Topical Steroids: New Labelling and Severe Side Effects, Including Withdrawal Reactions

12 June, 2024

The Medicines and Healthcare products Regulatory Agency (MHRA) has introduced new labelling requirements for topical steroids, along with a reminder about the potential for severe side effects, including topical steroid withdrawal reactions.

This update is crucial for healthcare providers and patients to ensure the safe use of these medications.


Topical steroids are commonly used to treat a variety of skin conditions due to their anti-inflammatory properties. However, their misuse or overuse can lead to severe side effects. The MHRA’s new labelling requirements aim to improve patient awareness and safety regarding these medications.

New Labelling Requirements

  • Clear Warnings: The new labels will include clear warnings about the risks of prolonged use and the potential for severe side effects.
  • Usage Instructions: Detailed instructions on proper application and duration of use will be provided to prevent misuse.

Severe Side Effects of Topical Steroids

  • Skin Thinning: Prolonged use can cause skin thinning (atrophy), making the skin more susceptible to injuries.
  • Stretch Marks: Overuse can lead to the development of permanent stretch marks (striae).
  • Infection Risk: Topical steroids can suppress the local immune response, increasing the risk of skin infections.

Topical Steroid Withdrawal Reactions

  • Symptoms: Withdrawal reactions can occur when topical steroids are discontinued after prolonged use. Symptoms include redness, burning, and stinging of the skin, often referred to as “red skin syndrome” or “topical steroid withdrawal syndrome.”
  • Risk Factors: These reactions are more common in patients who have used high-potency steroids for extended periods.

Guidance for Healthcare Providers

  • Educate Patients: Healthcare providers should educate patients on the correct use of topical steroids and the importance of adhering to prescribed treatment durations.
  • Monitor Usage: Regular monitoring of patients using topical steroids, especially those on long-term or high-potency treatments, is essential to prevent adverse effects.
  • Manage Withdrawal: In cases of withdrawal reactions, healthcare providers should offer support and alternative treatment options to manage symptoms effectively.

Recommendations for Patients

  • Follow Prescriptions: Patients should follow the prescribed dosage and duration of use for topical steroids to minimise risks.
  • Report Side Effects: Any adverse effects or withdrawal symptoms should be reported to healthcare providers immediately.
  • Avoid Self-Medication: Patients should avoid using topical steroids without medical advice, especially for prolonged periods.


The introduction of new labelling for topical steroids by the MHRA is a significant step towards enhancing patient safety. By raising awareness of the severe side effects and the potential for withdrawal reactions, healthcare providers and patients can work together to use these medications responsibly and effectively.


Read more: Topical steroids: introduction of new labelling and a reminder of the possibility of severe side effects, including Topical Steroid Withdrawal Reactions – GOV.UK (

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