A dermatologist warned of the dangers of topical-steroid dependence, citing a case of a woman in her 30s who applied steroid-containing ointments to her face twice daily to relieve stinging or burning sensations, but whose symptoms worsened during the treatment and did not improve for a year after its cessation.
The woman’s condition indicated that her skin had become dependent on the steroids, and her symptoms, which occasionally caused her to say it felt as if her skin was on fire, were a result of the abrupt cessation of treatment and withdrawal, Shu-Tien Clinic dermatologist Hsu Chia-chi (徐嘉琪) said.
About 80 percent of topical steroid dependence occurs in women, with symptoms most often found on facial or perineal skin, Hsu said.
Patients often present with no visible rashes, only complications of treatment such as withered skin or vasodilatation — the dilatation of blood vessels — but they complain of significant burning or stinging sensations and say that only a certain ointment can relieve the irritation, she said.
“These patients mostly used ointments that contain medium and high-dose topical steroids on a daily basis,” Hsu said.
“Topical steroids are often used in ointments for treating skin inflammation, but improper use without a doctor’s prescription can easily lead to dependence,” she said.
Complications from treatment can include withered skin, vasodilatation, hirsutism and folliculitis — infection or inflammation of hair follicles.
For patients with withdrawal symptoms, steroid use cannot be stopped abruptly and use might need to be discontinued gradually while taking oral medicine, such as tetracycline or antihistamines prescribed by a doctor, Hsu said, adding that the woman whose case she cited recovered after about three months.
Many skin diseases cannot be cured in a short period, so patients might lose their patience and purchase ointments with heavy-dose steroids, but applying such ointments daily for four weeks can lead to topical dependence or weaken the skin’s immune system, Hsu said.
People should consult with a dermatologist before applying ointments to their skin, she said.
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