I have a lot of respect for Dr. Peter Lio — at least he is trying to learn about and raising awareness about TSW — but this article is wrong on a couple fronts, already pointed out in other comments. This article puts the blame on patients for misuse of topical steroids, but the reality is that many doctors (the majority it seems) either don’t know about or don’t believe TSW is real, and they ignore the risks of steroids noted in the drug inserts. Many patients end up with TSW after relying on their doctors’ guidance. We did.
“Topical steroid addiction” seems related to an inappropriate, excessive use of topical steroids, which is “abuse” – rather than correct “use”. It may arise especially when topical steroids are relatively easily available and are used without proper conventional and on-going dermatological advice, over very long periods.
Paradoxically another psychiatric term is used in this context: “steroid phobia”- a phobia being an irrational fear associated with avoidance behaviour. It is easy to see how hearing about “steroid addiction” can lead to “steroid phobia”.
Atopic eczema has no single cause: it originates from multiple causes, and the best treatment outcomes are based on this understanding. Conventional dermatological wisdom remains firm that topical steroids have an important part to play in the correct treatment of atopic eczema, and it is much more often their under-use, rather than their over use, that explains treatment failure.