If you've been suffering from extreme side-effects of topical corticosteroids and have decided to stop using them, it’s important to make yourself comfortable and to manage the symptoms as best you can. Although as yet there are no proven medications that will speed up or eliminate the uncomfortable withdrawal process, there are certainly ways of making things a bit easier for yourself.
Strategies For Managing Your TSW Journey
Emollients Use simple, non-irritant, unperfumed, oil or ointments, such as Skin Salvation; most conventional moisturisers can’t be tolerated on such sensitive skin, and it's certainly worth making sure that anything you put on your skin is anhydrous, ie a water-free ointment or balm, rather than a water-based cream that can sting raw skin.
In severe cases of TSW, it may be worth exploring ‘No Moisture Treatment’, which eschews even natural emollients in favour of allowing your skin to re-learn how to hydrate itself. Check out our blogs on NMT on our Info Hub for more information.
Patch test anything you apply on your skin for at least 24 hrs before widespread use!
Sleep aids Whether you use medical or natural sleep aids, you definitely need your beauty sleep in order to heal. Suggestions for getting a full night's sleep include: antihistamines before bed; melatonin; magnesium oil; calming sounds; sleep lamps; no screens for an hour before sleep; avoiding blue light; meditation.
Antihistamines Take before bed or before exercise to control the itch
Pain control tablets It can be helpful to take paracetomol or other pain killers to manage the distressing sensations of TSW if things get really bad.
Baths Take short, warm (not hot) baths to keep sore skin clean and infection free. You can add anti-infection or anti-itch agents such as:
- apple cider vinegar, tea tree oil or very dilute bleach (see our blog here for more information) can reduce risk of infection
- Oats in a sock
- Himalayan, Epsom or Dead Sea salts
- Baking soda
Cover up Try covering really raw areas with wraps, bandages, socks or gloves, either wet (ie with emollients) or dry, depending on what works for you
Non-irritant laundry detergents Stick to natural laundry detergents such as soap nuts, or those formulated for sensitive skin. Give washing an extra cycle without soap/powder if you need to. Wash at high temperatures to get rid of dust mites.
Keep clean Launder sheets and hoover floors frequently, to clean up shed skin and avoid infection
Comfortable clothes You might find yourself wanting to live in pyjamas! But day or night, find yourself some very soft, cotton clothes or pyjamas that won't overheat or damage fragile skin.
Keep comfy Treat yourself to soft and comfortable blankets and towels
Cool down Fans, ice packs, ice cubes, homemade ice lollies etc. Some sufferers find whole body ‘cryotherapy’ (cold therapy) is very effective to calm down inflammation.
Nutrition Eat well to nourish your body, while avoiding possible triggers for flare-up. Check your gut health (try kefir and pro/prebiotics); supplement with omega oils; avoid inflammatory caffeine or sugar.
Take care of yourself Get support for your mental health as well as physical by joining groups, talking about it, or getting referred for counselling if need be. Read our blogs (here, here and here) about coping with the mental stresses of TSW.
“Have faith in the process, have faith that you will get better, that your body knows how to heal itself. And it will. You won’t be in pain forever!”
Getting Medical Help
Ideally, everyone experiencing the symptoms of topical steroid addiction would be able to find a GP or dermatologist who understands the condition and will help them find an effective, safe management both for the TSA/TSW as well as for any underlying chronic skin condition.
For example, it’s vital that the risk of infection is taken seriously, flare-ups are managed effectively and that any withdrawal is done gently and gradually to avoid throwing your adrenal system into crisis. A good doctor will also make sure that any psychological effects of the withdrawal are taken into account, that you are treated with care and sensitivity, and referred for mental health care if necessary.
Unfortunately, it can be very hard to find medical professionals who even acknowledge the existence of TSA, let alone support patients through it. So most people going through TSW have to learn as much as they can and become experts in their own condition. Of course, a doctor doesn't have to agree with everything you say or do in order to take care of you.
What Can Balmonds Do To Help?
Balmonds offer information and support, whether you’re going through topical steroid withdrawal, looking for safe long-term management strategies or wondering whether your symptoms match the condition.
Check out our TSW Info Hub for more information about Topical Steroid Withdrawal/RSS.
Skin Salvation is a safe, effective, non-steroidal, intensively hydrating emollient that works in four crucial ways to help you manage your TSW or chronic dry skin:
- It is free from the preservatives, perfumes, parabens, essential oils, coconut oils, nut oils, soya, and other common irritants that can hurt so much when applied to such sore. sensitive skin.
- It nourishes depleted skin with the essential fatty acids, vitamins and other nutrients the epidermis needs to repair and regenerate.
- It uses beeswax to protect broken or raw areas by providing a fine, protective barrier over the skin - like a sticking plaster over a wound - reducing itchiness and stinging.
- It hydrates, softens and conditions severely dry, flaking or shedding skin.
For more information about TSW, its symptoms and how to manage them, go to the ITSAN website.
With much gratitude to Harriet Hammond for her photographs on this page (follow @tswharriet on her TSW journey)
Other hashtags to follow for peer-to-peer support: #thisisnoteczema #tsw #TSWFab5
Current medical advice is not to use daily topical steroids continuously for more than two to four weeks; then the frequency should be tapered to twice weekly use.
If you require medical advice we recommend you always contact your healthcare professional.
If you or someone you are caring for seems very unwell, is getting worse or you think there's something seriously wrong, call for emergency services straight away. For general medical advice, please contact your healthcare professional, this article does not contain or replace medical advice.
Do not delay getting help if you're worried. Trust your instincts.