Topical Steroid Withdrawal
Easing the pain of Topical Steroid Withdrawal (TSW)
'Cold Turkey' Is Not The Way
Dr. Chris Reynolds. M.B.,B.S.
"Every time I see a doctor or dermatologist they don't
know what I am talking about - they say steroids just thin
the skin. The most recent derm who I was told was one of the
best in Sydney started off by saying that TSW is a "load
of s**t" and doesn't really exist. I was so upset when
she told me to just go back on steroids."
Bev. Australia
Sound familiar? Many doctors, even dermatologists, simply
don't believe topical steroid withdrawal causes rebound flares.
The overarching belief is that symptoms are due to eczema.
If there's a flare, keep applying steroids and if it doesn't
get any better, use a stronger one to keep it under control!
One reason doctors deny the existence of TSW is because they
have no drugs available to counteract withdrawal symptoms.
They have no choice therefore but to recommend 'cold turkey'.
I have one word of advice if you are anticipating or already
using this method. "DON'T". There's a better way.
It may be the most popular method advocated by doctors, but
unfortunately it invariably results in severe suffering for
the patient. It can be extremely difficult to tolerate withdrawal
symptoms that can take more than 4 years to overcome - and
even then one can be left with permanent skin damage.
WHAT IS TSW?
Topical steroids (TS), were first used for treating eczema
in 1951 apparently "revolutionising" its treatment. Unfortunately,
like many new 'miracle' drug treatments, it was soon realised
that prolonged use atrophied the skin and caused various other
adverse side effects. Today there are an estimated 250 million
TSW sufferers worldwide.
Even after a few days of TS use, microscopic damage to the
skin can be detected. After prolonged use though, macroscopic
damage occurs and is often irreversible. There are many other
potential adverse effects from long-term use. Also, the immune
competence of the skin, which protects our bodies from external
invaders, becomes compromised.
"Flares" or "rebound" effects, well
known to TSW sufferers, can occur just hours after ceasing
the drugs. The reaction can be severe, extremely distressful
and difficult to control. Burning pain, weeping, fragile,
easily damaged skin, constant itching, scratching, dryness,
recurrent bacterial infections, patchy discoloration, disfigurement,
depigmentation, cracking and tightening of the skin, and even
urgent hospitalisation for treatment of blood-poisoning may
occur. The unsightliness of one's skin can lead to adverse
psychological effects.
Eventually rebound symptoms come to control the patient's
life while skin damage relentlessly continues. Increasingly
stronger steroids and even anti-cancer and immune-suppressant
drugs such as Protopic (tacrolimus) and clobetasone (some
600 times "stronger" than hydrocortisone) are used.
These unfortunate individuals are often referred to as "steroid-addicted",
but their rebound symptoms are no fault of their own. After
all, doctors prescribed the drugs that created the situation.
To be fair though, given the limited tools at their disposal
i.e. modern pharmaceuticals, they had no other choice.
In many cases the original problem, atopic eczema, spontaneously
recovers, but the patient is left with TSW. Terms such as
"topical steroid addiction", "red skin syndrome" etc. are
often used to describe this condition but are not believed
by many doctors. Also, these terms describe symptoms,
not the actual status of the skin.
(I prefer to use a more descriptive term: 'Topical steroid-caused,
thinned and inflamed skin' or, in medical terminology,
Iatrogenic atrophic dermatitis. (IAD))
Iatrogenic - a Greek term, meaning "brought forth
by the healer"
Atrophic - the partial or complete wasting away of a part
of the body
Dermatitis - inflammation of the skin
HOW DO TOPICAL STEROIDS DAMAGE MY SKIN?
The skin is a highly complex organ; the body's largest in
fact. TS damage involves structural as well as functional
deterioration. Even after a week or two of TS "treatment",
there is a reduction in the size of skin cells and the number
of cell layers forming the skin. Reduction in cell division
and growth leads to damage to the 'microcirculation' i.e.
tiny blood vessels and nerves that control blood flow.
This compromises oxygen and nutrient supply essential for
growth, and skin cells are progressively destroyed. In fact,
the potency or "strength" of TS is measured and categorised
"scientifically" by their relative ability to constrict capillaries.
Damage to the lymphatic system, one of the components
vital for effective immunological protection further
reduces the skin's ability to protect itself (and subsequently,
the body) from infection.
Eventually, the skin becomes thin or atrophied, and
inflamed. If continued, TS can cause irreversible
damage and permanent atrophy. For example see how
much damage they can do to finger nails after long term use
(and how wheatgrass restored them to normal).
WHY DOES MY SKIN BURN?
Based on numerous observations using wheatgrass for healing
and skin recovery, it appears that the minute capillaries
in the skin and the tiny nerves that control their calibre
have been severely damaged. However, this does not prevent
engorged, larger, deep-tissue blood vessels forcing
blood into the upper layers of this damaged skin. Because
of nerve damage here, the blood flow is unregulated, but some
sensory nerves survive which react to the increased pressure
causing pain, "red skin", burning and weeping. (See figure)
Dr. Marvin Rapaport, a well known dermatologist in the US
explains "red skin" and "burning" in
this video which I strongly recommend to all sufferers
of TSW and their carers. This is a game-changer in understanding
withdrawal symptoms and is ideal for convincing doubting doctors
and others.
WHAT IS WHEATGRASS?
The "wheatgrass" I prescribe for my TSW patients is a potent
extract derived from young wheatgrass sprouts. This is the
stage of growth where maximum bioactivity has been detected
in the plant.
Wheatgrass and other cereal grasses have been the subject
of extensive clinical and laboratory research since the 1930's
in the US and until the present day. Highly successful for
treatment of burns, injuries, skin pathology including TSW
and many other conditions, it appears wheatgrass is (a)
an efficient anti-inflammatory, (b) a potent immune-modulator
and (c) an activator of growth factors to start repairing
damaged skin. These are all important features necessary for
skin recovery and infection prevention. There is no one
modern pharmaceutical that can achieve all these goals, and
possibly none of them.
View some examples of wheatgrass induced Growth Factor activity:
Healing
of diabetic foot ulcers
New
hair growth in alopecia
Rapid
skin graft healing
HOW DOES WHEATGRASS HELP TSW?
Being a potent anti-inflammatory and immune-modulator wheatgrass
extract can help control rebound by stimulating new skin growth,
reducing pain, burning and itching. It most likely achieves
this by repairing the function of the tiny nerves that control
the supply of blood to the skin, (see figure above) significantly
aiding the healing process.
Wheatgrass has successfully helped many of my patients over
the TSW hurdle. Damaged skin in time gradually reverts to
normal in the majority of cases if you persevere. However,
this is not a 'quick fix'. It takes time - around 6 months
- but even so-called "irreversible damage" can be overcome
eventually. By comparison, because the skin structure and
function has not been restored, 'cold turkey' patients are
often left with permanent atrophy and associated skin
dysfunction.
MANAGING TSW WITH WHEATGRASS (ALL AGES)
Please go to Dr Chris’s website, www.wheatgrasshealing.info for more information.
Email received from NZ customer 2nd February 2015:
I just wanted to let you all know how much your product
helped me get through my struggle through TSW.
First of all, thank you for recognising it as a real condition!
After going through a traumatic two months of going cold turkey
and dealing with doctors who would not take me seriously even
though I looked and felt like a sun burnt zombie it was so
encouraging to finally find a product that is recommended
for treating TSW.
Anyway, after using the wheatgrass cream alongside weaning
off the topical steroids it probably took me a total of 4-5
months to get to a point where my skin was functioning with
nothing at all and the plus side was that during this time
I was able to go about my life as normal compared to an agonising
two or three years I could have faced if I continued cold
turkey, so thank you!!
Also I found it really helpful that you explained the
science behind how TSW works and how wheat grass can help.
Such a good product!
I hope that you can help many more people in desperate
situations and maybe soon TSW will be a recognised condition
and steroids will stop being so easily dished out!
All good things,
Olivia
 ORGANIC
Antioxidant Skin Recovery Spray
Price: NZ$39.90 including GST.
Click here for more information
»
^ TOP OF PAGE
|
