There are no agreed protocols in modern medicine for treatment of Topical Steroid Withdrawal , as it is not recognised as a distinct clinical entity. Patients seeking help for Topical Steroid Withdrawal are usually prescribed with more topical corticosteroids, which more often than not proves counterproductive. Patients, on the other hand have become more aware, and a recent study found a six fold increase of the hashtag #topicalsteriodwithdrawal on social media platforms such as Instagram between 2018 and 2022.
Topical corticosteroids (TCSs) have been in use since 1950 and they have since been the mainstay for the treatment of multifarious skin conditions. An estimated 10.5 million tubes of TCSs were prescribed in England during 2020-21.
The Medicines and Healthcare Products Regulatory Agency recently issued a warning on the long term use of TCSs. It recommended that if after ceasing the use of TCSs, patients experienced skin burning and redness due to Topical Steroid Withdrawal (TSW), to consult their GP. It is possible that a growing number of patients experiencing such symptoms has contributed to the Agency issuing this caution.
In view of the limited choices available for the treatment of TSW, homeopathy can be explored as a potential avenue for treatment. Homeopathic remedies are gentle and free from any side effects, and generally have a good track record of treating skin conditions. As such, it is not uncommon for homeopaths to receive a growing number of inquiries related to the treatment of TSW. Indeed my experience regarding such inquiries is no different.
Kate (not real name) contacted me two months ago to seek homeopathic treatment when she was six months into TSW. She had used topical steroids for just under a year to treat stubborn eczema on her neck, but after ceasing the use of steroids, TSW symptoms appeared rapidly. Attempts to control and cope with the flare up was not only physically distressing but also took a toll on her emotionally.
As a result of TSW, Kate’s torso and thighs also became affected, as her skin became extremely dry and cracked and presented with crust-like symptoms. Her arms, neck and face were worst affected, having “reptiles like scales” which released fluid and were generally covered with red, inflamed and bumpy patches.
Kate’s TSW symptoms were accompanied by an intense itch, the scratching of which resulted in bleeding on various parts of her body. She felt a burning and stinging pain as a result of the raw skin, and found it difficult at times to tolerate the touch of clothing on her skin.
Although Kate used moisturiser liberally, her dry and flaky skin would absorb the moisture rapidly, resulting in her feeling the need to apply more within a matter of minutes. She experienced distress during the day and was unable to sleep well at night, leading to a deterioration in her physical and emotional well-being.
While recounting her ordeal during the initial consultation, she could not help “not scratch” her already raw and sensitive skin on neck and face, thus perpetuating the vicious circle only to make it even worse –as is the dilemma of TSW.
As I made further inquiries during the course of her consultation, it became clear that the TSW symptoms were a manifestation of the body’s attempt to offload the toxins which had built up over time as a result of long-term TCS use. The major organs responsible for eliminating the toxins from the body were under stress.
Kate had sluggish bowels movements which occurred once in 3-4 days and a tendency towards constipation. I prescribed her a bowel nosode remedy aimed at stimulating the gut. I often see in my practice that a healthy gut has a direct positive effect on skin health.
The long term use of steroids had placed Kate's liver under stress, and required detoxification. The homeopathic remedy of Berberis aquifolium is an effective liver stimulant and also has an elective affinity for dry and scaly skin. As such, this remedy also formed part of my prescription.
Constitutional remedies are powerful tools that classical homeopaths employ to deal with deep-seated physical and mental/emotional imbalances. I have seen the effectiveness of these remedies time and time again in the course of my practice. In Kate’s case, the homeopathic remedy Lycopodium was prescribed as a constitutional remedy. Lycopodium has a large sphere of action, and has a strong influence on both skin and Liver.
Four weeks after using the remedies, Kate reported a marked improvement in her skin – her arms and hands were substantially healed (as shown in the illustration above). Her legs and torso were experiencing much less dry skin and flakes, with moisturiser needing to be applied a few times a day. Her face and neck, which earlier would bleed from excessive scratching, had healed noticeably. The redness (often also referred to as Red Skin Syndrome) was also significantly better. The overall progress that she made in four weeks was extremely positive.
Kate further reported that the itch has decreased considerably, as well as the general soreness. She was able to get a good night’s sleep, and wear the clothes she preferred without worrying about the effect on her skin. Overall, she was feeling far more comfortable than she had been a month earlier.
One noteworthy is that the homeopathic remedies helped to improve her quality of life significantly. TSW also has a psychosocial dimension, and my treatment protocol was directed to specifically address this aspect. Kate reported that she felt calmer and more focused.
Although her treatment remains ongoing, the giant leap taken in the short space of four weeks is illustrative of the efficacy of homeopathy in treating TSW, especially when there are not many alternative options. And this comes with the added bonus of holistic improvement.
Some more "before & after" images showing cases of topical steroid withdrawal treated at Holistic Homeopathy
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