What is Topical Steroid Withdrawal (TSW)?

Topical Steroid Withdrawal (TSW), also known as Red Skin Syndrome or Steroid-Induced Dermatitis, is a serious and often misunderstood condition that can occur after stopping the use of topical corticosteroids — medications commonly prescribed to treat chronic skin issues like eczema, atopic dermatitis, psoriasis, or rashes.

Topical steroids are anti-inflammatory creams or ointments designed to reduce redness, itching, and swelling. While they can be effective in the short term, long-term or frequent use — especially of medium- to high-potency steroids — may lead to the skin becoming dependent on the medication. When the steroids are discontinued, the skin can go into withdrawal, leading to a range of painful and debilitating symptoms. This is what’s known as Topical Steroid Addiction and Withdrawal.

Common Symptoms of TSW

People going through TSW often experience:

• Red, burning, and inflamed skin (often worse than the original condition)

• Peeling and flaking skin

• Swelling (edema)

• Oozing or weeping

• Extreme dryness and tightness

• Itching and stinging sensations

• Thinning or sensitive skin

• Insomnia, fatigue, and emotional distress

• Hairloss

• Depression

• Anxiety

• Nervepains

• Zingers

• Fungal infections

• Eczema Herpeticum infections

• Impetigo

These symptoms often come in cycles or flares, and they can spread across the body even in areas where steroid creams were never applied. TSW can last for months or even years, depending on factors like the strength and duration of steroid use, as well as individual health conditions.