Doctors move to allay topical steroid withdrawal fears

Doctors have reassured people with eczema that topical corticosteroids are safe and effective when used as prescribed, in the wake of high profile media coverage highlighting what they say is a ‘very rare’ reaction to the treatment.
 
The report, broadcast nationwide on ABC earlier this week, relays the personal story of a patient who purportedly experienced topical steroid withdrawal and is critical of doctors who he says ignored his plight.
 
‘It’s really concerning and it’s scary that doctors still now will prescribe topical steroids all the time to people without giving them fair warning of what could actually happen,’ the patient, Jordan Hendey said.
 
‘A lot of doctors … tell us that this is a lie. They tell me that I’m making something up.’
 
However, while not disputing the ‘unbearable and excruciating’ pain felt by Mr Hendey, doctor groups, including Eczema Australia, the Australasian College of Dermatologists (ACD) and the RACGP are concerned the report may unnecessarily discourage patients from using the treatment.
 
‘Topical steroid withdrawal is a very rare reaction,’ ACD President Dr Adriene Lee said. ‘Millions of people around the world have used topical steroids to manage their eczema effectively.
 
‘The benefits … far outweigh any risks, which is why they continue to form the foundation of care for eczema.
 
‘Far more commonly what we see in those who experience a deterioration of their skin after discontinuing topical steroids is evidence of undertreated eczema or a resurgence of the underlying eczema.
 
‘Unfortunately, dermatologists see far more suffering caused by the avoidance of topical steroid treatments, which in turn can lead to the development of more severe disease.’
 
An estimated 2.8 million Australians have eczema, including one in three children under six. For Dr Anneliese Willems, a GP and member of RACGP Specific Interests Dermatology, it was vital to set the record straight.
 
‘As with all medications, a small number of patients can experience side effects, while many can benefit,’ she said.
 
‘Eczema is a complex and chronic condition that requires a high level of self-management, which makes it essential that there is time during consultations for patients to talk about their concerns relating to steroids, and for GPs and dermatologists to listen, explain the evidence behind these treatments, and tailor care to the individual.’
 
As part of the response, Eczema Support Australia (ESA) is working closely with GPs, pharmacists, nurses and dermatologists to develop a series of educational resources to support Australians impacted by eczema.
 
Managing Director Melanie Funk said anyone concerned should speak to their GP or dermatologist to ensure they have an Eczema Care Plan tailored to them for using their steroid creams, moisturisers and other treatments.
 
‘Eczema can be a debilitating, lifelong condition,’ Ms Funk said.
 
‘Far more people with eczema benefit from topical steroids than experience a reaction. It would be a tragedy if some Australians were deterred from using a therapy that is proven to provide relief and prevent their eczema from worsening.’
 
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eczema topical steroid withdrawal