Phases of Topical Steroid Withdrawal explained. Stages of TSW.

Phases of Topical Steroid Withdrawal.

Note: the timeline of healing can be different in the following cases:
1) - the lowest point can be later in time in case of triggers that delay the healing rate of TSW (such as not enough sleep, stress, alcohol use, exposure to allergens and irritants). To understand Triggers that delay the healing rate of Topical Steroid Withdrawal, you can watch the long version on this topic (video nr 3 on this channel). Many TSW patients also experience flares during their TSW healing process due to these triggers.
2) - some topicals can have irregular timelines. This has been observed in a small percentage of cases after the use of a certain immunosuppressant cream and a certain high potent steroid cream. In those cases the patient may experience a period of good skin, but when the skin gets triggered, the patients still goes (back) into TSW.

Important in this video is understanding the role of irritant exposure. This is a trigger that can slow down the healing rate of TSW considerably, but many TSW patients are not aware of irritants in their environment. This is because a normal healthy skin does not react to irritants. Also a thinned skin which is treated with topical steroid creams does not react to irritants (the reaction is suppressed because of the use of the TS creams). But when a person stops using the steroid creams, these irritants become a problem when someone is going through TSW.

Important in this video is understanding the role of irritant exposure. This is a trigger that can slow down the healing rate of TSW considerably, but many TSW patients are not aware of irritants in their environment. This is because a normal healthy skin does not react to irritants. Also a thinned skin which is treated with topical steroid creams does not react to irritants (the reaction is suppressed because of the use of the TS creams). But when a person stops using the steroid creams, these irritants become a problem when someone is going through TSW.

Also important in this video, is understanding that when the skin starts looking normal again, it has reached only 70% skin thickness. It's still thinned, very fragile and sensitive and you can easily flare from all kinds of triggers.

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[chrisbrowning]

I have been living with TSW for over two months and have dry skin with some redness still. My skin is flaking but in very small pieces, so I do exfoliate once every morning very gently with a soft towel. I have had some small areas weep for a few hours but they are drying up now and I still have swollen lymph nodes in the groin area. I have been giving Methotrexate which I started a week ago to help calm my immune system. I have stuck to a NMT( no moisture treatment ) for most of the time and making sure I have enough Protein and vitamins every day. If anyone is going through this please stay strong and remember for every day that goes by, you are winning!

[shanebuell]

It’s because are cells are sensitive to B3, which case us to have a niacin flush. Do not use lotions, throw them away. Work on doing (NMT) No moisture technique. You want your limit the amount of water you drink and no more hot showers. I take ice bath and wash up in all cold water. Do not take oat meal bath it suffocates your skin to be able to breath just like lotion. You want to fall asleep before 10pm and try sleep as much as you can this helps the healing. I also do long term fasting . Work your way up at first. Longest I’ve fasted for was 72 hours and helped my skin so much. But limit your b3 intake. I’m over 4 years of tsw.

[movarmaa]

Great video, thank you. Just one question, can TSW come back after years of having no steroids? Say 9 years?

[nancygregg]

After you recover, does the original problem come back, ie eczema?

[october-he]

Hi, any difference between psoriasis/eczema biopsie and tsw biopsie?
The problem with the soles of the feet is that over time, calluses form over them again and then they feel like armor. And underneath, after a while the inflammation flares up again, followed by insane itching, redness and hundreds of very very tiny gray dots (I almost suspect that it is dyshidrosis). I had a total of 4 biopsies on the soles of my feet. The first (2013) could not verify exactly whether it was psoriasis or eczema. The second (2016) showed eczema. The third (2017) and fourth (2023) both showed psoriasis.

[deniceevan]

I have been using steroids creams for 2 months straight i just noticed my skin cant fo with yhe cream, if should stop it i just get rashes and I decided to make research to find i have TSW😭😭

[F_Arrow]

How is a flare defined? I hear the words cycles and flares but struggle to know the difference. My body for the most part is just dry with thick elephant skin on elbows and behind knees but my face tends to go through the shedding, bleeding and sometimes oozing the most. Can have better periods in between but never totally normal. My forehead in particular seems to be affected the most. This has been case for 2.5-3 years and I'm 23 months steroid free so just trying to figure out the phase I'm in.

[quartd]

I've spent $70 in the past month on lotions trying to nail down the cause of my daily flair ups.

[jaypsocampo]

I use oral steriods for my eczema instead of topical ones. is it as bad as topical?

[wellwisher]

So why are is it still so readily available????

[Dypmdn]

Can TSW happen in my ear? I was put a cream that contain steroid in my ears because my ears feel dry..after that, i stop using it..i notice that my ears become red, flaky, and sometimes itchy..is it TSW ? Or psoriasis?…other thing, does TSW and psoriasis look same?..other than that, now my ear has flakes..i want to ask something..when i peel the flakes, the new flakes will form ? Or no flakes anymore after i peel it? Tq

[neceetastic]

Please help me I can’t find a case like mine. I used neomycin polymyxin with dex (steroid) .01% for 8 months on my eyes. I stopped and immediately got rash on my eyes. I am in week 3 and rash is now spreading to arms very slowly and hands. Does this mean I have a mild case? I didn’t suffer from eczema prior to this or any skin conditions.

[fatyaalkharijah]

Does steroid use for two months also cause TSW? I use mometasone furoate 0, 1 for couple weeks and then some chinese lotion that turns out contains steroid as well..

[VickyG]

This timeline is completely off for our experience

[Dypmdn]

Where is the TSW appear on skin? the TSW appear on the skin that we have put the steroid cream? Or whole body ?

[rer]

Are there ways to help the skins thickening/healing process?

[xyrocknirmou]

Hi do you think dryness and flakiness is a good sign in TSW and means that im very far in the process of healing and should i peel of the flakes because flakes triggers and its possible to reduce deep bone itching or its impossible because the tingling is so not managable

[JatinRohilla-ef]

I don't know what is happening, but my skin first become red then in 2 or 3 days it dry and within a week it completely disappear and then the next day same cycle happens. And it last for 3 4 months. BTW it is only on my neck whereas my whole body is completely cleared. So it is a way of healing ?

[mnayak]

What I put on flaky dry itchy skin, very itchy

[guwop]

Im only 60% 2 years of topical steroid withdrawal