Systematic Review of the Topical Steroid Addiction and Topical Steroid Withdrawal Phenomenon in Children Diagnosed with Atopic Dermatitis and Treated with Topical Corticosteroids

Background A 2015 National Eczema Association study concluded that topical steroid withdrawal is an effect of prolonged, frequent use of topical steroids occurring mostly in adult women. It is unclear whether children develop topical steroid withdrawal. Objective The aim of this study was to assess current evidence regarding topical steroid withdrawal in children. Methods This study is a systematic review of medical literature as well as online social media sites and blogs regarding topical steroid withdrawal in children. Results Literature search yielded zero studies on/or reporting classic topical steroid withdrawal in children; however, periorificial dermatitis, which is generally a steroid-induced disorder in children, was reported in >320 cases. Of 142 social media blogs on topical steroid withdrawal, 26 were blogs discussing children. Twenty-seven cases were included in this review. Length of topical steroid use ranged from 2 months to 12 years. Conclusions Topical steroid withdrawal occurs in children and can result from discontinuing topical steroids used for as little as 2 months. Resultant signs/symptoms can last >12 months, even with short duration of use. Clinicians and caregivers should be aware of this possible adverse effect of topical steroids and monitor the effects of topical steroids on infants/children, but more data are needed on this condition.