BRITS who use a common skin cream could be at risk of a life-threatening complication, experts have warned.
Patients who lather on topical steroids to treat conditions like eczema and psoriasis are at risk of adrenal suppression, according to UK medicine’s watchdog.
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The condition, also called Addison’s disease, happens when the gland responsible for producing the essential hormones cortisol and aldosterone get damaged.
It can arise from “overuse of topical steroids […] is life-threatening” and “needs urgent treatment”, the Medicines Healthcare and Regulatory Agency (MHRA)
About 10.5million tubes of topical steroids – at varying degrees of strength – are prescribed yearly to patients with different skin ailments.
The new warning, published this week, comes after 267 people reported reactions similar to topical steroid withdrawal (TSW) over the last two years via the Government’s Yellow Card Scheme.
TSW refers to a combination of symptoms that may emerge days, weeks, and months after a person stops using certain medications.
Typical signs include skin redness, burning, stinging, intense itching, peeling of the skin or oozing open sore.
They happen because the body becomes reliant or addicted over a long period.
What is Addison’s disease?
Addison’s disease is a rare illness affecting the adrenal glands, which produce the essential hormones cortisol and aldosterone.
The disease is usually a result of problems with the immune system.
It damages the gland and prevents it from producing enough of either of the hormones.
Around 9,000 people have the disorder in the UK, with more than 300 new cases diagnosed each year.
Symptoms include fatigue, muscle weakness, low mood, loss of appetite or unintentional weight loss and increased thirst.
Over time, you may also experience:
- dizziness
- fainting
- cramps
- exhaustion
It is treated with medicine to replace the missing hormones, which must be taken for the rest of the sufferer’s life.
The NHS states that the condition can affect people of any age, although it’s most common between the ages of 30 and 50.
It’s also more common in women than men, guidance states.
If you are worried about any of your symptoms you should see your GP.
In the event of an emergency, always call 999 or visit your nearest A&E department
After a separate report by the MHRA in 2021, guidance on the risks of TSWs is now included as patient information with all topical steroids.
Despite this, TSW is still not a properly recognised condition.
Patients also reported suffering from other side effects, including skin thinning, generalised pustular psoriasis, Cushing’s syndrome – which happens when there is too much cortisol in the body.
In response to the new report, the MHRA said the cream will be labelled with more information about its strength and the associated risks.
It said the changes aim to help patients avoid “important risks” associated with long-term high-potency topical steroids.
It added that while “topical steroids are highly effective…when prescribed and used appropriately”, they can “rarely lead to serious side effects”.
What is topical steroid withdrawal?
THE term ‘topical steroid withdrawal’ refers to a combination of symptoms that may emerge in the days, weeks and months after a person stops using certain medications.
They happen because the body becomes reliant, or addicted, over a long period of time.
The potentially debilitating symptoms of TSW can include:
- Burning
- Weeping
- Flaking
- Shedding
- Peeling
- Spreading
- Swelling
- Redness
- Wrinkling
- Thin skin
- Pus-filled bumps
- Cracking
- Itching
- Nodules
- Pain
- Insomnia
- Hair loss
- Shivering
- Fatigue
- Depression
- Disability
Treatment
The skin should eventually return to normal, but it may take time.
If you are worried, speak to your GP.
They could offer:
- Over-the-counter pain relievers
- Oral corticosteroids to help taper off topical steroids
- Light therapy
- Antibiotics, if your skin becomes infected
Source: the National Eczema Association and the Independent Pharmacy