Tapering Off Topical Steroids
Tapering is a common method advised by doctors for patients who wish to discontinue their use of topical steroids. This means gradually reducing the potency, application frequency, or both. A common example includes moving down the “topical steroid ladder,” where a patient starts on a high-potency steroid and slowly transitions to lower-potency options. Some dermatologists recommend spacing out applications—reducing daily use to every other day, then weekly, with intermittent steroid-free breaks in between.
In the TSW Assist survey, participants were asked if they have tried tapering down their usage of topical steroids.
Answer: Yes (Tried Tapering Off)
Total: 60 responses (34.5%)
Mixed Success
- Success Stories: 6 respondents found tapering down effective, with gradual reduction in symptoms and some eventually being able to stop completely. Examples include successful reduction from very potent to mild steroids, and using methods like the Dr. Aron regimen.
- Partial Success: 4 respondents experienced temporary relief or mild improvements but still faced significant challenges.
Negative Experiences
- Prolonged Symptoms: 20 respondents reported that tapering did not alleviate symptoms and often prolonged the withdrawal process. They experienced severe flares, increased inflammation, and other intense withdrawal symptoms.
- Worsening Symptoms: 10 respondents mentioned that their condition worsened despite tapering, leading to severe flares and the need to revert to steroids or other treatments.
Challenges in Tapering
- Difficult Process: 15 respondents highlighted the difficulty of the tapering process, describing it as excruciating, painful, and mentally challenging.
- Lack of Medical Support: 5 respondents mentioned the absence of support from doctors and dermatologists, leading them to rely on self-research and community advice.
Answer: No (Did Not Try Tapering Off)
Total: 114 responses (65.5%)
Abrupt Discontinuation Approach:
- Common Choice: 60 respondents chose to stop using topical steroids abruptly (cold turkey), rather than tapering off.
- Severe Reactions: 30 respondents who abruptly stopped topical steroids reported severe withdrawal symptoms, including intense flares, skin inflammation, and emotional distress.
Lack of Awareness:
- Unawareness of Tapering: 10 respondents were unaware that tapering was an option or necessary, leading to abrupt discontinuation of steroid use.
Immediate Discontinuation:
- Ineffective Steroids: 8 respondents stopped using steroids immediately because the treatment had stopped being effective
- Personal Choice: 6 made a personal choice to stop immediately due to concerns about long-term effects and a desire to avoid further steroid use.
Medical Advice:
- Inconsistent Guidance: 5 respondents received varying advice, with some being advised to stop immediately by their doctors, while others received no guidance or support from medical professionals.
