi.org/10.1136/bmj.1.5645.670

Mohta A, Sathe NC. Topical Steroid Withdrawal (Red Skin Syndrome). 2024 May 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.

Verma SB. Sales, status, prescriptions and regulatory problems with topical steroids in India. Indian J Dermatol Venereol Leprol 2014; 80: 201–203.

https://doi.org/10.4103/0378-6323.132246 DOI: https://doi.org/10.4103/0378-6323.132246

Stalder JF, Aubert H, Anthoine E, Futamura M, Marcoux D, Morren MA, et al. Topical corticosteroid phobia in atopic dermatitis: International feasibility study of the TOPICOP score. Allergy 2017; 72: 1713–1719.

https://doi.org/10.1111/all.13189 DOI: https://doi.org/10.1111/all.13189

Hajar T, Leshem YA, Hanifin JM, Nedorost ST, Lio PA, Paller AS, et al. A systematic review of topical corticosteroid withdrawal («steroid addiction») in patients with atopic dermatitis and other dermatoses. J Am Acad Dermatol 2015; 72: 541–549.e2.

https://doi.org/10.1016/j.jaad.2014.11.024 DOI: https://doi.org/10.1016/j.jaad.2014.11.024

Stories and Photos of TSW Syndrome. [accessed March 24, 2025] Available from https://www.itsan.org/stories-and-photos/

Stalder JF, Barbarot S, Wollenberg A, Holm EA, De Raeve L, Seidenari S, et al. Patient-Oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe. Allergy 2011; 66: 1114–1121.

https://doi.org/10.1111/j.1398-9995.2011.02577.x DOI: https://doi.org/10.1111/j.1398-9995.2011.02577.x

Pierre Fabre Eczema Foundation. [accessed March 24, 2025] https://www.pierrefabreeczemafoundation.org/etre-accompagne/supports-et-outils

eczemawise app. [accessed March 24, 2025] https://www.eczemawise.org/

Cotter C, Burton T, Proctor A, Moss C, Flohr C. Topical steroid withdrawal syndrome: time to bridge the gap. Br J Dermatol 2022; 187: 780–781.

https://doi.org/10.1111/bjd.21770 DOI: https://doi.org/10.1111/bjd.21770

Arnold KA, Treister AD, Lio PA. Dupilumab in the management of topical corticosteroid withdrawal in atopic dermatitis: A retrospective case series. JAAD Case Rep 2018; 4: 860–862.

https://doi.org/10.1016/j.jdcr.2018.06.012 DOI: https://doi.org/10.1016/j.jdcr.2018.06.012

Shea M, Grinich E, Simpson E. Topical steroid withdrawal treated with ruxolitinib cream. JAAD Case Rep 2024; 48: 5–7.

https://doi.org/10.1016/j.jdcr.2024.03.011 DOI: https://doi.org/10.1016/j.jdcr.2024.03.011

Wollenberg A, Kinberger M, Arents B, Aszodi N, Avila Valle G, Barbarot S, et al. European guideline (EuroGuiDerm) on atopic eczema: part I – systemic therapy. J Eur Acad Dermatol Venereol 2022; 36: 1409–1431.

https://doi.org/10.1111/jdv.18345 DOI: https://doi.org/10.1111/jdv.18345

Alsterholm M, Af Klinteberg M, Vrang S, Sigurdardottir G, Sandström Falk M, Shayesteh A. Topical steroid withdrawal in atopic dermatitis: patient-reported characterization from a Swedish social media questionnaire. Acta Derm Venereol. 2025; 105: adv40187.

https://doi.org/10.2340/actadv.v105.40187 DOI: https://doi.org/10.2340/actadv.v105.40187

Haddad F, Abou Shahla W, Saade D. Investigating topical steroid withdrawal videos on TikTok: cross-sectional analysis of the top 100 videos. JMIR Form Res 2024; 8: e48389.

https://doi.org/10.2196/48389 DOI: https://doi.org/10.2196/48389

Gust P, Jacob SE. The role of delayed-delayed corticosteroid contact dermatitis in topical steroid withdrawal. J Am Acad Dermatol 2016; 75: e167.

https://doi.org/10.1016/j.jaad.2016.05.048 DOI: https://doi.org/10.1016/j.jaad.2016.05.048

Shobnam N, Ratley G, Saksena S, Yadav M, Chaudhary PP, Sun AA, et al. Topical steroid withdrawal is a targetable excess of mitochondrial NAD. J Invest Dermatol 2025 Feb 10. [Epub ahead of print].

https://doi.org/10.1016/j.jid.2024.11.026 DOI: https://doi.org/10.1016/j.jid.2024.11.026