Friday, November 8, 2013

5 Months Off Topical Steroids - Can Topical Steroids Cause Eczema?

Today marks my 5th month since stopping my topical steroid use and I want to give an update. First, a brief history. I used betamethasone dipropionate ointment USP, 0.05% very sparingly on a spot about 1/4" in size on my lower extremities about once every other day for 18 years. This spot was biopsied at the time as Psoriasis. It didn't really bother me much and I only used the ts on advice from my doctor. After using it for about a month, I complained that the red spot kept coming back and was told to apply it daily even when the spot was clear, as that would keep it away.

Fast forward about 18 years and what appeared be be eczema showed up in a small spot on the palm of my right hand. So, I started applying the ts on that spot too. Over the course of about a year that spot grew and spread over the entire palm and fingers. Then it spread to my left hand and by a year later I was covering both hands with this powerful drug like it was a moisturizer 2-3 times per day. I didn't know the drug was as dangerous to use as I later found out. Various doctors over the years would always renew my script without ever once talking to me about the effects of using ts long term. My last doctor had called in my script for 5 tubes of the ts ointment when I had asked to renew just the one. I assumed the drug must be half way safe if he is prescribing 5 tubes for me and hasn't warned me about any bad effects from using it. Wrong assumption!

About 6 months ago I tried doing prednisone for a week in a desperate attempt to rid myself of this rash unsuccessfully. I had reached the point where the ts were no longer effective, and my hands were a bloody mess with multiple skin splits, deep fissures, swollen, and raw as hamburger. The ts had completely destroyed the skin barrier in my hands. My hands looked as bad as the worse case I have ever seen in any picture so far. I jumped on the internet searching for answers because after seeing my doc and two derms, I was in such bad condition from further treatment with even stronger steroids that I wanted to die. I knew they were killing me but wasn't sure how or why. After spending countless hours over several days of researching I finally found my answer. We all know what that is. I was addicted to topical steroids. Well, not I, rather my body was addicted to the drug. Thanks to Dr. Rapaport, Dr. Fukaya, the Itsan website, and the many blogs that tsa/tsw people have made I was able to figure out what was wrong with me. Actually, I already knew, but confirming what I thought I knew made it all fall into place for me. I truly appreciate all of you and your efforts to expose the truth. This is why I started my own blog, to help others who go through what I had gone through. Doing my own blog will help someone else in the future so it feels good to pay it forward. That's the least I can do.
 
OK, at 5 months I am doing very well. I have suffered immensely but in spite of it all I feel pretty good. I truly believe that is due to not moisturizing. I still have the sleepless nights, the zingers, the intense itching etc., but all these symptoms were greatly lessened by moisturizer withdrawal 3 months ago, and both my skin and symptoms are slowly improving week by week. After initially stopping the steroids I had what appeared to be eczema pop up on both my arms and legs in large patches, where I had never used ts. These areas are now 99.9% healed and the skin appears normal. My hands are the last to heal since that is where I applied most of the ts, especially the area on my right hand where I first started applying it. That spot has been the most difficult to heal, has the thinnest skin from the ts, breaks open the easiest, and will obviously be the last place to heal. Oddly enough, the original spot on my lower extremity didn't react much to tsw and is just slowly disappearing.

The eczema that popped up on my arms and legs is what's called "steroid induced eczema". So, is the eczema that is on my hands. Real eczema in adults is fairly rare. As Dr. Rapaport noted, childhood eczema burns itself out in adulthood. That is how it worked with me and everyone in my family. Like Dr. Rapaport says, doctors today are confusing steroid induced eczema with real eczema. They haven't ever seen real eczema so they confuse it with the rash that topical steroids cause. It looks like eczema but doesn't "act" like eczema. It is steroid induced eczema, a side effect of prolonged ts use.

I want to say one thing here I feel is important. Many people fear clearing their tsw and then rebounding. Many people have had horrible rebounds after many months of improvement. I have feared rebounding as well due to reading about it. However, I no longer fear it because I no longer believe it will happen to me. Why do I believe it won't happen to me? Because I have come to the conclusion that the majority of people who have experienced rebounds have rebounds due to moisturizing during their recovery. I could be very wrong on this so we will have to wait and see. Something must be causing these rebounds as it doesn't make sense for them to happen without some kind of external cause. I know tsw "doesn't make sense". I have heard that too many times now but need to make sense even if it's not probable. When any healing is set back it is usually due to an external source and not from the actual disease. It can be due to stress, changes in diet, attitude, and many other things. I just don't believe tsw is that different from any other healing crisis.

I have had a couple "mini flares" but that's about it. I continue to slowly improve and it is very noticeable when measured by comparing this week to last week and so forth. My hands haven't improved in a discernible way to the naked eye by looking at a picture since posting my last pics so will post new pics later this month. All I want to know at this point is when can I call myself a vet? Just kidding!!

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