Monday, February 17, 2014

How To Best Manage Topical Steroid Induced Eczema On The Hands

The purpose of this post was to show the various ways I have learned to deal with my topical steroid induced eczema symptoms on my hands since doing moisturizer withdrawal approximately 7 months ago, into one place for easier understanding and referral. Trying to rewrite everything I have learned here will take up an enormous amount of my time. So, I decided instead to try and make this post a thread where all people who wish to learn about the best ways to manage tsw symptoms on the hands can post in this thread, and this thread can be a question and answer format similar to a forum. When you post here, try to include a link to pictures of your hands along with a little background on your condition. That isn't absolutely necessary, but if you can do this, it definitely helps. If no pics no worries, ask questions anyway.

I'm near the end of my recovery and will be going back to the life I had before tsw soon. Hopefully I'll be 100% recovered in another couple months at most. I'll leave this blog up for future reference but have other things in my life that I wish to attend to once my mission is complete. However, even after I leave the tsw scene, I will always try my best to answer any questions anyone might have.

What prompts me to write this post is there are many people with tsw symptoms on their hands and most do not know or understand how to deal with it very well and they continue to suffer needlessly. Same with most people with tsw on other areas of their bodies. Since my own hands were so bad from the start of my tsw, and quite possibly the worst condition I've ever seen out of anybody so far, I feel my experience can help most people. Seeing so many people with very minor symptoms compared to what I had to deal with continuously suffer so much makes me sad knowing how easy it really is to find relief and heal the hands to a point where the tsw symptoms are very manageable.

Unfortunately, most people do not deal with their tsw symptoms the way I have and try to find their own way. And they just continue to suffer not understanding why. They think they know why but most really don't as they fail to understand the logic of the various methods I use. This is what this thread is for. Ask questions if you want to understand and learn the logic and reasoning behind my methods. 

Looking back I can now see that the condition of my hands was far worse from the average person doing tsw from what I have seen in others over the past 8 months. As a matter of fact, I have yet to see anyone who has had it worse on the hands than I did. I have learned many things in those 7 months of dealing with tsw via no moisturizers and feel what I've learned should be of great value to those of you who have either began tsw without moisturizing, or those of you who have made the transition from moisturizing to not moisturizing, commonly referred to as "moisturizer withdrawal".

In my efforts to help people do MW over the last few months I have discovered that some have failed miserably in their attempts due to various reasons. Others have made it and are happy as clams. The ones who have failed miserably have been mostly people with more serious conditions and only failed at successfully doing MW because they didn't follow my methods, but instead thought they could do it in a different way. More power to you, but reinventing the wheel is probably not the best thing to do when in this situation as you probably now understand.

There is plenty of info on this throughout my blog, but much of it is me talking about things I did at those specific times. And some of the info may not be relevant now, or outdated. I have learned much from my experience on what works well, and what doesn't work so well, in dealing with the various tsw symptoms we experience while not moisturizing. These symptoms differ from the symptoms people experience while moisturizing. I see some people struggling with not moisturizing and there is no need for it to be such a struggle. There are ways to compliment not moisturizing to make yourself more comfortable and to find much more success in doing it that most people don't do.

Although I experienced topical steroid withdrawal symptoms on several areas of my body, the main area where I had the most severe symptoms was my hands. This is probably the most debilitating area to have topical steroid poisoning symptoms out of any other area of the body, and I wanted to make a thread just for hand care during tsw for people who DON'T moisturize. IF you moisturize, see my DIY Guide for Moisturizer Withdrawal During Topical Steroid Withdrawal to learn how to make the transition from moisturizing to not moisturizing. And don't be afraid or timid about asking me questions or clarification on anything I have written.

I would like to note here as well that I see many people who have successfully done MW but are still having issues with symptoms on their face. There is a very simple solution to your problem. Do Dead Sea salt baths as I have been suggesting for the last 7 months, and in the way that I suggest they should be done for tsw symptoms on the face and head, and you will see what I mean within just a couple weeks.

So, for those of you who want to know the various ways that I have learned in dealing with tsw on the hands, just comment here on this post and I will answer to the best of my ability. I hope to have this as an ongoing thread so others can learn from the questions and answers here. This will save me a lot of time and it will be much more helpful for others to see this information in a question and answer format, as opposed to me writing out a very long post on all the various problems that can arise and how I deal with each of those problems.


  1. Hi Dan, I tried to open the link but it said I didn't have permission. Any ideas?

    1. Just fixed it. Thanks for letting me know!

  2. Hi Dan,

    I'm currently in TSW and my hands are also the worst for me. Literally since the beginning my hands looked like I got burnt with hydrochloric acid. My palms were completely destroyed - red, raw, oozing, a million wounds, peeling. Most TSWers only had symptoms on the back of their hands but my hands were different. I couldn't find any pictures of your hands when it was bad but I can only imagine it was probably as bad as mine. I had it on both hands too. Everyday I would gauze the shit out of both hands - I looked like I was going boxing haha.

    Anyway, I'm almost at month 6 right now, and my healing has been amazing. I started seeing improvement in my hands as soon as I started soaking in dead sea salts and MW from month 4 to 5. My palms were doing amazing until recently it started getting itchy again!! I scratched them and now its starting to split open. Not as bad as before but I'm scared it's going to keep spreading like before. Did this happen to you again the second time after your hands healed?

    1. Hi Julia, when I went to my doc and showed him my hands he was so stunned he immediately said they had first degree burns and gave me a powerful cream meant for serious burn victims. I spent 7 nights putting that stuff on and I thought I was going to die. I went back and told him look it isn't doing anything, to which he said I want you to stay on it and I said forget it I won't ever put it on again. He said then you need to see a Derm today. I said fine. So, went to a Derm and she treated me with stronger steroid creams for a week and on the follow up she decided to refer me to the best in the biz. By the time I saw him 6 weeks later, I had discovered what as wrong (tsa) and gave him the evidence and asked for support in stopping ts. He told me I have chronic eczema and would have to be on steroids for the rest of my life. I said forget that and he tried to talk me into protopic, which I said forget that too and went home to resume my tsw recovery on my own.

      My hands were like what you describe but I didn't think to take pictures at the time. My mind was on the pain I was in. I didn't think of that until 3-4 months in when I decided to do a blog like some others had done. So, I have no pics of those days when my hands were so bad I couldn't hold a camera much less take pictures with it.

      Back to you.....I'm so glad to hear the route you chose. You couldn't have chosen a better method to recover imo. I was one of the very first in the US to figure out that moisturizing was bad. At the time I was seen as a lunatic for my advocacy of no moisturizers. Everyone thought they made it easier to deal with tsw and provided comfort. How wrong they were and I knew it, probably because I'm a man and never used moisturizers so wasn't already brainwashed into believing they were something I should use. I could see they were making my life a living hell which is when I put my MW idea into plan and found myself in a much better place a couple weeks later. I would have never used moisturizers if it hadn't been for the fact that it was what everyone said to do (tsw vets on Itsan). But, within 6 weeks of using them I knew they were contributing to my not healing.

      Anyway, I too was wrapping my hands in gauge and tape right at the beginning of my tsw so know of what you speak all to well. Back to you...month six is a turning point where people often will flare. What you are going through seems normal course to me. You asked "Did this happen to you again the second time after your hands healed?"....YES, and many times throughout my first year. If cracks just starting I found that tto can be quite effective in healing small spots including those tiny pus filled pimples or whatever they are called. If too many cracks and lots of soreness I always go to my dss baths to help heal them. Then touch up spots with tto several times the next day if needed. Tto has to be used carefully as it burns and can create more itching. But I find the burn goes away within a half hour and the itching maybe a couple hours. Those small spots tend to heal up for me by the next day. I back off the dss baths when my skin isn't open as it can make me itchy and cause my skin to dry so found them not good to do when the skin is not broken.

      I had super bad flare at month 7, which sounds like what you might be going through, not sure. That flare lasted about two months and rash spread across the tops of both hands, popped up on my thighs, and arms. It was a really bad flare but I treated it the same way with going back to daily dss baths (the tops of my hands were swollen and inflamed, very warm to the touch and very sore), then every two days, then every 3 days, etc until I could go weeks without a dss bath. I would do an occasional bleach or acv bath when I felt it was needed. I hope this helps! Let me know if you need more clarification on anything I've said. I kind of jumped around much too cover.

    2. Hi Dan,

      Thank you for your reply!
      Wow. I'm shocked. Your hands sounds worse than mine. But yeah mine were so bad I couldn't do anything. Couldn't open anything, couldn't wash my hands, move or hold anything at one point. Man, I felt like I had no hands lol. I am glad I came across your blog about MW because my hands weren't healing at all after moisturizing them everyday for like 2 months. As soon as I started DSS and MW I saw improvement. Thank you so much!! I also agree that many TSWers still think MW is kinda crazy.. But I even noticed TSW sufferers who started their withdrawal at the same time as me, still moisturizing, still flaring non-stop and not much healing. Maybe I'm healing fairly quickly because of MW? Who knows. I feel a bit discouraged though because my hands looked like your recent pictures of your hands - no wounds or anything. Just elephant skin and a bit dry. They no longer bothered me for the last month.... Until now. The palm of my right hand started splitting open and becoming raw again. And flaking off chunks of skin, revealing raw skin underneath. Why is this happening! This is the ONLY part of my body that is flaring. Besides my flaky face and neck at least. I honestly didn't expect it to get worse again after healing like 90%. I started soaking my hands in Epsom salts since I ran out of DSS but I think you mentioned in a different post that DSS will heal the skin better than Epsom. Anyway I'm really hoping my palms heal again because I definitely don't want to be handicap again. When did you start noticing real improvement, like when your hands continuously got better without getting worse again?

      I honestly thought my withdrawal would be awful because of my TS usage. The first 2 months was horrible but after that things only got better. I truly believe that diet plays a role (as well as MW) so I was on a bunch of supplements and restricted diet since the beginning. I credit my healing to it lol. Do you believe anything else speeds up healing besides MW?

      Also did your withdrawal mainly affect your hands? My trouble areas right now are my hands and extremely dry face and neck. Itchy wrists. I had a random face flare twice this month but I feel like during TSW my body is so sensitive so I reacted to something in my work environment. It's hard to relate flares to anything though. But that's it for me at 6 months! Hoping I don't get any bad flares because I've been pretty stagnant for a while. Crossing my fingers. Hope you're doing fantastic yourself!


    3. Hi Julia, if you see my latest post you will see recent pics of my hands the way they are today, healed. As you've noted moisturizing greatly slows the healing process of a damaged skin barrier. One thing I need to make clarify, MW is merely the act of transitioning from using moisturizers to not using them. It usually takes 7-14 days for most to complete. You may be doing better than most because you did MW and no longer use moisturizers. Anyone doing tsw would. I've never heard of anyone recovering in 6 months so you probably are having a bad flare. I had a really bad one at month 7 and just treated it the same as I treated the rest of my tsw symptoms. Count yourself lucky that is the ONLY place you are flaring. I never really noticed a real turning point, just noticed a very slow gradual healing. There were times in this past year I thought I would never heal as my skin seemed to stay pretty much the same for the past many months. But, it was healing and now is healed. I do not believe anything speeds up healing by any significant amount, but am sure a good diet, exercise, and a good attitude must help some.

      My tsw symptoms were mainly on my hands where I used the most ts but I also had symptoms in numerous other places, some where I never used ts on, or even had eczema on when I was a kid. As long as you completely avoid putting crap on your skin, including soap, your recovery will be relatively easy compared to if you do.

      I see many people who started tsw about the same time as I did and the ones that stopped moisturizing are either healed now or very close to it. The ones that continued moisturizing are either the same, or worse than they were from the beginning. That should tell everyone something but most people believe what they want to believe. Reminds of a line out of a Simon and Garfunkel song, "A man hears what he wants to hear and disregards the rest". doo do doooo

  3. Hi Dan,

    I swear my hands looked like yours for the longest time and they still do except my palms now. Hopefully they heal soon =/ I'm doing MW my whole body except my face and neck since I work full-time. My face won't stop flaking and I'm suspecting that it's because I'm moisturizing it everyday with jojoba oil so it's not healing as fast. I can't really take time off work and school just to heal my face/neck so I don't know what to do. Sometimes I don't know whether I consider my skin flaring or not. Like i'll have some areas on my body that are inflamed but it'll go away in a day.

    Really? No soap? I've been showering everyday with a bit of Dr. Bronner's tea tree oil soap ever since the skin on my body started healing at month 4. It doesn't hurt my skin or dry it out unless I have a wound but I clean it anyway with ACV and then the soap. Since my face and neck is flaking like crazy and flaring at times, do you recommend me not to wash/clean it at all (not even with ACV) for it to heal faster?

    5 more days until my 6 month mark! Still a long way to go probably.. But honestly, I am happy where I am compared to many other fighters. The only thing I would BEG for right now is for my face to stop flaking and neck to stop itching. But, I have a feeling I probably have to do MW there for a long long time before it goes away, something I don't think I can do with my job and school.

    Thank you again Dan for making such an amazing blog and inspiring me to do MW which helped me sooooo much. MW all the way.

    1. Hi Julia, please see my reply to Geanna in my most recent blog post. Also, please note what happened to me when I started using soap at my one year mark when I "thought" I was healed.

    2. Thanks I just read it and it makes total sense. What did you do to clean your hands if it gets really dirty?

    3. please post any questions you may have on my newest post....this post is very old...thanks!