Skin: Eczema/Red Skin Syndrome/Topical Steroid Withdrawal (TSW)

"The most recent dermatologist - who I was told was one of the best in Sydney -started off by saying that TSW is a “load of rubbish, and doesn’t really exist.” I was so upset when she told me to just go back on steroids."
Bev. Australia. 2012

Human skin is highly complex and has many functions

skin structure
  • This illustration is a simplified version of the highly complex structure and multiple functions of human skin. The three main layers of the skin (epidermis, dermis, and hypodermis) are indicated in red. Some of the skin’s important functions include:
  • Protection of the body from injury.
  • Sensation of pain, touch, temperature, pressure and vibration.
  • Body temperature regulation.
  • Protection from infection. This crucially important function is achieved by immune cells, which, being very close to the surface of the skin, can be the first to suffer damage by topical steroids leaving the skin open to infection.  (See blue arrow in the illustration below).
skin structure and immune cells
  • Maintaining moisture. Together, the oils produced by sebaceous glands and sweat glands in the skin, prevent it from drying. Topical steroids can rapidly damage or eliminate this most important function, resulting in dry, often cracked skin that can be very painful and is prone to infection. Ironically, topical steroids are often used for treating dry skin in the hope it might assist recovery. In fact, it does the opposite by drying the skin, which then predisposes to cracked skin and risk of infection.
  • Besides protecting us from infection, cold and heat, there are many other functions our skin has to deal with. For instance, we have millions of nerve receptors all over our bodies that sense heat, cold, pain, vibration etc., all of which can be damaged or inactivated by topical steroids. Also, hair follicles and sweat glands that help heat to escape from the body can be damaged. Finally, capillaries and small arteries that bring oxygen and nutrients to the area and remove waste, can also be damaged.

A brief history of topical steroids

Topical steroids, introduced in 1951, impressed with their rapid "healing" effect for eczema. Rapid reduction of itching, inflammation (redness), along with apparent recovery, was hailed as a major medical "breakthrough". However, some patients developed the so-called “red skin syndrome”(See Fig. 1.) which was initially thought to be due to eczema. Instead, it turned out to be due directly to withdrawal from topical steroids.

As well as thinning the skin, these powerful drugs can be highly addictive. Often, the patient's dependency can be very difficult to overcome. (Read about adverse effects of topical steroids). They can also suppress the immune system, which increases the risk of infection.

Often, bright red skin areas appear, particularly on the head and neck, as seen in Figure 1. This is known as the "red skin syndrome".

red skin syndrome healed with wheatgrass
Fig.1. Red skin syndrome (severe), recovered by wheatgrass extract.

This patient had suffered severely from topical steroid withdrawal for several years. As well as redness and constant pain, she suffered marked fluid loss from her leaking skin. It took a year (online) to wean her off the drugs by using wheatgrass extract, and her skin recovered completely.

Wheatgrass extract has worked effectively for many thousands of sufferers. For some reason, some "TSW experts" encourage patients to "go cold-turkey" and put up with the pain and other severe withdrawal symptoms. Considering this method may drag on for several years, the patient may suffer immeasurably and unnecessarily from severe withdrawal symptoms such as  pain, skin scaling, cracking, weeping and infection.

This healing "method" should be avoided as the suffering it needlessly creates and the associated risk of wound infection can put the patient's life at risk.

The usual medical approach to TSW

The orthodox medical approach is to reduce inflammation with oral steroids such as prednisolone. However, severe rebound symptoms may occur if the drug is stopped abruptly or reduced, sometimes requiring hospitalisation. Addiction to these drugs is possible, and common. They might help ease pain, but do nothing to heal TS damaged skin. Successful medical management  may take several years of medical suprevision.

Although there is no "quick fix" to TSW, perseverance with wheatgrass extract will help relieve pain and in time, restore damaged skin such as seen in Figure 1. Recovery may take six to twelve months or longer, but wheatgrass extract can shorten this time significantly.

How wheatgrass helps overcome topical steroid withdrawal

As the skin gradually becomes thinner due to continued topical steroid use, it becomes increasingly prone to infection and inflammation. Also, pain receptors located in the skin are laid bare which can often result in severe pain. Continued use ultimately damages the skin's ability to protect the body from bacterial and other infections which must be treated promptly. This is good reason to have a doctor oversee the management of these complications. TSW can sometimes be life-threatening, hence the need for medical observation and treatment.

Even if hospitalisation is required, continued use of wheatgrass extract can help restore dakage to damaged blood vessels, sweat glands, hair follicles, sebaceous glands etc. that are so essential for normal skin function. This will take time, approximately 6 to 12 months, depending on the degree of skin damage. Patience, courage and professional care at this stage is essential.

The main aim should be to eliminate the use of topical steroids and to restore all skin functions to normal. Perseverance pays, and if one perseveres with ONCE WEEKLY APPLICATION OF WHEATGRASS EXTRACT IS SUFFICIENT the damaged skin will recover. Don't overtreat. It will probably take three to twelve months for the skin to return to normal. Perseverance pays.

This method is far more humane than going “cold turkey” which might take a year or more and cause severe suffering - a potentially horrifying experience that should be avoided at all costs. Wheatgrass extract application is a far more humane way to proceed, and, it works.

How to beat TSW with wheatgrass extract

Although fresh wheatgrass juice might assist healing of TSW, Dr Wheatgrass Skin Recovery Spray made from a wheatgrass concentrate, is considerably more potent and effective.

1Topical use (for the skin): Apply just a little Dr Wheatgrass Skin Recovery Spray over the worst affected areas only, no more than twice a week. Say, Monday/Thursday - and persevere. Overtreating is wasteful and unnecessary. Years of éxperience show that "less works best".

Do not expect an overnight "cure". It often takes considerable patience and courage (for both patients and carers) to overcome the symptoms of topical steroid withdrawal. Recovery from severe topical steroid damage could take anything from two or three months to a year. Perseverance is most important.

Try to be patient. Your skin is a highly complex, hyper-sensitive organ. It will take time to restore it to normal.

2. To strengthen the immune system, take wheatgrass juice or Dr Wheatgrass Supershots – just half a teaspoonful (2.5ml) twice weekly. Again, don’t overtreat.

Some practical advice:

Infants and children: Avoid soap and baths as much as possible as they remove the skin's natural oil which is so important for recovery and protection from bacteria and other micro-organisms. Preferably, wash with a warm, damp, soap-free flannel.

Adults: Each day without TS is a major victory. Mark your calendar for 12 months and tick off the days. You may or may not be fully recovered by then, but you will be well on the way.

Some other treatment possibilities

  • “COLD TURKEY” i.e. Stop topical/oral steroids, sweat it out, suffer immeasurably and possibly endanger your life.
    This so-called method, recommended by a well known non-medicaly qualified website (for some inhumane reason), is without doubt the most inhumane way of weaning a TSW sufferer off topical steroids.
  • TSW IS A SERIOUS MEDICAL PROBLEM and should be managed as such. Withdrawal symptoms are frequently severe, so this process should never be attempted without qualified medical supervision. (Read American dermatologist Dr. Marvin Rapaport's view on this topic.)
    My wheatgrass extract approach will not stop withdrawal symptoms immediately, but over time it will help accelerate restoration of the patient's skin, but topical steroids will worsen the damage.
  • GRADUAL REDUCTION OF TOPICAL STEROIDS This is another approach, but it requires regular monitoring and review by a medical professional. I have used this method successfully many times, but in combination with wheatgrass. It can be significantly more effective if the patient is encouraged to include the extract in the treatment plan.

POSTSCRIPT: Wheatgrass and other cereal grasses have been the subject of considerable clinical and laboratory research since the 1930’s. My own clinical experience has shown how effective it can be for treating many other conditions.

Dr. Chris Reynolds.

Case Study: Infantile eczema heals readily with wheatgrass extract

Many topical steroid addictions start during infancy. Try to avoid using topical steroids at all costs.

Figure 1. Note the damaged skin on the elbow of this infant after only 2 months’ use of topical steroids.

Figure 2. The same elbow after three-weeks' treatment with wheatgrass extract only. This child was fortunate. Had the TS not been stopped and replaced with wheatgrass, he may well have become TS-addicted.

topical steroid withdrawal child
Fig. 1. Topical steroid skin damage. Note wrinkled, scaling. inflamed red skin.
topical steroid withdrawal child cured
Fig. 2. Significant skin improvement after 3 weeks application of wheatgrass extract.

The majority of juveniles outgrow eczema by the time they turn 20. If they are still using TS by then, they may become addicted  for life. Ironically, patients are being “treated” to overcome side effects caused by drugs (TS) meant to improve their skin. I find this approach rather absurd. Instead, attempts should be made to wean them off these drugs as soon as possible. Often, stronger steroids are introduced at this stage to help prevent withdrawal effects, but this only aggravates the situation.

Topical steroids (TS) do a lot more damage than “thin the skin”. In fact, many children – even elderly adults – suffer from the side effects of these drugs, such as addiction and the pain suffered due to TS withdrawal when attempts are made to stop them.

Infancy is the best time to rid a child of topical steroids. Prolonged use can lead to addiction, permanent skin damage, and suffering for parents and child. Instead, apply a little wheatgrass extract over the worst affected areas twice weekly, and persevere.

Topical Steroid Skin Damage: Recovered by wheatgrass extract (2 Cases)

Elephant skin: This patient battled topical steroid withdrawal symptoms on and off for about 30 years. During that time she developed thick "elephant skin" over both elbows - a common complication of prolonged topical steroid use considered to be "irreversible". Application of wheatgrass extract over the affected skin for two months shows significant improvement. The deep ridges have reduced significantly in size.

wheatgrass heals topical steroid damaged skin
30 years of regular topical steroid damage restored by wheatgrass extract in 2 months.

Overnight drainage of fluid retention: This patient suffered for several years from grossly swollen legs and arms due to topical steroid use that interfered with her skin's blood and lymphatic circulation. (Fig. 4.) She applied wheatgrass extract regularly for several months along with several other skin applications. Her skin condition improved, but the swelling remained unchanged.

Then, her daughter persuaded her to stop ALL skin applications (moisturisers etc.) except the wheatgrass extract. About two weeks later, the swelling in the "before" pics disappeared overnight. When she woke that morning her bed was soaked through due to fluid loss from her legs. As shown in the photographs, her eczema recovered completely. (View detailed account.)

topical steroid withdrawal swollen leg
topical steroid withdrawal swollen arm