### What is Topical Steroid Withdrawal (TSW)? Topical Steroid Withdrawal (TSW), also known as topical steroid addiction or red skin syndrome, is a condition that can occur when people stop using topical steroid creams after prolonged use. These creams are commonly prescribed for eczema (atopic dermatitis) to reduce inflammation and itching. However, overuse or misuse of these creams can lead to negative side effects, including TSW. ### Symptoms of TSW Symptoms of TSW can include burning, weeping (skin oozing liquid), flaking, shedding, peeling, spreading, swelling, redness, wrinkling, thin skin, pus-filled bumps, cracking, itching, nodules, pain, insomnia, hair loss, shivering, fatigue, depression, and disability. ### Why is TSW Controversial? The diagnosis of TSW is controversial because not all doctors agree that it is a real condition. Some doctors believe that the symptoms attributed to TSW are actually due to the underlying skin condition not being adequately controlled. There is also a lack of extensive research on TSW, making it difficult to diagnose and treat. ### How to Use Topical Steroids Safely To avoid the risk of developing TSW, it is important to use topical steroids as prescribed by a healthcare professional. This usually involves using the appropriate strength for the affected area and not using high-potency steroids for more than two to four weeks. It is also important to gradually taper off the medication rather than stopping abruptly. ### Conclusion If you suspect you have TSW, it is important to advocate for yourself and seek medical advice. Do not hesitate to get a second opinion if your symptoms are dismissed. Always use medications as directed and be aware of the potential side effects. Stay informed and take control of your health.