How to transition off using steroid cream after 20 years?

No guidelines: The thing you worry about is the effect of the steroids absorbed thru the skin on your body. I m not aware of any tapering down guidelines. I would decrease the amount of cream put initially gradually and then give more time between applications until you stop.

Consultation: Talk to a dermatologist, and have them evaluate your particular condition so as to have the treatment targeted to your real situation. The steroid cream is generally not a long term answer.

Why?: Varying potency of steroid creams, but generally should not use any for more than two weeks at a time. Some absorption into the system is unavoidable. Two major risks of chronic topical steroid -- permanent thinning of exposed skin with cosmetic changes, and chronic suppression of adrenal gland function. Morning adrenal blood test can assess the latter. Find alternative for skin problem!!