PS16 Attitudes and perceptions of topical steroid withdrawal among dermatologists and patients: a scoping review

Abstract

Topical corticosteroids are a mainstay of dermatological therapy and are widely regarded as safe and effective when used appropriately. However, in recent years, attention has been drawn to ‘topical steroid withdrawal’ (TSW), a contested phenomenon characterized by severe cutaneous and psychological symptoms following cessation of prolonged topical corticosteroid use. While patient narratives describing TSW have gained prominence, professional consensus regarding its legitimacy and definition remains limited. We aimed to map and critically examine the existing literature on attitudes, beliefs and perceptions surrounding TSW among dermatologists and patients. A scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported using the PRISMA-ScR framework. MEDLINE, CINAHL, PsycINFO and Web of Science were searched from inception to January 2026, alongside grey literature sources. Studies exploring clinician or patient attitudes, perceptions or experiences related to TSW were eligible for inclusion. Data were charted independently by two reviewers and synthesized narratively. Nineteen studies published between 2014 and 2025 were included, comprising surveys, qualitative studies, mixed-methods research, narrative reviews and analyses of online content. Five themes were identified: lack of consensus on TSW legitimacy and definition, divergent clinician and patient explanatory models, psychological and social impacts on patients, the role of online communities and social media, and corticophobia with clinical consequences. Clinician-focused studies frequently reported diagnostic uncertainty and concern about misinformation, while patient-focused literature framed TSW as a distinct, debilitating condition, often accompanied by perceived dismissal and mistrust. Social media emerged as a key driver shaping beliefs and amplifying discordance. TSW remains a polarizing and poorly defined concept, marked by a mismatch between clinician uncertainty and patient conviction. Although consensus on its classification is lacking, the relational and clinical consequences are tangible. Improved communication, preventive prescribing practices, patient-inclusive consensus building and high-quality research are needed to bridge perspectives and support patient-centred care.