Despite being vital for treating inflammatory skin conditions, topical corticosteroids (TCS) are often misunderstood, Dr. Pooja Aggarwal debunks common myths and clarifies their safe and effective use.

By Deepika Khurana

Topical corticosteroids (TCS) are essential treatments for various inflammatory skin conditions but are often misunderstood. Here’s a breakdown of common myths and facts surrounding their use, clarified by Dr. Pooja Aggarwal, Senior Consultant - Dermatology, Artemis Hospitals:

Myth: Steroids cannot be used on broken skin or at the same time as any other cream.

Fact: Steroids can be used on broken skin under medical supervision. Simultaneous use with other creams is often acceptable if recommended by a healthcare professional, ensuring compatibility and effectiveness.

Myth: Steroids cause weight gain, suppress the immune system, prevent skin healing, and should be stopped after a few days.

Fact: Steroids can lead to weight gain and suppress the immune system, especially with long-term use. They may slow skin healing, depending on the type and application. Duration of use should follow the doctor's guidance; abrupt cessation of systemic steroids can be harmful and should be tapered off gradually under medical supervision.

Myth: Topical steroid withdrawal, ‘Red skin syndrome’, or ‘TCS addiction’ are not real.

Fact: 'Red skin syndrome' or 'TCS addiction' refers to prolonged use causing skin redness, burning, and worsened symptoms upon stopping. Though not universally acknowledged, some patients report severe withdrawal symptoms. Proper use under supervision is generally safe; complications from misuse are rare.

Myth: Long-term use of topical steroids has no significant side effects.

Fact: Long-term use can cause skin thinning, easy bruising, stretch marks, discoloration, small blood vessels (telangiectasia), and increased hair growth. High-potency types can lead to systemic effects like hormonal imbalances and adrenal suppression. Proper medical supervision ensures effective treatment with manageable risks.

Myth: There is no maximum duration for using topical steroids.

Fact:  Duration varies based on steroid potency, condition treated, and individual factors. High-potency steroids should not be used continuously for more than 2-4 weeks. Lower-potency types can be used longer under supervision. Intermittent use with breaks may be needed for chronic conditions. Follow healthcare provider's guidance for safe and effective use.

Myth: Applying topical steroids is straightforward and doesn’t require specific instructions.

Fact: Apply as prescribed, using recommended amount and frequency. Limit duration to prevent long-term side effects. Apply thinly; a small amount is usually sufficient. Avoid sensitive areas unless directed. Check for adverse reactions. Gradually taper off under supervision to avoid withdrawal symptoms.

These insights empower patients to make informed decisions about their dermatological care. Always consult with a healthcare provider for personalised guidance and safe treatment.