---

Skin Diseases: Steroid Drugs

Answer

The decision to prescribe a particular drug is a clinical one, and should be based on the patient’s medical needs. Decisions about what medicines to prescribe are made by the doctor or healthcare professional responsible for that part of the patient’s care, and prescribers are accountable for their prescribing decisions, both professionally and to their service commissioners. It is for the general practitioner or other responsible clinician to work with their patient and decide on the course of treatment, with the provision of the most clinically appropriate care for the individual always being the primary consideration.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for continually monitoring the safety of medicines and taking action to minimise risks to patients where necessary. The MHRA has reviewed topical steroid withdrawal reactions, and first communicated about these reactions in September 2021. This communication is available at the following link:

www.gov.uk/drug-safety-update/topical-corticosteroids-information-on-the-risk-of-topical-steroid-withdrawal-reactions.

Since then, the MHRA has continued to monitor reports of topical steroid withdrawal reactions and has undertaken a further review, which was published in May 2024. This review is available at the following link:

www.gov.uk/drug-safety-update/topical-steroids-introduction-of-new-labelling-and-a-reminder-of-the-possibility-of-severe-side-effects-including-topical-steroid-withdrawal-reactions.

Further advice has been sought from dermatologists, the National Eczema Society, and the Commission on Human Medicines, and the MHRA is taking forward a number of actions, including updated warnings in the product information and the inclusion of information regarding the potency of topical steroids on the packaging. The MHRA is engaging with the British Association of Dermatologists who have released an updated statement. The statement is available at the following link:

https://cdn.bad.org.uk/uploads/2024/02/22095550/Topical-Steroid-Withdrawal-Joint-Statement.pdf.

Topical corticosteroid product information contains the following warnings about the dangers of long-term use: ‘Long-term use of topical steroids can result in the development of rebound flares after stopping treatment (topical steroid withdrawal syndrome). A severe form of rebound flare can develop which takes the form of a dermatitis with intense redness, stinging and burning that can spread beyond the initial treatment area. It is more likely to occur when delicate skin sites such as the face and flexures are treated. Should there be a reoccurrence of the condition within days to weeks after successful treatment a withdrawal reaction should be suspected. Reapplication should be with caution and specialist advise is recommended in these cases or other treatment options should be considered’.

Secondary information

Type

Written question

Reference

13769

Session

2024-26

Subjects

Steroid drugs Skin diseases

Link

View this Written question on www.parliament.uk