Topical corticosteroids can treat inflammatory skin conditions, such as eczema. In rare cases, an individual may experience withdrawal symptoms after they stop using a topical corticosteroid. This is known as topical steroid withdrawal (TSW).

Topical corticosteroids for eczema come in a range of strengths. Mild versions are available over the counter (OTC), and more potent versions are available via prescription.

This article explores what eczema is, what topical steroids are, and what TSW is. It also discusses when to contact a doctor and answers some frequently asked questions.

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Eczema is a chronic inflammatory skin condition. The most common type of eczema is atopic dermatitis. The condition can range from mild to severe, with people typically experiencing flare-ups, in which the symptoms can intensify for days or weeks.

The symptoms of eczema can vary among people but typically include itchy skin. The itching can sometimes be intense and cause people to scratch their skin, which in turn may worsen the symptoms.

Other symptoms of eczema include:

In lighter skin, eczema patches may appear red, while in darker skin, eczema patches may appear gray, purple, or dark brown.

Learn more about eczema on skin of color here.

Topical steroids are anti-inflammatory formulations that come in several different forms, such as:

  • creams
  • lotions
  • ointments
  • gels

People can apply topical steroids directly to the skin. They are the most common medication for the treatment of eczema.

Researchers are currently not sure of the precise causes of eczema, although evidence suggests that an overactive immune system, genetics, and environmental factors all play a part.

Topical steroids are effective as a treatment for eczema because they can suppress the overactive immune system and reduce inflammation.

They range in strength from mild to ultra-high potency. Different strengths of topical products may include the same active ingredients in different concentrations.


Lower concentrations and amounts of topical steroids pose less risk of side effects when the body absorbs the steroid.

If a person’s eczema affects large areas of their skin, a doctor may suggest a milder topical steroid, as the person will need to use more of it. Someone with mild eczema symptoms may also benefit from a mild strength topical steroid.

Types include:


Doctors may prescribe moderate to high strength topical steroids to treat folded areas of skin that may rub and cause irritation, such as the armpits and backs of the knees, or areas that have thin skin, such as the eyelids.

Types include:


Strong topical steroids may be more effective for treating eczema in areas where a person’s skin is thicker, such as the palms and soles. A doctor may also prescribe high strength topical steroids for someone with severe eczema.

Types include:

  • mometasone furoate
  • betamethasone dipropionate
  • diflorasone diacetate


A doctor may prescribe very high potency topical steroids for people whose eczema did not respond to high strength treatment.

Types include:

  • clobetasol propionate
  • halobetasol propionate
  • flurandrenolide

Some people may experience TSW within days or weeks of stopping treatment. This may lead to symptoms that are worse than those of their original skin condition.


People who experience TSW often have skin that has returned to its natural state without eczema before they stop treatment. Symptoms that may develop after ending treatment can include:

  • scaly, dry skin
  • thick, hardened skin
  • lesions
  • itching
  • discoloration
  • skin sensitivity
  • excessive sweating
  • burning and stinging

Other symptoms may include:


Researchers do not know what causes TSW. More research and data are necessary to determine the causes, the number of people who develop TSW, and how much topical steroid a person would need to use to develop the condition.

Researchers have found that people who use topical steroids over a long period of time, and those who use moderate to high strength topical steroids daily, are at higher risk of developing TSW. These people are also at risk of skin thinning.


Researchers have not developed a standard treatment for TSW. A doctor will typically advise a person to stop using the steroid medication and let their skin heal over time. The effectiveness of this strategy can vary among individuals.

A doctor may prescribe a course of oral steroids to help with TSW. They will gradually reduce the strength of these drugs throughout treatment.

Research suggests that a medication called dupilumab, which treats eczema and asthma, may help treat TSW, but more research is necessary. Additionally, the Food and Drug Administration (FDA) has not approved the medication for this use.

A person who experiences any symptoms of TSW should contact their doctor to rule out other causes and seek treatment. They should not stop taking or change how they use any medication their doctor has prescribed without discussing it with them first.

Someone with severe eczema symptoms may also contact a doctor to discuss treatment, as OTC treatments may not be effective. Eczema treatment can reduce the severity of symptoms, but there is no cure.

People who are experiencing pain or discomfort that interferes with their day-to-day life or sleep schedule should speak with a doctor.

Below are some of the most common questions about TSW and eczema.

How common is topical steroid withdrawal in people with eczema?

Experts do not know exactly how many people develop TSW or what percentage of people who use topical steroids develop the condition. Researchers believe it occurs in rare cases.

How long does topical steroid withdrawal last?

People can experience TSW for different amounts of time. The withdrawal symptoms may last from days to years, and a person’s skin may take from weeks to years to return to its usual state.

Does topical steroid withdrawal go away?

Yes, TSW can go away if a person stops using topical steroids completely and permanently. However, a person should not stop using topical steroids without consulting a doctor.

Topical steroids are a common treatment for eczema. They range in strength and are available in various forms, including creams, lotions, gels, and ointments. Mild topical steroids are available OTC, and a doctor can prescribe higher potency treatments.

People who use moderate to high strength topical steroids daily, or use topical steroids over a long period of time, are at greater risk of developing TSW. Symptoms may include itching, burning, lesions, and insomnia.

Researchers do not know what the exact causes of TSW are. People are at lower risk of developing TSW when they use low concentration topical steroids over a short time period.