Wellness Within Tips on Topical Steroid Withdrawal

Our Tips on Topical Steroid Withdrawal Symptoms

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Topical Steroid Withdrawal (TSW) refers to an adverse reaction after the use of topical steroids has been discontinued1. Topical steroids are often used in the treatment of skin conditions, such as eczema and dermatitis, and a long term usage of topical steroids may result in an addiction. Once addicted, topical steroids appears to stop working which eventually lead to various flare up, also known as red skin syndrome.

Do note that I am not medical practitioner nor medically trained. The tips below are some which I have adopted through my journey, some of which are highly recommended by others who are also in this journey with me. This isn’t just about TSW, this journey is about using natural alternatives for wellness from within.

 

Symptoms2 Our Tips

Red burning skin

Raw, painful skin

Red face, red arms and red skin are common symptoms of TSW. If there are no open wounds, the redness will fade away after some time. If there are oozing spots, refer to our tips below! I would use a tubular or compression bandage to prevent myself from scratching and to relieve the pain.

Eczema-like rashes

Rashes / Hives

These rashes could be itchy, so wrapping with bandage can help to reduce the direct impact of scratching and prevent any infection.

Edema

Swollen skin or swollen body parts containing fluid. Hands and feet often swell during TSW

Keep swollen limbs elevated using pillows to reduce pressure on the feet. Leg and foot massages will also help to reduce the edema by massaging from the ankles to the back of knees and the back of knees to the upper thigh3.

Oozing skin

Plasma from dilated blood vessels

Allowing the plasma to sit on the skin allows the plasma to be absorbed back, which can be helpful. However, do what you’re comfortable with. While on the go, cover up will prevent the broken skin from being infected by dirt and bacteria. Cover up also allows us to be less conscious. Where possible though, allow the plasma to be absorbed back into the skin.

Once the ooze has dried up, applying a Zinc Cream can help the wounds heal quicker. Most people would recommend Desitin or Sudocream, but I only use natural baby diaper rash cream which does not contain any harmful or toxic ingredients as we should try to reduce any chemical load on the body. Zinc Cream can be very drying, so I would apply a generous layer of oil (like this one from Necessity Brand for spot treatment) before applying Zinc Cream. Some people have found oil to be irritating to the skin, so use only products that your skin is happy with.

Itchy and Dry Skin

Non-stop itching / Very Very Dry Skin / Cracks / Cuts

Do what you’re comfortable because being in this process of withdrawal can be quite unbearable. Try to relax when you feel an itch is about to come or take natural antihistamines such as Quercetin or Vitamin C to manage the itch. Meditation or classical music will help take the mind off the itch too.

Some have found that moisturizers and lotions irritate their skin as well, so avoiding moisturizers is common among others. I would use a tubular or compression bandage to help prevent myself from scratching too much. Some have also used salt soaks to dry out wounds and oozing, but I personally found that soaking my cracked feet in dead sea salt soak caused my feet to ooze. I prefer using an oil as a general moisturizer (like this one which absorbs very quickly) so the cracks don’t get worse.

Shedding or Flaking skin

This stage of shedding is quite frustrating because you may feel very upset seeing or feeling the skin everywhere. This is a passing phase. The dry skin has to go before new skin will surface, so this phase is actually a good sign! You will find that no matter how much you moisturize, the skin continues to be very dry. Some people have tried to stop moisturizing to trick the skin into producing its own oils and it was helpful for them. You could supplement with taking more Omega 3 such as Fish Oil. I have found Krill Oill to be more very useful as it contains Omega 3, Vitamin A, E, D and antioxidant Astaxanthin4. However, note that Krill Oil is obtained shrimp-like creatures so beware if you have a shrimp allergy. Surprisingly, I have a shrimp allergy but I had no allergic reaction to Krill Oil.

Difficulty regulating body temperature

Sweating easily / Turn cold quickly

Always bring a jacket along so you can put it on whenever you are feeling cold. The most difficult part is sweating because you become warm very easily and quickly and sweat tends to irritate the skin. I find that wearing a bandage even on a hot day prevents scratching or further damage and it helps absorbs the sweat. Also, I found that sweat is actually good for dry skin because it contains not only water, but minerals, lactic acid and urea5 6. Urea in its natural form is a humectant which attracts moisture and is found naturally in the skin7. However, synthetic urea should be avoided, such as urea or aqueous cream, as it was found to be harmful to the body8. As your body gets rid the unnecessary steroids and chemicals, your body will be able to regulate temperature better.

Enlarged or swollen lymph nodes

Seek medical advice from doctor if you spot any swollen lymph nodes. This is very common while in withdrawal and if the doctors are not concerned about it, then the swell should fade away.

Thinning hair or bald spots

I found that my eyebrows were more sparse and I was dropping more hair than usual. Harsh chemicals in mainstream and conventional shampoos might make the hair loss worse, so switching to a natural shampoo will be helpful in nourishing and preventing further loss. The hair will eventually grow back, but care should be taken for prevention.

Eye irritation

Dryness / Redness / Soreness / Occasional blurry vision

I had several occasions where the eyes are stuck together prior to TSW, this seem to be a symptom of TSW as well. This is an indication of an eye infection and you may need to seek medical advice. However, this situation for me went away. Ensuring proper hygiene (ie don’t rub your eyes with dirty hands) is essential.
Decreased energy levels

Exhaustion and fatigue

Because of the lack of sleep, you will find that your energy levels are very low. Also, as topical steroids prevent the adrenal glands from producing its own cortisols, over time the adrenal stops producing the hormone, hence resulting in adrenal fatigue. Supplements such as Fish Oil, Magnesium, Vitamin C, B and D can help with adrenal fatigue together with a whole healthy diet9.

Difficulty sleeping

Insomnia or unable to sleep through the night

Doctors may prescribed sleeping aids if you have difficulty sleeping, however those can be addictive. Try supplements such as Valerian Root which helps to increase your brain’s GABA level and thus causing a sedative effect10. If itch is the problem causing the insomnia, try taking an antihistamine every other day so you don’t become reliant or cause too much chemical load on the body. I find that Vitamin B helped with my sleep as well, although it’s not directly supplemented for insomnia.

Change in appetite

Weight loss / Weight gain / Loss of appetite

Listen to what your body wants. If you are losing appetite and not eating, supplement with vitamins and omega 3 to help your body recover. Drinking lots of water will also prevent the body from dehydrating.

 

Your body will tell you what it needs, so always listen to what your body needs. Having support from family and friends is essential so you don’t feel alone fighting in this journey. Do what you feel is the most comfortable for you. If you ever need a listening ear, feel free to contact me.

 

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The writer is the co-founder of Wellness Within and withdrew from steroids since July 2014.
image source; 1 Derm Net NZ; 2 ITSAN; 3 Slism; 4 Mercola; 5 Wikipedia; 6 Stack; 7 The Naked Chemist; 8 EWG; 9 Dr Axe; 10 Dr Axe