Red Skin Syndrome, also known as Topical Steroid Addiction and Withdrawal, is a debilitating condition that can arise from the use of topical steroid creams to treat a skin problem such as eczema.Learn More
RSS affects thousands of people around the world, of every age and background. View photos and stories from some of our brave RSS veterans.View photos
Topical steroids can be effective in treating eczema and other skin conditions, but proper use of these powerful drugs is essential.Learn More

The International Topical Steroid Addiction Network, ITSAN, was originally formed to raise awareness about a condition called Topical Steroid Addiction and Withdrawal, now known as Red Skin Syndrome. Since its founding in 2012, ITSAN has grown into a wide online community of  RSS sufferers around the world contributing ideas, funds and inspiration.

ITSAN raises awareness of Red Skin Syndrome (RSS), fosters physician and patient education, and supports affected individuals. Many of our participants, staff, and board members work on a volunteer basis, spending many hours per week to help the cause.  All of ITSAN’s Executive Board have either suffered from Topical Steroid Withdrawal themselves or known or cared for a loved one who has.

ITSAN is a diverse community of individuals, caregivers, medical professionals, and parents united by our commitment to understanding Red Skin Syndrome, and our desire to help alleviate the suffering of anyone facing this painful experience.
We hope that topical steroids will be prescribed with more caution and monitoring. We also hope that through sharing our experiences we can someday find a cure, or short of a cure, to identify best practices for treating RSS and reducing the pain and suffering of all who are affected by this debilitating condition.

Physician Statements

I have certainly seen Red Skin Syndrome, now multiple times. Generally, I find that these patients tend to have more widespread involvement on their body, but almost always have face and neck involved. Unlike eczema, it tends to be more red and flushing or blushing in appearance, although many patients will also have eczematous and scaly lesions at the same time.
Peter Lio, MD
Steroid addiction is a more subtle and more insidious type of side reaction. It is common but is not high in medical consciousness because it frequently goes unrecognized. Hence, it is underreported and not well characterized. Because it develops in stages, often slowly, both the physician and the patient may fail to incriminate the steroid.
Albert M. Kligman, MD, PhD
Though the topic of topical steroid addiction (TSA) is troublesome for physicians, we should not postpone facing it. It is not a temporary tide, TSA is real. Please search articles in PubMed. At the minimum, warning of TSA as a side-effect of topical steroids must be added in the guidelines of all areas of atopic dermatitis treatment.
Mototsugu Fukaya MD, JDA