A-Z of Corticosteroid Withdrawal: Pimples and Pustules

P is for Pimples, Pustules and Papules

I am quite glad that I have not actually experienced this symptom myself during steroid withdrawal, but from reading the itsan forum and the many articles written by dermatologists on the subject, it would seem that various types of spots on the skin are very common upon cessation of steroid creams.

Sometimes an individual can wake up to find their whole face covered in tiny red spots. This is obviously very distressing and frightening, as well as having the effect of making the person feel very self conscious.

Pustules can be a sign of folliculitis, which is an infection that occurs sometimes in people with TSW. Any kind of infection should be treated by a medical practitioner as soon as possible.

Here are some of the comments that people on the itsan forum have made on this subject:

"folliculitis is a fairly common sign and symptom of topical
steroid withdrawal/addiction. It consists of pustules, which are like
pimples, and a lot of us get those. It can be superficial (non-
infected) or deep where it would cause a boil from an infection. You
can see the difference in the two. If it looks like pimples, and they
go away over a few days, I wouldn't worry about it; only take caution
if it looks infected and causes a furuncle (boil), in that case
consider antibiotics definitely. Our normal flora is pretty imbalanced
and upset from the corticosteroids we used, so it can be easy for an
infection to occur; I would say the most important risk factor for
infection in us sufferers is that our skin protective barrier is
diminished. "


"J woke up spotty AGAIN grrrr!  Last night he had one little spot on his ear, and woke up this morning with the upper part of his face spotty, so off to the docs we trot this morning, and apparently he has folliculitus (that's a new one for us!) "


"About 4 months ago, I started getting these weepy bumps that were tender or itchy. They looked like pimples to a degree, but had an entirely different nature about them than I was used to (and goodness knows I had years of experience with acne). They couldn't be popped and they seemed to spread in clusters over my cheeks and chin."


So here we have yet another unsightly symptom of topical steroid withdrawal. Pimples can be caused by staph bacteria on the skin, which can get out of control, so great care is needed to keep the skin clean during TSW to keep the bacteria levels down. Luckily, the immune system should be better equipped to deal with infection as it no longer has steroids suppressing it, but severe infections may require antibiotics.