“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.
Depending on the number and character of their functional groups, steroid molecules may show diverse reactivities. Moreover, the reactivity of a functional group varies according to its location within the molecule (for example, esters are formed readily by 3-OH groups but only with difficulty by the 11β-OH group). An important property of steroids is polarity —., their solubility in oxygen-containing solvents (., water and alcohols ) rather than hydrocarbon solvents (., hexane and benzene ). Hydroxyl, ketonic, or ionizable (capable of dissociating to form electrically charged particles) groups in a steroid molecule increase its polarity to an extent that is strongly influenced by the spatial arrangement of the atoms within the molecule.
If you have had a previous fragility fracture, you will usually be offered treatment with medicines to prevent steroid-induced osteoporosis if you are prescribed long-term steroid tablets. This is regardless of your age. If you are an older person, you will also usually be offered preventative treatment with medicines even if you have not had a previous fragility fracture. The medicine usually used to prevent steroid-induced osteoporosis is one of a group of medicines called bisphosphonates. For more information about these medicines, see the separate leaflet called Bisphosphonates. There is evidence that these medicines can improve bone strength and reduce the risk of some fractures for people taking steroid medicines.