Skin burning after corticosteroids: how to recognize and relieve this little-known syndrome?

What is red skin syndrome? 

Definition

Red skin syndrome, also known as red burning skin syndrome, steroid dermatitis, topical steroid rebound phenomena (TSRP), and topical steroid withdrawal (TSW), is a skin reaction associated with the use or withdrawal of corticosteroids. It differs from other skin conditions such as eczema or psoriasis in the intensity of the burning sensation and extreme skin sensitivity. This reaction can occur after both topical and systemic use of corticosteroids and is often underestimated.

When does it occur? 

Red skin syndrome usually occurs after abruptly stopping corticosteroid treatment or after prolonged use. Individuals with sensitive skin or a history of skin conditions are particularly at risk. Symptoms may appear a few days or weeks after discontinuing treatment, making it difficult to recognize without medical supervision.

Causes and risk factors 

Prolonged use of corticosteroids 

Corticosteroids are effective at reducing inflammation, but prolonged use can weaken the skin. The skin barrier becomes thinner, more fragile, and less resistant to external aggressions, which increases the risk of severe reactions such as red skin syndrome.

Withdrawal or sudden discontinuation 

Suddenly stopping corticosteroids can trigger a rebound effect, causing redness, heat, and burning on the treated areas. The skin, accustomed to the anti-inflammatory action of corticosteroids, reacts excessively when they are withdrawn. Gradual withdrawal, supervised by a healthcare professional, is essential to limit the intensity of symptoms.

Other risk factors 

Some people have more sensitive skin, while others have a history of skin conditions that predispose them to severe reactions. The combination of these factors with prolonged corticosteroid treatment or abrupt discontinuation significantly increases the risk of developing red skin syndrome.

Symptoms to look out for 

Redness and inflammation 

The skin becomes very red and irritated, often in a diffuse pattern. This redness may be accompanied by warmth in the affected area and a burning sensation.

Burning and itching 

Those affected describe an intense burning sensation, sometimes accompanied by severe itching. These symptoms can make everyday activities uncomfortable and affect sleep.

Fragile and irritated skin

The skin becomes extremely fragile, prone to flaking and irritation. With the skin barrier compromised, it reacts quickly to external factors such as friction or temperature changes.

Treatment and solutions to relieve the skin

Gentle care and hydration 

It is essential to use gentle, moisturizing skincare products to restore the skin barrier. Repairing creams and certain oils can soothe the burning sensation and improve skin comfort.

Consultation with a dermatologist 

A dermatologist can assess the condition of your skin and recommend a personalized treatment. In some cases, specific treatments may be prescribed to calm inflammation and help with healing.

Gradual withdrawal from corticosteroids 

Gradually reducing the dose of corticosteroids under medical supervision helps limit the intensity of symptoms and prevent red skin syndrome. Patience and professional support are essential for optimal recovery.

Prevention and best practices

Limit long-term use of corticosteroids

Using corticosteroids only as prescribed by a doctor and for the recommended duration reduces the risk of skin conditions as side effects.

Follow medical advice

It is crucial to strictly follow your doctor's instructions for withdrawing or reducing treatment. Withdrawal too quickly can trigger severe red skin syndrome.

Recognize early signs 

Quickly identifying the first signs of burning, redness, or skin fragility allows for early intervention and prevents symptoms from worsening.

Key Takeaways

• Red skin syndrome is a skin reaction associated with long-term use or withdrawal of corticosteroids.
• It manifests as intense redness, burning, itching, and skin fragility.
• Risk factors include prolonged use, abrupt withdrawal, and individual skin sensitivity.
• Gentle care, moisturizing, and treatments prescribed by a dermatologist are essential for relieving the skin.
• Gradual withdrawal of corticosteroids reduces the intensity of symptoms and promotes recovery.
• Prevention requires strict adherence to medical instructions and early detection of signs of burning or skin fragility.
• Medical follow-up is essential for appropriate care and to avoid complications.

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