Monday, February 6, 2017

Topical Corticosteroid Withdrawal Considerations

For those of you seeking alternatives to topical steroids for various skin conditions such as eczema, psoriasis, atopic dermatitis, acne and rosacea, dermatitis, rashes, scaly skin, etc., and/or "TOPICAL STEROID INDUCED" eczema, psoriasis, atopic dermatitis, dermatitis, rashes, scaly skin, etc., there are many things to consider. One of the most important things to bear in mind is topical corticosteroid withdrawal is far easier for people who have used lower potency topical steroids in small and infrequent applications over a short period of time. My observations of people doing topical steroid withdrawal over the past 3+ years have shown me these people are the best candidates for eliminating steroids from their lives altogether. However, they will still need to address the root cause(s) of their skin issues, as do people who have used very heavy amounts of TS.

People who have used high potency TS (or TCS - same thing) daily for years might consider NOT withdrawing from them, and seeking professional help instead. Especially, now that there are newer biological drugs that have been developed lately, as well as other options. Stopping TCS after just a couple years of daily use can be extremely difficult, even life altering, and although most people seem to be able to eventually recover, the suffering is often extreme, depending on various factors.

Another thing to consider is once you have made the commitment to not ever use topical corticosteroids again, don't make the same mistakes I and others have made. That is part of what my blog is about, sharing my own experiences so that others can benefit.

My first several months of TSW were so hellish it's nearly impossible to describe. This path isn't for the faint hearted. Since about months 7-8 my recovery has had it's ups and downs. Mostly easy with about 95% healed skin most the time, but also with some very big setbacks. Some were anniversary flares, (think cellular memory), but others were self inflicted.

My latest was making the worst decision I have made since I began my TSW over 3 years ago. My hands were doing about the same most of last year, mostly healed but not all the way. Over the summer I did a ton of work on the house and other projects, and in the process I screwed up my hands by spilling gasoline on them one time, heating oil another time, caulking material on them for hours while I caulked the exterior of my house, etc., etc. They went from good to very bad by fall, so I made the decision to try a course of prednisone to see if it would get me over the hump and finally healed for good. I figured at a minimum I could get a temporary break from the pain. I also figured at worst, since it was an oral steroid and not topical, my skin would just revert back to where it was prior to taking the prednisone. Man oh man was I wrong!

My skin reverted back, and kept reverting back to the point where I had near full body rashes, and my hands ended up much worse. WTF! So, here is the alarming part of it all! In the first 3 months of my TSW over 3 years ago, I was able to clear all spots where I used very little TS. Places like my eyelids and ears. I never once had an irritation on those spots after that until doing this one course of prednisone! And, the nerve zingers came back in my hands! Another symptom usually only seen at the beginning stages of TSW.

So, this shows me a lot about how difficult it is to heal from long term steroid use and the damage it causes, and especially just how damaging topical corticosteroids are to the body. Just one course of oral steroids for 3 weeks can undo over 3 years of healing from topical steroids? Apparently to a great degree. I wish I had done a one week course instead of three, but it is what it is. The saving grace here is that deep bone itching did NOT return! This, and the fact that I am now healing again, makes me think I will recover very quickly comparatively. Needless to say, I'm back to managing symptoms again! Time will tell for sure.

On Dead Sea salt baths.....I find them very effective only in certain cases, and only at certain times, depending. This is much different from what I used to think. They seem to work best for early TSW if one wishes to quit using moisturizers.

On a different note, the American Academy of Dermatology guidelines on AD care are the basic guidelines that most all doctors go by. What disturbs me is the lack of studies on a variety of subjects, such as studies using moisturizers that are much safer (IE:organic unrefined palm oil) than most recommended ones. Studies on the effects of topical corticosteroids overuse on the human body. Studies on the thousands of people who are in variously stages of TCS right now. Why aren't these people and the effects the TCS had on them being studied? So many studies that should be done but aren't being done. I have noticed that far too many of the studies that are done, are done with the financial backing of pharmaceutical companies, as opposed to being private or government funded.

The ADD states on their website "The application of moisturizers should be an integral part of the treatment of patients with AD as there is strong evidence that their use can reduce disease severity and the need for pharmacologic intervention." This statement seems to be based on very little and conflicting evidence. Is it possible this logic leads people to use TCS due to the effects the moisturizers cause to their skin? In other words, do people turn to TCS because of the skin barrier damaging ingredients in the moisturizers, sunscreens, lotions, etc.? There are even studies that show long term use of even the safest and natural moisturizers damages the skin barrier. There are studies that show the skin produces more cortisol when dry and less when moisturized. Just exactly how do we separate the wheat from the chaff?

Well, let's take a look at who recommends using moisturizers and the like. OK, you know who that would be. Now, let's look at the recommended moisturizers by the National Eczema Association. If you do a little research you will find that many of these recommended moisturizers are manufactured by the same pharmaceutical companies, or their subsidiaries, that manufacture the topical corticosteroids! Most all doctors treating your skin issues are using the guidelines of organizations like the ADD and the NEA. Makes you go hmm.

Even more disturbing is the seemingly lack of interest in the area of how once people start using TCS, the drugs are nearly impossible to stop without experiencing very real and serious rebound effects. I know of noone who uses TCS and CAN stop using them permanently, other than people who have done TSW. Doctors call the visual symptoms of TSA/TSW "atopic dermatitis". I call them "steroid induced symptoms".

Doctors rely on evidence-based medicine only. There is a good reason for that, but sometimes logic and common sense must come into play if the best solutions are to be found. I personally believe people have been, and continue to be, "brainwashed" by big business since birth. Be very wary of the falsehoods that are so prevalent in our society today. Do your own research and form your own opinions. Don't take my word for anything, or anyone else. Educate yourself as much as you possibly can, because you are the only one who has to live with YOUR decisions.

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