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Topical Steroid Concerns in Dermatology Highlighted in Nationwide Survey
This survey highlights several key findings related to patient concerns and caregiver concerns over topical steroids (TCS).
Approximately 9 in 10 adults and parents of children living with atopic dermatitis, plaque psoriasis, and seborrheic dermatitis being treated with topical steroids (TCS) express concerns over side effects, new data suggest.1
These findings and others were highlighted in a new release by Arcutis Biotherapeutics, Inc., following a national survey assessing perceptions of TCS use in dermatology.1 This nationwide survey was titled ‘Skin Insights: Steroid Perceptions in Chronic Inflammatory Skin Diseases,’ and it explored attitudes among caregivers toward steroid safety, whether care strategies emphasize short-term flare control or longer-term prevention, and clinician-patient communication.
“Psoriasis is a chronic disease that requires lifelong management — and much the same could be said of seborrheic dermatitis and eczema,” Leah M. Howard, JD, president and chief executive officer of the National Psoriasis Foundation, said in a statement.1 “This survey highlights an important trend: most treatment plans still focus on a reactive approach focused on taming flares, instead of a proactive, long-term disease management strategy to prevent flares.”
The national survey was conducted online and administered by Wakefield Research in August and September 2025 on behalf of Arcutis. It was also done in collaboration with the National Eczema Association and the National Psoriasis Foundation. The survey included adults in the US aged 18 years and older diagnosed with seborrheic dermatitis, atopic dermatitis, or psoriasis, as well as parents responding on behalf of their children meeting the same diagnostic criteria. All respondents had prescriptions for TCS.
Dermatologic diseases can often lead to notable psychological distress. These findings add to the overall understanding of patient concerns over treatment. The survey yielded several key results. These findings suggest many patients and caregivers continue to report frequent disease flares and rely on reactive treatment approaches instead of proactive management strategies. Other findings include:
- In the findings from 1000 adults and 500 parents evaluated, 72% of adults and 80% of children experienced uncontrolled symptoms at least once per month, with some noting daily flare occurrences.
- Consistent with this pattern, 79% of adults and 78% of parents believe their own or their child’s treatment plan is mainly focused on calming flares once they occur, rather than preventing flares via sustained disease control measures.
Topical corticosteroids continue to be a cornerstone of treatment for these conditions. In the release, every survey participant was shown to have a prescription for at least 1 topical steroid at some point. Investigators found 67% of adults and 57% of parents reported a prescription within the previous year. Despite TCS’s widespread implementation, concerns over steroid-related side effects were nearly universal:
- At least 1 potential short- or long-term adverse effect worried 88% of adults and 91% of parents.
- The most often cited concerns over TCS included skin thinning, noted among 59% of adults and among 55% of parents; hypopigmentation, noted by 46% and 51%, respectively; and acne, noted by 36% and 35%, respectively.
- Almost half of the survey respondents noted they were reluctant to discuss long-term steroid utilization with their clinician. This included 48% of adults and 45% of parents.
Investigators further highlighted the burden of uncontrolled disease and its extension well beyond physical symptoms. When symptoms remained uncontrolled, investigators found 65% of adults and 72% of parents reported persistent discomfort. Frustration also affected 56% of both cohorts. Self-consciousness and embarrassment were reported by 54% of adults and 58% of parents, and anxiety by 52% and 44%, respectively.
Additionally, the team found more than half of subjects in both arms (55%) reported discomfort over uncontrolled disease in public or social settings. Emotional distress was also shown to impact treatment decisions, with 40% of adults and parents looking for alternative medications because of anxiety or depression. The survey additionally noted 36% of adults and 39% of parents did so given side effects.
Social participation was frequently limited during flares. Nearly half of adults (47%) avoided meeting friends, while children commonly missed social engagements (51%), school (54%), or activities related to sports (43%). In 1 important finding, the survey highlighted psychological strain as often persisting even when symptoms improved.
Additional findings suggest 59% of adult patients and 61% of parents reported ongoing issues related to self-consciousness over scarring or marks from prior flares. The study also noted more than half worried about when symptoms might return (57% and 55%, respectively). Investigators found only 20% of adults and 19% of parents reported being fully confident regarding their prescribed treatments maintaining control.
“[These] results demonstrate that even when symptoms are well controlled, many adults and children live with an undercurrent of worry in anticipation of the inevitable next flare,” Howard said in a statement.1 “This persistent emotional strain is part of the hidden burden of chronic skin diseases.”
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