Nationwide Survey Finds Widespread Concern About Topical Steroid Use, Emphasizes Need for Long-Term Management Strategies in Chronic Inflammatory Skin Disease

A nationwide survey of adults and parents of children with chronic inflammatory skin diseases found high levels of concern about topical steroid use, frequent uncontrolled flares, and a predominant reliance on reactive treatment approaches rather than long-term disease management strategies, according to results released by Arcutis Biotherapeutics.

The survey, Skin Insights: Steroid Perceptions in Chronic Inflammatory Skin Diseases, included 1000 US adults and 500 parents of children diagnosed with plaque psoriasis, atopic dermatitis, or seborrheic dermatitis who had been prescribed a topical steroid at some point. It was conducted in August and September 2025 to assess perceptions and behaviors related to topical steroid use and to explore attitudes toward short-term flare control vs proactive, long-term care.

Frequent flares and reactive treatment plans

Among respondents, 72% of adults and 80% of children experienced uncontrolled disease at least once per month, with some reporting flares as often as daily. Nearly 8 in 10 adults (79%) and parents (78%) agreed that current treatment plans focus primarily on responding to flares after they occur rather than preventing them through sustained disease control.

Investigators noted that these findings suggest persistent gaps in the management of chronic inflammatory skin conditions, which affect an estimated 46 million people in the United States.

Concerns about topical steroid safety

Topical steroids were reported as the most commonly prescribed topical therapy across all surveyed conditions. All respondents had been prescribed at least one topical steroid in their lifetime, and 67% of adults and 57% of parents reported a prescription within the past year.

Despite their widespread use, 88% of adults and 91% of parents reported concern about at least one short- or long-term adverse effect. The most commonly cited concerns included skin thinning, hypopigmentation, and acne. Nearly half of respondents—48% of adults and 45% of parents—reported hesitancy to discuss long-term steroid use concerns with their or their child’s health care clinician.

Emotional and social burden of uncontrolled disease

Beyond physical symptoms, the survey highlighted substantial psychosocial impact when disease was uncontrolled. Respondents reported daily discomfort, frustration, embarrassment, anxiety, and avoidance of social or public settings. More than half of adults avoided meeting friends during flares, while 54% of children avoided school and 43% avoided sports activities because of disease-related symptoms.

Even during periods of symptom control, many respondents reported ongoing anxiety about recurrence. Approximately 59% of adults and 61% of parents reported self-consciousness related to residual skin changes, and more than half expressed worry about when the next flare would occur.

Implications for clinical practice

The findings underscore a potential need to reassess long-term management strategies for chronic inflammatory skin diseases, particularly in patients reliant on episodic topical steroid use. Survey results suggest that clinicians may benefit from proactively addressing patient concerns about topical steroids and discussing treatment approaches that prioritize sustained disease control.

According to the survey authors, the high prevalence of emotional distress, activity avoidance, and uncertainty around long-term treatment highlights an opportunity to improve shared decision-making and explore nonsteroidal or proactive management options where appropriate.

Reference: Arcutis Pharmaceuticals. Nationwide Survey Underscores Concerns with Use of Topical Steroids and Need for Long-Term Treatment Strategies Facing the 46 Million Americans with Chronic Inflammatory Skin Conditions. News release. January 21, 2026. Accessed January 21, 2026. https://www.globenewswire.com/news-release/2026/01/21/3222712/0/en/Nationwide-Survey-Underscores-Concerns-with-Use-of-Topical-Steroids-and-Need-for-Long-Term-Treatment-Strategies-Facing-the-46-Million-Americans-with-Chronic-Inflammatory-Skin-Condi.html