Topical steroid withdrawal psoriasis

Occlusive Dressing Technique

Occlusive dressings may be used for the management of psoriasis or other recalcitrant rub a small amount of cream into the lesion until it disappears. Reapply the preparation leaving a thin coating on the lesion, cover with pliable nonporous film, and seal the edges. If needed, additional moisture may be provided by covering the lesion with a dampened clean cotton cloth before the nonporous film is applied or by briefly wetting the affected area with water immediately prior to applying the medication. The frequency of changing dressings is best determined on an individual basis. It may be convenient to apply Triamcinolone acetonide cream under an occlusive dressing in the evening and to remove the dressing in the morning (., 12-hour occlusion). When utilizing the12-hour occlusion regimen, additional cream should be applied, without occlusion, during the day. Reapplication is essential at each dressing change. If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted.

References: 1. Bikowski J, Pillai R, Shroot B. The position not the presence of the halogen in corticosteroids influences potency and side effects. J Drugs Dermatol . 2006;5(2):125-130. 2. Del Rosso J, Friedlander SF. Corticosteroids: options in the era of steroid-sparing therapy. J Am Acad Dermatol . 2005; 53(1 Suppl 1):s50-s58. 3. US Food and Drug Administration NDA 017765. Promius Pharma, LLC, Princeton, NJ: Aug 1977. 4. Rosenthal AL. Clocortolone pivalate: a paired comparison clinical trial of a new topical steroid in eczema/atopic dermatitis. Cutis . 1980;25(1):96-98. 5. Kircik LH. A study to assess the occlusivity and moisturization potential of three topical corticosteroid products using the skin trauma after razor shaving (STARS) bioassay. J Drugs Dermatol . 2014;13(5):582-585. 6. Cloderm [package insert]. Princeton, NJ: Promius Pharma, LLC; 2017.

The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.

Each user experiences their own unique feelings when using steroids and coming off the drug. When someone chooses to stop using they can experience a variety of withdrawal symptoms linked to addiction. Symptoms can include mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, the desire to take more steroids, and depression. Evidence for steroid addiction is certainly not as strong as it is for other drugs like cocaine or heroin. Though it is clear that people develop a tolerance and dependence on them and willingly experience negative consequences when using steroids - both of which are signs for drug dependence.

Topical steroid withdrawal psoriasis

topical steroid withdrawal psoriasis

Each user experiences their own unique feelings when using steroids and coming off the drug. When someone chooses to stop using they can experience a variety of withdrawal symptoms linked to addiction. Symptoms can include mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, the desire to take more steroids, and depression. Evidence for steroid addiction is certainly not as strong as it is for other drugs like cocaine or heroin. Though it is clear that people develop a tolerance and dependence on them and willingly experience negative consequences when using steroids - both of which are signs for drug dependence.

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