Topical steroid withdrawal reactions: a review of the evidence

It’s important that you don’t stop taking steroids without speaking to the person treating you first. Steroids are taken in different ways, and the dosage may vary depending on the condition you have. The table below gives an idea of how often you might need to take steroids.

  • You might be prescribed anabolic steroids for certain medical conditions.
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  • If this happens, there’s a very small chance it can cause serious side effects, such as adrenal gland problems, high blood sugar (hyperglycaemia), or problems with your eyesight.

Steroid creams are safe to use during pregnancy, but if you’re breastfeeding you’ll need to make sure any cream is wiped off before feeding. Very strong topical steroids aren’t usually prescribed during pregnancy and breastfeeding. If you’re taking steroid tablets you might need to avoid live vaccines, such as yellow fever.

Materials for healthcare professionals and patients

Corticosteroids, often known as steroids, are an anti-inflammatory medicine. If treatment with a local corticosteroid is clinically justified beyond 4 weeks, a less potent corticosteroid preparation should be considered. Many of these products are cheap to buy and are readily available OTC along with advice from pharmacies.

  • It is more likely to occur when delicate skin sites such as the face and flexures are treated.
  • Often anaesthetic cream is used on the skin, and local anaesthetic mixed with steroid in the injection.
  • See your doctor or the person treating you straight away if you develop chickenpox, shingles or measles, or if you come into contact with someone who has any of these illnesses.
  • These adverse events are experienced by patients shortly after stopping treatment, with a rebound of the original eczema that then spreads further.
  • The authors stated that by this point, the initial limited areas of dermatitis had expanded significantly.

Talk to your GP about other conditions you have and medicines you take, like high blood pressure, stomach ulcer or diabetes. At your annual asthma review, your GP or asthma nurse can talk to you about your risk and what you can do to reduce this risk. But if your asthma is poorly controlled and you need to take steroid tablets, you may be more at risk of severe disease from COVID-19.

Ointment or cream?

If you want to check that your medicines are safe to take with your medication, ask your Pharmacist or GP. A high dose of inhaled steroids can sometimes cause more serious side effects but this is rare. Corticosteroids are powerful medications that can sometimes have side effects.

Literature review

My skin is so much stronger and stable and is learning to function by itself. When I got out the car at Cryozone Health that first day, I could barely walk or move. I was below 7 stone, in agony, tired and exhausted and emotionally and mentally drained. My body was ripped to shreds with open wounds and scabs and I was red raw.

Steroid Treatment Card (blue card)

Talk to your doctor or nurse about effective contraception before starting your cancer treatment. Let them know straight away if you or your partner falls pregnant while having treatment. It’s sometimes necessary for steroid tablets to be taken for longer periods.

It is important to remember that even treatment with steroids within 72 hours of onset of symptoms will not guarantee a full recovery in all cases. However this treatment will give you the best possible chance of making a full recovery and should be taken if prescribed by your GP. Where facial paralysis is thought to be caused by an infection, various medical treatments may be prescribed. Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment.

Note that it’s not recommended to use topical corticosteroids to treat acne. Taking steroid tablets for a long time can make you more likely to get infections. If you feel feverish or unwell, or develop any new symptoms after starting steroids, it’s important to tell your doctor or rheumatology nurse.

Patients should follow their healthcare professional’s advice on where, how often and for how long to use topical corticosteroids. Patients experiencing symptoms after stopping their topical steroid treatment should contact a healthcare professional for guidance. We advise anyone experiencing potential withdrawal symptoms to speak to their healthcare professional before starting to use these products again. Suspected adverse side effects can be reported to us through the Yellow Card scheme.

There’s no clear evidence that hydrocortisone skin treatments affect male or female fertility. But tell the doctor or nurse that you’re using hydrocortisone cream so they can give the vaccine in an untreated area of skin. To reduce the risk of side effects your doctor may recommend that you only use hydrocortisone for a few weeks at a time. Hydrocortisone skin treatments work on your skin’s cells to stop these chemicals being released.

Common concerns about taking steroids

This is based on the whole area being treated therefore if only a proportion of the area is affected the number of FTU should be adjusted accordingly. Users tend to exercise more when they’re taking high doses to make the most of their improved performance during this time. You shouldn’t drink any more than the UK guidelines of 14 units a week. You shouldn’t save these units up to drink all in one go, so try to spread your units across the week and have some alcohol-free days.

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