Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent assessment his Department has made of the potential impact of topical steroid creams on (a) physical dependency and (b) withdrawal effects among users.

The Medicines and Healthcare products Regulatory Agency (MHRA) has reviewed topical steroid withdrawal (TSW) reactions, and first communicated about these reactions in September 2021 through our Drug Safety Update, which is widely disseminated among health care professionals. This communication is available at the following link:

www.gov.uk/drug-safety-update/topical-corticosteroids-information-on-the-risk-of-topical-steroid-withdrawal-reactions.

The MHRA has continued to monitor reports of TSW and undertook an additional review in 2024, which can be found at the following link:

www.gov.uk/drug-safety-update/topical-steroids-introduction-of-new-labelling-and-a-reminder-of-the-possibility-of-severe-side-effects-including-topical-steroid-withdrawal-reactions.

During this review, further advice was sought from dermatologists, the National Eczema Society, and the Commission on Human Medicines. Consequently, the MHRA took forward a number of actions, including ensuring that there are updated warnings in the product information that is supplied with the creams, and the inclusion of information regarding the potency of topical steroids on the packaging. The British National Formulary (BNF) has updated their topical steroids potency information in line with the outcomes of the MHRA’s review. The BNF’s treatment summary for topical corticosteroids is available at the following link:

https://bnf.nice.org.uk/treatment-summaries/topical-corticosteroids/

Furthermore, the MHRA engaged with the British Association of Dermatologists who have released an updated statement that is available at the following link:

https://cdn.bad.org.uk/uploads/2024/02/22095550/Topical-Steroid-Withdrawal-Joint-Statement.pdf

Following these discussions, the British Association of Dermatologists has formed a Topical Steroid Withdrawal Working Party Group (TSW WP) in collaboration with National Eczema Society, Scratch That, the Primary Care Dermatology Society, and the British Dermatological Nursing Group. The objective of the TSW WPG is to develop expert consensus guidance on supporting people with concerns about TSW, including a Patient Information Leaflet, and any revision to the above joint statement, as appropriate. Further information on the TSW Working Party Group is available at the following link:

https://www.bad.org.uk/topical-steroid-withdrawal-joint-statement/