Treatment of Topical Steroid Abuse on the Face

Supportive Skincare

• Apply alcohol-free moisturizing creams or ointments twice daily, preferably containing urea (5%-10%) 1, 2
• Use soap-free shower gel and/or bath oil 3, 4
• Avoid hot water, alcoholic solutions, and harsh soaps 3, 4
• Avoid all skin irritants, solvents, and disinfectants 5, 2

Managing Withdrawal Symptoms and Complications

• Topical calcineurin inhibitors (tacrolimus 0.03%-0.1% ointment or pimecrolimus 1% cream) can be used as steroid-sparing agents for facial inflammation 6
• Oral tetracycline antibiotics for at least 6 weeks: doxycycline 100 mg twice daily OR minocycline 50-100 mg twice daily 1, 2
• Topical antibiotics (clindamycin 2% or erythromycin 1% cream or metronidazole 0.75%) for localized lesions 3, 8
• Oral H1-antihistamines: cetirizine, loratadine, fexofenadine, or clemastine 3, 8, 4

Secondary Infections

• Obtain bacterial/fungal cultures if infection is suspected 1, 2
• Antiseptic solutions (aqueous chlorhexidine 0.05% or povidone-iodine) for erosive lesions 6
• Appropriate antimicrobial therapy based on culture results 1, 2

Reassessment Timeline

• Reassess after 2 weeks to evaluate response and adjust therapy 3, 8, 1, 2