• Burning or stinging on application
• Worsening of an existing skin condition such as acne or rosacea
• Folliculitis (blocked hair ducts)
• Skin thinning (atrophy)
• Stretch marks (striae)
• Easy bruising and tearing of the skin
• Enlarged blood vessels (telangiectasia)
• excessive hair growth (hypertrichosis)
• Periorificial dermatitis (redness, rash, spots around the mouth)
• Red skin syndrome/steroid rosacea
• Pustular psoriasis
• Changes in skin colour

In very rare cases, steroid use can cause or worsen Cushing’s Syndrome, hypertension, Type 2 diabetes, eye damage, osteoporosis or delayed growth in children.

Background: what are topical corticosteroids?

Topical corticosteroid creams are routinely prescribed to help calm down inflammation, itchiness and rashes, particularly those associated with eczema and psoriasis. They can be very effective in reducing the risk of infection and in soothing the distress and damage of intense itchiness.

However, steroids are powerful drugs and should be used very carefully and for short periods of time only. That’s because they can have some really significant side-effects, and can affect the body in some quite damaging ways when overused.

Side effects are more likely if you're:

• using a more potent corticosteroid
• using it for a long time, or over a large area of the body
• using potent steroid on broken skin or on delicate areas (face, eyelids, genitals, skin creases)
• elderly or very young
• using steroid creams under bandages or wraps

So, while steroids have their place in critical care, they are not appropriate for the long-term treatment of eczema; eczema and other chronic skin conditions need effective, non-steroidal strategies for day-to-day management of symptoms, which include avoiding triggers and keeping skin in the best condition possible.

Balmonds offer information and support, whether you’re going through topical steroid withdrawal, looking for safe long-term management strategies or wondering whether your symptoms match the condition.

For more information about TSW, its symptoms and how to manage them, go to the ITSAN website.

With much gratitude to Laurie Ashley for her photographs on this page (follow @lauries.story_ on her TSW journey)

Other hashtags to follow for peer-to-peer support: #thisisnoteczema #tsw  #TSWFab5

Current medical advice is not to use daily topical steroids continuously for more than two to four weeks; then the frequency should be tapered to twice weekly use.