Sunday, January 5, 2014

Moist Wound Healing And Moisturizing Are NOT The Same Thing!

There seems to be some confusion about both moist wound healing and moisturizer withdrawal. Moist wound healing and moisturizing are NOT the same thing. I want to try and clarify what moist wound healing is, and also why I feel it's not an appropriate method for topical steroid withdrawal treatment any more than moisturizing is. First, an excerpt from a recent email exchange I had with Dr. Fukaya on the subject.

Hi Dr. Fukaya, what is your opinion on the use of the "moist wound healing" method for people going through TSW?

Dr. Fukaya: "It is a method for wound healing with minimum scar which has become popular recently in Japan. It is not a specific method for eczema sufferers."

Dr. Fukaya, I apologize, I forgot to include this with my previous question. What is the difference between moist wound healing and moisturizing? Thank you so much!

Dr. Fukaya: "Maybe I have already answered to the question by the last reply. Moist wound healing is for the deep wound and moisturizing is for the superficial skin."

Now keep in mind Dr. Fukaya has also said in the past... "I agree with Dr. Sato in that moisturizer withdrawal speeds up in certain cases. However, it is a hard landing method. I know some patients drop out from TSW itself by selecting moisturizer withdrawal. If you are enough strong and like to shorten the TSW period, I recommend it. In your age, I suggest you can use moisturizer in the future after TSW. People with normal skin also use moisturizer when they become elder. I suggest you should refrain from soap in taking a shower or bath. It will remove sebaceous matter which is a natural moisturizer." For the record, I am 58 years of age.

Moist wound healing and moisturizing are NOT the same thing! Slathering on Vaseline weakens the skin barrier, causes irritation and aids moisturizer addiction, meaning the skin stops making it's own oil. Keeping superficial wounds moist is NOT an effective, faster healing, or a better prevention for healing TSW symptoms like some people currently believe. Moist wound healing is for deep wounds.

Below is an explanation of what moist wound healing is used for by WiseGEEK.

"Moist wound healing is an approach to wound care where people keep the wound moist to promote rapid healing with reduced scarring. This is not effective or appropriate for all wounds, but can be suitable for patients with issues like diabetic ulcers and burns. A wound care specialist can evaluate a patient to determine which option is best and provide specific advice on dressings and wound care procedures.

Traditionally, the approach to wound care was to keep the wound dry. This promoted the formation of a scab, allowing healing to take place below the surface. Doctors believed this limited odors, chances of infection, and other common wound care problems. In the 1960s, the approach to wound care began to shift, and some care providers started recommending moist wound healing for some situations."

My thoughts on the subject: Moist wound healing and moisturizing should not be confused. Neither is an effective method for dealing with topical steroid withdrawal symptoms for many reasons. MW is best for tsw symptoms, and we don't need science to validate this. You don't need double blind studies or science to understand simple things. Please note that a wet environment can also be detrimental as this could lead to maceration and tissue breakdown.

Moist wound healing is for an actual wound where you keep it permanently covered until healed and do not disinfect, bathe, etc., the wound. It allows the wound to regenerate without forming a scab. It is an approach to wound care where people keep the wound moist to promote rapid healing with reduced scarring. This is not effective or appropriate for all wounds, and certainly not appropriate for TSW steroid induced eczema. Any more than it would be appropriate for "normal" eczema.

On Moisturizing:
Studies suggest that long-term treatment with moisturizers on normal skin may increase skin susceptibility to irritants. See Effect of long-term use of moisturizer on skin hydration, barrier function and susceptibility to irritants.

My conclusions: In understanding why the skin reacts the way it does during TSW as most of us do, it is not difficult to understand why the moist wound healing method is not an effective method for TSW. The term "moist wound healing" specifically refers to wound care where people keep the wound moist to promote rapid healing. It is best suited for deep wounds, serious burns, amputations, deep ulcerated wounds and the like. Moist wound healing should not be confused with moisturizing. Moisturizing is slathering a product on your skin. Here is a common explanation. Find out what moisturizers can and can't do for your skin and how to select a moisturizer that suits your needs. If you believe what you read on that site I have a bridge I'd love to sell you! Take note of that last sentence on the second page.

"If a moisturizer doesn't improve the condition of your skin or you notice skin problems after using a moisturizer, see your doctor or dermatologist. He or she can help you create a personalized skin care plan by assessing your skin type, evaluating your skin's condition and recommending moisturizers likely to be effective."

Like maybe TOPICAL STEROIDS? What a merry-go-round! Destroy your sin barrier with chemicals like Dimethicone and toxic petro chemicals and go to a Derm and get prescribed topical steroids to take care of the damage. Even if you were to ignore most of the suggestions and use the most benign moisturizer such as organic white palm oil, studies show you will still weaken or destroy your skin barrier with prolonged use. All evidence points to moisturizer withdrawal as the most effective method for dealing with TSW. The skin's hypersensitivity, a moist environment is detrimental as this leads to maceration and tissue breakdown, and the irrefutable fact that continuous moisturizing even with the safest things like pure water damages the skin barrier over time. It's not rocket science. Just common sense.

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