Cessation of Long-term Topical Steroids in Adult Atopic Dermatitis: A Prospective Cohort Study
Belinda Sheary, Mark Harris
Abstract
BACKGROUND: Although there is much interest in social media about topical steroid withdrawal, little is known about what happens to people who cease long-term topical steroid use. OBJECTIVE: The aim of this study was to examine outcomes in adults with a history of atopic dermatitis who were concerned about topical steroid withdrawal and decided to stop using topical steroids. METHODS: Twenty-four participants were recruited from an Australian online support group, and they were emailed a series of questionnaires over 2 years. RESULTS: Stopping topical steroid use had a large impact on the participants' quality of life for many months. Overall, participants' incidence and severity of symptoms decreased over the study period, and their Dermatology Quality of Life index scores improved. The majority reported their skin symptoms either had resolved or had only a small effect on their lives 2 years later. However, individuals' quality of life scores fluctuated, and in every questionnaire, large ranges in scores were seen, demonstrating that the experiences of participants differed considerably. CONCLUSIONS: Counseling patients who are considering discontinuing long-term use of topical steroids regarding their prognosis is difficult as outcomes vary. However, many will improve significantly over the first 2 years.