Severe Eczema or Topical Steroid Withdrawal?!

Back in 2019, we were still unfamiliar with Topical Steroid Withdrawal (TSW) or Topical Steroid Addiction (TSA). We also believe many doctors and dermatologists are unaware that Steroids will cause addiction because steroids seem to effectively clear the flare-up skin.

On Parent’s day, July 28 , 2019, celebrated with a lunch buffet, but the day didn't go as planned. My daughter was shivering excessively and looked unwell, prompting a visit to the nearest GP.

Concerned by her extremely red skin and shivering, the doctor suggested hospitalization, noting that shivering could indicate potential sepsis—a life-threatening condition!

The doctor quickly wrote us the referral letter and we rush to the hospital. She was immediately admitted, and a group of dermatologist came to check her skin conditions, and perform various tests. They diagnosed it was an extreme and infected flare-up of atopic eczema.

We later learned that Red Skin Syndrome (RSS) and shivering is a common symptoms of Topical Steroid Withdrawal (TSW). Shivering is caused by the body’s inability to thermoregulate due to the effects of prolonged steroid use.

During her hospital stay, my daughter received heavy doses of steroids for three days. Her whole body was being buttered with steroids. Although we disliked the reliance on steroids, we were relieved to see her skin improve.

We were pleased when the doctors announced she could be discharged when they came to check her on the third day. We felt that the doctors and nurses were genuinely happy about my daughter’s recovery.

Usually, showering was agonizing for her, as the water felt like acid on her skin. Nevertheless, I ensured she bathed regularly to maintain hygiene and prevent infections.

Instead of screaming in pain, she joyfully sang in the bathroom for 45 minutes on her last day of hospital stay—a stark contrast to her usual quick showers of less than five minutes. I had to interrupt her when a nurse informed us that the bathroom was flooding.

Finally, she was discharged with a long prescription including:

Topical Steroids: Betamethasone 0.025%, 0.1%

Oral Steroids: Prednisolone 10 mg, 20 mg, 30 mg

Antibiotics: Tetracycline

Antihistamine: Hydroxyzine HCI 25 mg

Others: Asthma inhaler, paracetamol, supplements, moisturizer, shower gel,...

However, her clear skin lasted only about a month before her skin flared-up again...