"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 has many functions and sensory receptors
Figure 1 gives us some idea as to the complexity of human skin structure, yet it is mainly the outer layer of the skin that suffers from topical steroid damage.
It doesn't take long before the skin begins to thin, reducing its protective and many other essential functions, as shown in the picture. When the patient tries to stop using the steroid, withdrawal effects such as red skin, pain, weeping, infection, insomnia and itchiness often quickly follows. Continued use of topical steroids simply aggravates these symptoms making the healing process considerably more difficult.
Such damage to or thinning of the skin therefore leaves patients open to infection, pain, inflammation (red skin) and addiction to the drugs themselves.
When one considers that important skin functions such as sensation, body temperature control and protection from infection can be compromised by topical steroids, one wonders why these drugs are ever prescribed.
- How topical steroids damage immune cells that are essential for protecting the skin from infection
Immune cells (blue arrow), are located very close to the skin surface where they protect the body from bacterial and other infections. Topical steroids can rapidly damage or destroy these cells, thinning this immunological protection.
About topical steroids and the damage they can do
Topical steroids were first introduced in 1951, when they were seen to "heal" eczema by rapidly reducing itchiness, inflammation (redness), and eliminating the eczema rash. At the time, they were hailed as a breakthrough for treating eczema (and many other skin conditions) and the drugs were soon prescribed globally. However, before long it was realised that they could be highly addictive, which made dependency difficult to overcome or control.
Often, bright red skin areas appear, particularly on the head and neck, as shown in Figure 3. This soon became known as the "red skin syndrome".
Read about adverse effects of topical steroids (Wikipedia).
This patient, (Fig. 3.) suffered severely from topical steroid withdrawal for several years. As well as "bright" redness and constant pain, she suffered marked fluid loss from her leaking skin. It took a year to wean her off the drugs by using wheatgrass extract instead. As you can see, her skin recovered completely.
While wheatgrass extract has proven itself effective for helping many sufferers to cease topical steroids completely, some "TSW experts" encourage patients to "go cold-turkey" instead. Unfortunately, these patients invariably suffer considerable pain and other severe withdrawal symptoms. When pain is severe or the skin shows signs of infection, cracking, weeping, etc., risk of suicide is a reality, so the patient should only be managed by a qualified medical practitioner.
The usual medical approach to TSW
The orthodox medical approach is to reduce inflammation with oral steroids such as prednisolone, then follow up with topical steroids. However, severe rebound symptoms may often occur if the drug is stopped abruptly or even reduced, so that hospital admission may be necessary. Also, addiction to these drugs is likely. They may help ease pain, but do nothing to heal TS damaged skin. Successful medical management may take several years.
Although there is no "quick fix" to TSW, perseverance with wheatgrass extract will help relieve pain and in due course, restore damaged skin to normal, as shown in Figure 1. Recovery may take six to twelve months or longer, but the extract can shorten this time significantly.
How wheatgrass extract can help overcome topical steroid withdrawal
As the skin gradually thins due to continued topical steroid use, it becomes increasingly prone to infection and inflammation. Also, pain receptors located in the skin are laid bare, often causing severe pain. Continued use ultimately damages the skin's ability to protect the body from bacterial and other infections which must then be treated with antibiotics which also have potential side effects.
Alternatively, light application of wheatgrass extract - once weekly or even less - and perseverance, can do much to reduce withdrawal symptoms of pain, redness, skin cracking etc. It may take a year or even more (remember, the skin has been severely damaged), but I have seen it work many times. Eventually, the skin recovers.
In short, aim to eliminate topical steroids by applying wheatgrass extract instead, and ultimately restore all skin functions to normal.
Finally, compared with the "cold turkey” approach often recommended by non-medical "experts" the wheatgrass extract approach will help the patient recover. However, there is no "quick fix", because topical steroids frequently do major damage. On the other hand, wheatgrass extract is a far more humane appoach than drugs or "cold turkey", and has helped many patients overcome their addiction.
How to treat TSW with wheatgrass extract
Although fresh wheatgrass juice may assist healing of TSW, Dr Wheatgrass Skin Recovery Spray made from a potent wheatgrass concentrate, is considerably more effective.
1. Topical use (for the skin): Apply just a little Dr Wheatgrass Skin Recovery Spray over the worst affected areas only, no more than once a week - and persevere. Overtreating is wasteful and unnecessary. Many years of éxperience have proven 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. Try to persevere.
2. To strengthen the immune system, take wheatgrass juice or Dr Wheatgrass Supershots – half a teaspoonful (2.5ml) daily. Again, don’t overtreat.
Some practical advice:
For 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, wipe the skin with a warm, damp, soap-free flannel.
Adults: Each day without TSW symptoms 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.
- TSW IS A SERIOUS MEDICAL PROBLEM and should be managed by a medical practitioner. Withdrawal symptoms are frequently severe, so this process should never be attempted without adequate supervision. (Read American dermatologist Dr. Marvin Rapaport's view on this topic.)
My wheatgrass extract approach will not immediately stop withdrawal symptoms, (neither will anything else) but in time it will restore the steroid-damaged skin.
- 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, but always in combination with wheatgrass extract.
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.
A case of an infant with topical steroid skin damage recovered by wheatgrass extract
Note: Many topical steroid addictions begin during infancy. Avoid using topical steroids on children 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 topical steroid-addicted.
Most 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 often being “treated” to overcome side effects caused by topical steroids, with topical steroids, which seems rather absurd. Instead, they should be weaned 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 condition and addiction.
Also, topical steroids (TS) do a lot more damage than “thin the skin”. In fact, many children – and even elderly adults – suffer from the side effects of these drugs when withdrawal is attempted.
"Elephant skin" restored almost to normal by wheatgrass extract (2 Cases)
Case No. 1. This patient battled topical steroid withdrawal symptoms on and off for about 30 years. During that time she developed thick, so-called "elephant skin" over both elbows, which is a common complication of prolonged topical steroid use generally considered to be "irreversible". Howevr, application of wheatgrass extract over the affected skin for two months shows significant improvement. Note the deep ridges that have reduced significantly in size, and the marked improvement 5 years later as shown in the picture on the right.
Case No. 2. Overnight drainage of fluid retention: This patient suffered for several years from grossly swollen legs and arms due to topical steroid use that apparently 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, but although her skin condition improved, the gross swelling remained.
Then, more as an afterthought, 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.)
It seems that wheatgrass extract is able to signal skin (and many other) abnormalities to the brain, which then responds accordingly to "normalise" the affected area(s). (See: How wheatgrass extract heals.)
- More cases of wheatgrass healing eczema and topical steroid skin damage
- Return to Cases & Conditions
- Read more about the dangers of TSW (Wikipedia)
Some other skin conditions that respond well to wheatgrass extract treatment: