Thursday, November 21, 2013

Is "A One Size Fits All" Approach Appropiate For Topical Steroid Withdrawal?

 Please bear in mind, I'm not a doctor and the following are only my opinions. Do not take anything you read on my blog as medical advice, because it is not intended to be. I can be dead wrong in why opinions and conclusions. The following is for informational purposes only.

Is there a "one size fits all approach" for topical steroid withdrawal? Let's examine the question. Joey had an extreme case of tsw due to 40 years of ts use. From pictures I've seen, she had really major edema, red skin syndrome, and nearly full body symptoms. See Joey's Pictures. She had a very bad case. Kristina Ventura is a board member who eventually connected with Joey via Facebook after a long desperate search in finding a cure for her daughter. I think Kelly had a pretty bad case of tsw but not quite clear on that.

Since some on the the board, Joey, and many of the few vets on the forum seem to have all experienced extreme tsw cases, this might be why they hold so strong to their beliefs about moisturizing. Their approach is based on their own experiences, along with experiences in helping other people with extreme cases of tsw.

However, I'm not sure if a "one size fits all" approach is appropriate in tsw when it comes to moisturizing. Not all who do tsw have extreme symptoms such as these people had. I personally have suggested all people to not moisturize, but I have to wonder if that should apply to the most extreme cases or not, as it might not be possible for them to not moisturize early on in tsw due to their extreme condition. I would consider my own tsw as "middle of the road". Not extreme but not mild since I lost 90% of the use of both hands for 2-3 months. MW enabled me to regain the use of my hands sooner than if I had continued to moisturize, but still, my case wasn't as bad as these "vets" had in their experiences.

From all of the blogs I have read so far, it appears the severity of various peoples tsw symptoms varies widely due to many factors such as length of time they used ts, ts strength, how much applied, and how addicted they are to it. It is clear to me that moisturizing prolongs skin irritation and healing. But, if one has full body symptoms they might need to moisturize initially, and then after a period of time, say within a few weeks, do moisturizer withdrawal at that point.

In conclusion, I have to assume most tsw cases fall somewhere in the middle as far as severity goes. Therefore I believe most people doing tsw should not moisture at all during MW. But people who have used a lot of topical steroids for decades may consider very light moisturizing in the beginning of tsw. I would strongly urge anyone who does moisturize to only use natural moisturizers like white palm oil for a short period. Avoid all products with man made ingredients derived from petroleum. And to keep in mind that companies often advertise moisturizers as "natural" when they are not. Read the ingredients. If there is more than one ingredient don't use it.

Also, bear in mind, even using the most natural of moisturizers, such as white palm shortening, irritates the skin due to the skin's super hypersensitivity in the early stages of tsw. So, if one begins tsw by moisturizing, one should consider moisturizer withdrawal within a reasonable amount of time before the moisturizing causes more problems.

8 comments:

  1. I got a little coconut oil on my hand last night cooking and it was ok today. It was on a mostly healed part with no broken skin. Scared to put it on the webbing between my fingers that is flaky and still shedding. I am desperate for some natural oils to come back to my hands before it gets really cold and windy

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    1. Hi Ingrid! I wouldn't put it between your fingers, just witch hazel if they ooze. Otherwise, maybe try the colloidal silver like jsan suggested. I haven't used it so not sure on it's effectiveness for what you are describing. I had to do dead sea salt baths every single day with an occasionally intermittent bleach and/or ACV bath until late into month 4. Now, I am doing about two dss baths per week only. I still haven't use any soaps or shampoos in 5 months with the exception of shampooing my hair twice.

      You will know when your skin calms down and it's time for it to start producing it's own oils. In the meantime I would suggest daily dead sea salt baths and waiting it out. Sun would help immensely but it's not the right time of year. Maybe a home UVB unit if you can afford one. The smaller hand held units go for about $300 on up I think. Or, tanning beds, but I would urge extreme caution with that method. You can also wear the white cotton gloves under regular gloves in outdoor weather.

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  2. Hi Dan I love your blog and have been very interested in the no-moisturiser routine.. I started tsw in March and are having my 2nd very bad flare, I stopped moisturising 6 days ago and for the first few days could hardly move, now I am only like that for the first hour after my bath. My skin in very very dry but there are some small very soft patches of skin inbetween now! What I wanted to ask you is what should I use on my skin in the sun? do I need anything? I am going abroad next week and am dreading it because of this last flare..

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    1. Hi Rella, good to meet you! That first 6 days was terrible I know. Your skin should start feeling a much better in the next few days if your experience turns out to be anything like mine. The skin will be very dry but you will find it is much more comfortable. Be sure to try and not pick it off and allow the dead skin to naturally fall off when it's ready.

      I wouldn't put anything on the skin. It needs the sun badly. You just want to be sure it doesn't get sunburn, so be sure to keep your exposure to any affected areas limited. Sun exposure is the very best thing you can do for your skin. What do you mean by "soft patches"? Are you doing daily dead sea salt baths?

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  3. Hi Thanks for your reply. I do find it really hard not to pick or scratch the dead skin off I just cant leave it alone I am constantly feeling it. It itches a lot but a different itch to when I was moisturising not so raw just dry! The soft patches are nice skin inbetween the dry and rashy, just wish there was more of it.. I have never used dead sea salts only epsom salts do you think they are better?

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    1. Hi Rella, I understand all to well. Just try to rub in lieu of picking. The only time I was able to not pick at my skin was the two times I did MW. After the skin dried and scabbed over, it began to just peel off in sheets on its own. The process took about 7-10 days. I was just determined to allow my skin to heal and it worked both times. My main problem was multiple skin splits and fissures making my hands nearly useless. Afterwards, my fresh skin began to lose it's smoothness pretty quickly and was more like rough sandpaper for a few weeks. I would rub it constantly causing tiny bits of dead skin to fall everywhere. In some ways I felt it helped fill in the remaining tiny open (almost microscopic) areas with tiny bits of dried skin which seemed to be like added protection from the elements. Hard to explain. But, I don't really know if it helped or hindered rubbing it constantly. I do know that the longer we leave that dead skin on the longer the new skin has to grow before being exposed to the elements.

      Anyway, after MW my skin slowly improved. I could see the difference week after week. All steroid induced eczema went away on my body except for the hands, and they are nearly 90% clear now. My intense itching stayed after MW but gradually subsided as the weeks went on. Tsw for me was pure hell for my first two months while I moisturized, and pretty much a breeze ever since MW.

      You know, I have never tried Epsom salts but did dead sea salts only because my research showed they would be the best out of the two. I was very timid at first using a coupe tablespoons of salt per bath, but learned you have to use 1-2 pounds to get any of the minerals absorbed into your skin that you're after. So, I upped it gradually every day and discovered it didn't bother me and reached 2 pounds per bath within a week. I absolutely love the effects on my steroid induced eczema skin, and have now gone from doing the baths every day to twice a week.That is how much I have healed.

      I think it's important to combine the right things when doing MW. Based on what I know, they are, daily dead sea salt baths, daily sun exposure when possible, and using water diluted tea tea oil on any skin that still splits or oozes after MW when the skin is dry bit spots aren't quite totally healed yet. I hope this helps. Feel free to pick my brain anytime. I'm happy to help.

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  4. So I'm a few days shy of 8 months. My skin is faaaabulous, super soft all over especially my neck. Totally moisturizer free for well over a month now. I can also drink red wine now with absolutely no histamine reaction :) The bad thing, my hands and wrists continue to trouble me. Not surprising since that's where I used steroids all day long as I slaved away at the coffee shop for 8 months.

    Anyway I'm going to try tanning again. Let you know how that goes.. I just feel like I desperately need the sun.

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  5. I'm about 2 months into TSW and one month into MW. It was the best decision I made, other than to quit TS (duh). Good luck!

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