Can some patients' bodies become 'addicted' to topical steroids?

(Akron Beacon Journal / Tribune News Service)

Emily Bennett's 9-year-old son's history of eczema began when he was 6 or 7 months old. At first, the pediatrician recommended over-the-counter hydrocortizone creams. When that didn't help, he was prescribed a topical corticosteroid cream, but his eczema continued to worsen.

Over the years, with visits to several specialists, he was prescribed more topical steroid creams of different potencies for different parts of his body a very mild one for his eyelids, a somewhat stronger type for the tops of his ears, another for face and neck only, a total of seven different types. Bennett and her husband, who live in Erie, carefully followed the rules for application of the creams, as well as other therapies.

Their son was tested for allergies he is allergic to peanuts and has asthma and the family has tried special diets and given him probiotics.

In February, when he had a big "flare," as a resurgence of eczema is called, his mother says she noticed something different.

"This isn't eczema anymore," she said to herself. Her son's skin was red in a way it hadn't been before.

As she did research and talked with other parents, she and her husband became convinced the topical corticosteroids they had been faithfully applying under the care of a doctor were not only not helping their son, they might actually be doing harm. They concluded that his body had become addicted to the prescription medicines.

Do a little research about topical steroid addiction, and you'll quickly discover it's a controversial subject. Mainstream physicians point to the overwhelming benefits of topical corticosteroids for patients with eczema, also called atopic dermatitis. While there is no cure for the disease, they say the medicine controls the inflammatory flares and prevents terrible suffering in children and adults. For reasons not understood, eczema affects about 18 percent of children but only 3 percent of adults; most children grow out of it.

On the other hand, some patients say the drugs themselves have caused damage, often manifested in Red Skin Syndrome, in which the blood vessels in their skin remain dilated. In getting off the topical steroids, they report months- to years-long suffering from withdrawal in which they endure maddening itching, painful "stingers" and skin that flakes and oozes, producing a metallic odor. They say these symptoms occur on parts of their skin that were previously not affected by eczema because the skin is one organ and the withdrawal can be felt in many areas.

A large part of the medical community views some, although not all, of the reported symptoms as simply a recurrence of eczema, which, they point out is a chronic disease with no cure, whose difficult symptoms are ameliorated by topical steroids and other measures.

The rest is here:
Can some patients' bodies become 'addicted' to topical steroids?