If you have been using steroid cream or ointment for a skin condition like eczema, psoriasis, or dermatitis, you may have come across stories about something called topical steroid withdrawal, or TSW. It has been in the news recently, and some of what you have read may have felt alarming. You are not alone in feeling that way.


So, is TSW real?

Yes, it is. Topical steroid withdrawal is a real adverse reaction that can happen when people stop using topical corticosteroids after prolonged use. The UK medicines regulator, the MHRA, formally recognized it as a side effect in 2021 and has since required new warning labels on all steroid creams and ointments. In 2024, new packaging rules came into force requiring products to be clearly labeled by potency, so you can see exactly what strength you are using.


Dermatologists have debated TSW for decades, and the evidence base continues to grow. A 2025 study from the National Institutes of Health (NIH) in the US identified the first biological mechanism behind TSW, and in 2026, a panel of leading dermatology experts published the first agreed-upon set of diagnostic criteria. The science is moving in the right direction.


What does TSW actually feel like?

TSW is not the same as a normal eczema flare. The key difference, according to clinical research, is that burning rather than itching is the dominant sensation. Other Sam visitors who have experienced TSW often describe a raw, stinging sensation rather than the familiar itch of a flare. The redness tends to be intense and may spread beyond the areas where the cream was originally applied. Some people also notice sensitivity to temperature, or skin that weeps or peels in ways that feel different from their usual condition.


These symptoms typically begin within days of stopping the cream and, for most people, improve significantly over one to two years. That timeline is longer than anyone would want, but it is worth knowing that recovery is likely.


Who is most at risk?

TSW is not something most people using steroid cream need to worry about. The evidence consistently points to a specific pattern of use as the main risk factor: strong or very strong steroid creams, used for months or years, on sensitive areas like the face, eyelids, or genitals. A large review published in the Journal of the American Academy of Dermatology found that the vast majority of TSW cases involved the face or genital area and that almost all patients had been using a moderate-to-high potency cream for a prolonged period.


Using a mild steroid cream as prescribed for a skin flare on the body, for a defined period, is a very different situation. Guidelines from both NICE and the American Academy of Dermatology support using topical steroids in this way, and do not flag this as a significant risk for TSW.


What should you do if you are concerned?

The most important thing: do not stop your cream suddenly without first speaking to your doctor. Abruptly stopping a topical steroid can actually trigger or worsen a reaction. Your doctor can help you step down gradually, switch to an alternative, or refer you to a specialist if needed.


It is also worth knowing that there are good alternatives to long-term steroid use for sensitive areas. Creams called calcineurin inhibitors, including tacrolimus and pimecrolimus, are recommended by dermatology guidelines specifically for the face and eyelids and do not carry the same withdrawal concerns. For people with moderate-to-severe eczema, newer biologic treatments can manage the condition without relying on topical steroids at all.


If you are using a steroid cream two or more days a week to keep your skin under control, rather than for short flares, that is a good conversation to have with your doctor. Research shows that a "weekend therapy" approach, applying cream to previously affected areas two days a week after gaining control, can keep eczema at bay with far less steroid exposure overall.


A note on the news coverage

The recent BBC reporting has brought TSW to a much wider audience, and that is largely a good thing. People deserve to know about this condition. But it is also worth noting that news stories naturally focus on the most severe cases. The science tells a more nuanced story: TSW appears to be uncommon when topical steroids are used as directed, and the risk is strongly tied to prolonged, unsupervised use of high-potency creams on sensitive skin. Steroid creams, used appropriately, remain safe and effective treatments for millions of people.


If you are worried about your own situation, please talk to your doctor or dermatologist.