WHAT IS TOPICAL STEROID WITHDRAWAL (TSW)
Topical steroids are medical treatments prescribed to treat inflammatory and autoimmune conditions that present with symptoms on the skin, such as dryness, flakiness, soreness and irritation and redness. Read on for information on healing the topical steroid withdrawal stages.
The NHS says that topical steroids are used for treating:
eczema – such as atopic eczema
contact dermatitis – which causes symptoms such as dandruff and scaly patches on the skin
psoriasis
And, they also state that these topical treatments (usually in the form of a cream, lotion, gel, ointment or solution) cannot cure these conditions, but, they may help tackle the symptoms of them. They cannot be used by people who have rosacea or acne, and are not always suitable for pregnant or breastfeeding women.
Whilst they can provide temporary and much needed relief for these conditions, use of them can cause a wide range of side effects (these are the ones listed on the NHS website):
Less common side effects can include:
worsening or spreading of a skin infection you already have
inflamed hair follicles (folliculitis)
thinning of the skin, which can make the affected skin more vulnerable to damage; for example, you may bruise more easily
stretch marks, which are likely to be permanent, although they'll probably become less noticeable over time
contact dermatitis, which is a skin irritation caused by a mild allergic reaction to the substances in a particular topical corticosteroid
acne, or worsening of acne
rosacea, which is a condition that causes the face to become red and flushed
changes in skin colour – this is usually more noticeable in people with dark skin
excessive hair growth on the area of skin being treated
Side effects are more likely if you're:
using a more potent corticosteroid
using it for a very long time, or over a large area
Because of the potential side effects, it is not always possible to use these treatments for a long time, your doctor may reduce or even stop these treatments to give your body “a break” from the steroids. When these treatments are stopped, you may suffer from topical steroid withdrawal (TSW). This is a painful and sometimes debilitating condition which results in very dry, very sore skin. Your skin may peel, itch, ooze and weep and the original condition you were treating may flare back up (sometimes worse than before).
WHAT CAN YOU DO TO AVOID TSW?
Minimise the use of topical steroid treatments!
We are not advocating (and this is not medical advice) ignoring the advice of your doctor, but, sometimes it is possible to treat the symptoms of eczema or psoriasis with a topical product that does not contain steroids. These can be bought “over the counter”, are often made with natural or plant-based substances, and you can use them much more than a steroid containing treatment (i.e., you can apply them more frequently, you can use more product in a single application and you do not have to take a break from using them!).
Look out for products containing good, nourishing emollients like cocoa butter, shea butter, coconut oil or babassu oil. Oils like hempseed oil, sunflower seed oil or olive oil are excellent moisturisers, are completely safe to apply to the skin and minimise dryness. Natural waxes can also help form a gentle barrier on the skin locking in moisture and minimising the harmful effects of exposure to the environment.
In addition to these, products containing skincare actives like hyaluronic acid, niacinamide, vitamin E and humectants like glycerin are excellent for hydrating, softening, soothing and plumping the skin and can help the skin renew its uppermost layers.
Avoid anything perfumed or with colourants added in – these will definitely irritate your skin and can trigger or aggravate a flare up.
Keep the areas clean by using a gentle, pH balanced cleanser to gently cleanse the skin and always gently pat dry. Avoid soap – these have a very high pH and can upset the acid mantle of your skin and potentially cause irritation. A soap-free cleanser (liquid or in bar form), with no colour and fragrance is the best option.
WHAT CAN WE DO TO HELP?
We have a number of products that are designed specifically with inflammatory skin conditions in mind. Our products are vegan, plant-based, made with natural, non-irritating ingredients and have been formulated by our resident biochemist to be minimally irritating, suitable for sensitive skin (they are even sensitive enough for baby skin). They do not contain parabens, silicones, sulphates, artificial fragrance or perfume, artifical colour, absolutely no petroleum products and they are plastic-free and often zero waste.
Our Intense Hydration Hyaluronic Acid Cream is packed with Oat Oil, Hyaluronic Acid, Babassu Oil, Cocoa Butter, Vitamin E, Niacinamide and Glycerin will provide an intense hit of hydration, boosting moisture retention in the skin, soothing irritation and dryness and promoting the natural moisture barrier of the upper layers of skin. It is free-from parabens, sulphates, fragrance & colour, is non-irritating and completely vegan.
Our Ultimate Repair & Hydrate Balm is a completely natural balm rich in cocoa butter, calendula oil, arnica oil, babassu oil, carrot seed oil and hempseed oil. This balm is hydrating, soothing and promotes the regeneration of the skin cells. It is free-from parabens, sulphates, fragrance & colour, is non-irritating and completely vegan.
Our AHA Cleansing Bar is a soap-free, pH balanced cleansing bar which gently cleanses the skin and the alpha-hydroxy acids in the cleanser can penetrate the dead, damaged skin cells of an eczema or psoriasis outbreak and rapidly and gently slough away the damaged skin cells, boosting regeneration of the new skin cells underneath. The cleanser will gently exfoliate the skin (without using a physical exfoliant) helping keep it soft, smooth and radiant. It is free-from parabens, sulphates, fragrance & colour, is non-irritating and completely vegan.
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