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4 Side Effects of Long-Term Steroid Use for Eczema and Psoriasis

Topical steroids are commonly prescribed for eczema and psoriasis to reduce inflammation and provide quick relief from itching and redness. While they can be effective in the short term, prolonged use comes with significant risks. Many people are unaware of the long-term side effects, which can sometimes be worse than the original condition. If you or a loved one rely on steroids for skin conditions, it’s important to understand these potential consequences.


1. Skin Thinning (Atrophy)

One of the most well-documented side effects of long-term steroid use is skin thinning, also known as atrophy.


How It Happens:

Steroids work by suppressing inflammation, but over time, they also break down collagen and elastin—the proteins that give your skin structure and strength. This leads to thinner, more fragile skin that is prone to bruising, tearing, and delayed wound healing.


Signs of Skin Thinning:

  • Skin appears paper-like and translucent

  • Easy bruising and visible blood vessels

  • Increased sensitivity to minor injuries or friction


Can It Be Reversed? In mild cases, skin may gradually regain some of its thickness after discontinuing steroids. However, if the damage is severe, it can be permanent. Moisturizers rich in ceramides and collagen-boosting ingredients may help support the skin’s recovery.


2. Steroid Dependence & Rebound Flare-Ups


Over time, the body can develop a dependence on topical steroids. When you try to stop using them, the skin often experiences rebound flare-ups, where symptoms return more aggressively than before.


Why It Happens:

Steroids suppress the immune response and constrict blood vessels. When you stop using them, the suppressed inflammation can surge back, causing intense redness, burning, and swelling.


Symptoms of Steroid Rebound:

  • Worsening of eczema or psoriasis symptoms after stopping steroids

  • Red, inflamed, and hypersensitive skin

  • Persistent itchiness and discomfort


What Can You Do? To reduce the risk of steroid dependence, it’s best to use them only as prescribed and for short periods. If you need to taper off, do so under the guidance of a healthcare provider. Non-steroidal treatments, such as Cold Atmospheric Plasma (CAP) therapy and barrier-repair creams, can help manage symptoms without triggering withdrawal effects.


3. Systemic Side Effects (Adrenal Suppression & Hormonal Imbalance)


Though topical steroids are applied to the skin, they can still be absorbed into the bloodstream, especially when used over large areas or for extended periods. This can lead to systemic side effects, meaning they affect the body beyond the skin.


Potential Systemic Effects:

  • Adrenal Suppression – Long-term steroid use can interfere with the adrenal glands' ability to produce cortisol, a hormone essential for stress response and metabolism. This can lead to steroid withdrawal syndrome, characterized by fatigue, dizziness, and body aches when steroids are discontinued.

  • Hormonal Imbalances – Prolonged steroid use can disrupt natural hormone levels, potentially leading to weight gain, mood changes, and even menstrual irregularities.

  • Delayed Growth in Children – In young children, chronic steroid use has been linked to slower growth rates due to its effect on hormones.


How to Reduce the Risk: To minimize systemic absorption, avoid using steroids on large body areas or under occlusion (such as wrapping the area with plastic). Always follow medical advice regarding dosage and duration.



eczema and psoriasis


4. Topical Steroid Withdrawal (TSW)


One of the most severe side effects of long-term steroid use is Topical Steroid Withdrawal (TSW), also known as Red Skin Syndrome. This occurs when the body becomes so reliant on steroids that stopping them results in extreme withdrawal symptoms.


Symptoms of TSW:

  • Severe Redness – Often described as "red sleeve syndrome," where affected areas turn bright red, inflamed, and hot to the touch.

  • Intense Burning & Itching – Many sufferers report unbearable discomfort that disrupts sleep and daily life.

  • Oozing & Flaking – The skin may leak fluid and shed excessively as it struggles to heal.

  • Skin Sensitivity & Pain – Even gentle touch or water exposure can cause pain.


Who’s at Risk?

  • Individuals who have used moderate-to-strong steroids for months or years

  • Those who have escalated their steroid use over time due to diminishing effectiveness

  • Patients who experience rebound flares when trying to stop steroids


Can TSW Be Treated? Recovery from TSW varies from person to person. Some opt for a strict “no moisture” approach, while others find relief through alternative therapies such as Cold Atmospheric Plasma (CAP) therapy, which promotes skin healing without steroids. The key is to allow the skin to recover naturally while managing symptoms safely.


Final Thoughts: Weighing the Risks

Steroids can be helpful in the short term, but they are not a long-term solution for eczema and psoriasis. If you are currently using topical steroids, consider discussing alternative treatments with your healthcare provider. Awareness and early intervention can prevent severe side effects and improve long-term skin health.


Key Takeaways:

✔ Long-term steroid use can cause permanent skin thinning ✔ Stopping steroids abruptly can lead to rebound flare-ups and dependence ✔ Systemic effects like adrenal suppression and hormonal imbalances are possible ✔ Topical Steroid Withdrawal (TSW) is a serious condition that can take months or years to heal ✔ Exploring non-steroidal treatments may provide safer, long-term relief

Understanding these risks empowers you to make informed decisions about your skin health. If you suspect you’re experiencing steroid side effects, seeking guidance early can help you transition to safer treatment options.



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