What is the evidence based protocol for tapering off topical Corticosteroids? And when to consider tapering off instead of discontinuing abruptly? After 2 months for example?
It depends on which corticosteroid the patient is on, how much the patient has been taking and how long the patient has been taking it.
The factors like potency, frequency, duration, etc. of TCs determine the withdrawl effects. Tapering of TCs could be done by applying On-and-Off days slowly.
I think it depends on the type of that topical steroid, potency, duration, combination with other drugs... but in general tapering may be needed after 1 month of it use to be on the safe side.
Tappering of TC is not recommened in most skin diseases, as prolonged use of TC beside their side effects, there is a risk of tackphylaxis. If u want to tapper Tc so either change it to lower concentration or lower potency ,or alternate day applicalion.
In most cases it depends on chronicity of disease and how much the treated body part is susseptible to corticosteriods side effects.
Gradual tapering of topical corticosteroids program :
Day 1: You apply the steroid creams .
Days 2–3: Steroid-free days.
Day 4: You apply the steroid creams .
Days 5–6: Steroid-free days
And so on.
Dear Mostafa Elsersy , topical steroids were previously classified to potent and ultrapotent then a new classification raised accordng to veihicle from group one clobetasol proprionate to hydrocotione group 7. if we apply group one to 40% of skin under occlusion , cortisol mornning level affected, i.e in usual applictions to topical steroids cotisol ML not affected, then no need for tappering.
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