Topical Steroid Withdrawal: Perspectives of Dutch Healthcare Professionals

Topical steroid withdrawal (TSW) is a highly controversial condition, typically reported following prolonged and/or frequent use of topical corticosteroids. Despite growing public awareness, knowledge of topical steroid withdrawal remains limited. Therefore, this study aimed to explore the perspectives of Dutch healthcare professionals (HCPs) on topical steroid withdrawal. A web-based survey was conducted among 168 Dutch HCPs. The results show that erythema (64.1%) and a burning sensation (60.3%) were the most frequently selected symptoms associated with TSW. The majority of respondents (69.6%) attributed TSW symptoms to atopic dermatitis (AD) flares and/or the adverse effect of topical corticosteroid use. Only a small percentage (12.2%) firmly believed that TSW is a distinct clinical entity, while 17.6% believed that it does not exist. Preferred treatments included using other topical immunomodulators, reinitiating and subsequently tapering topical corticosteroids, and providing non-drug and psychological support. While HCPs felt confident in addressing concerns about topical corticosteroids and topical steroid withdrawal, approximately one-quarter (24.2%) preferred not to treat patients refusing topical corticosteroids. This study highlights variations in perception among HCPs and the need for robust research to establish clear diagnostic criteria and guidelines regarding TSW. Finally, improved awareness and open communication between HCPs and patients are essential when addressing topical steroid withdrawal.