Earlier this year, I visited the Cold Atmospheric Plasma (CAP) Clinic for TSW in Bangkok. The following recount is from a chapter in my new book Taper.
On my quest to explore modern treatments for TSW, I encountered hundreds of social media posts and patient narratives that led me to CAP. This innovative treatment was being utilised to aid people coping with TSW. I was captivated by numerous testimonials from people worldwide receiving CAP therapy at clinics in the United Kingdom and Bangkok. In February 2024, driven by hope and curiosity, I flew to Bangkok to learn more.
From the moment I stepped into the clinic in Bangkok, I felt a warming sense of community. The waiting room was busy with patients, each sharing their stories of battling eczema, skin atrophy, and severe withdrawals from topical steroids.
Every person I met—wrinkled, peeling, red, and hunched over—reminded me of my former self. It was like looking into a mirror of my past struggles. Many had uprooted their lives, relocating to Bangkok indefinitely to undergo continuous CAP treatment. Among them were some teenagers accompanied by their parents, all united together by a collective hope for healing and shared suffering caused by their skin condition.
I met Jordan, a fellow Aussie who had been undergoing CAP therapy at the clinic for the past two months. Jordan had ceased using topical steroids altogether and had endured immense suffering over the past few years. I had been following his journey on Instagram, witnessing one of the most severe cases I had ever seen, with his entire body covered in open sores, dry scales, and his skin burning a bright red. Jordan is one of the most well known advocates in the TSW community, sharing his story in interviews with the ABC and 7NEWS. Despite his condition, Jordan exuded creative energy and excitement. He was working on a documentary in a back room, interviewing all the patients who came to the clinic to share their journeys. He interviewed me as well, and it felt like a therapy session. Jordan asked me personal questions about my journey, and I found myself sharing deeply emotional stories and experiences that I had completely forgotten. It was a cathartic experience for me.
I also met Aliya, who was undergoing CAP treatment at the clinic. Aliya worked remotely as a consultant for the Canadian government and was able to continue her work while receiving CAP therapy in Bangkok. It was her second visit to the Bangkok clinic, and she intended to stay indefinitely. Aliya had made the difficult decision to cease using topical steroids completely after chronic skin complications after prolonged topical steroid usage.
She shared how, when she began CAP treatment, her neck had been covered in thick, hardened skin that severely restricted her movement. Observing her skin health on that day we met, the skin on her neck looked quite healthy. I couldn’t imagine how much pain and recovery she had gone through.
After spending some time in the front office, exchanging stories of our skin struggles, I finally met Jay. He entered through the front door and greeted me warmly.
Peerawat Jay and CAP Therapy for TSW
Peerawat Jay is a practitioner who has been dedicated to treating TSW people for 15 years in both Thailand and Singapore. He pursued a four-year preclinical M.D. program at Mahidol University from 1995 to 1999, where he graduated with first-class honours and received the prestigious Rockefeller Scholarship. Following this, between 1999 and 2004, Peerawat engaged in Ph.D. coursework and research. Unfortunately, due to financial constraints, he was unable to complete his dissertation by 2005, resulting in his discontinuation from the clinical portion of the program.
In 2004, Peerawat began working at an aesthetic device company that ran a clinic specialising in laser therapy for aesthetic purposes. During his tenure, he noticed that certain laser treatments could potentially thin the skin, leading to redness and sensitivity. Motivated to address this issue, he collaborated with his father-in-law, Dr. Chanchai Chutsirimongkol M.D., to develop a device aimed at reversing skin thinning and promoting skin regeneration.
As Peerawat treated more patients with skin thinning issues, he observed that prolonged use of topical steroids exacerbated some cases. Collaborating with Dr. Chanchai, they devised a treatment strategy that effectively reversed these conditions, deepening Peerawat’s understanding and expertise in managing TSW. Over the years, his experience with increasingly severe cases has significantly broadened his knowledge and refined his treatment approaches.
Despite the controversial nature of TSW treatment, Peerawat’s dedication to the field only grew stronger. He travelled to Singapore to share his expertise and ensure the ongoing availability of effective treatments for TSW. Currently, based in Thailand he continues to support a global community of sufferers, collaborating closely with a team that includes Dr. Chanchai Chutsirimongkol M.D., Dr. Sirayut Benjaoran M.D., Dr. Sarintip Tangyoosuk M.D., Dr. Wattanapak Khamphui M.D., and Dr. Achjima Tangkul M.D. Together, they strive to provide relief and solutions for individuals affected by TSW.
Jay kindly invited me to observe the initial consultations for two new patients. One patient was a teenage boy from Thailand, and the other was a young woman from Perth, Australia. Both of them were accompanied by their parents. During the consultation, Jay meticulously explained his treatment protocol for TSW in depth. He was sincere and well-informed, using diagrams and charts to ensure the condition and the treatment plan for both patients and their parents.
The CAP treatment operates on three core principles aimed at regenerating skin affected by TSW:
- Cellular Regeneration
The therapy triggers growth factors in skin cells to enhance their regeneration rate39. - Bacterial and Fungal Eradication
By interacting with pathogens on the skin, the treatment targets and eliminates harmful bacteria and fungi. This helps improve skin recovery and prevents infections that could worsen the condition - Micro-Exfoliation
The therapy includes a gentle micro-exfoliation process to manage hardened and damaged skin, facilitating smoother and healthier skin appearance
Jay recounted numerous cases of previous patients who had experienced symptoms such as hardened, oozing skin, and skin atrophy due to excessive use of topical steroids. He explained how damaged skin could result in heightened sensitivity to the external environment, as the epidermal layer becomes significantly compromised.
Jay also assists patients in identifying specific triggers in their lifestyles that can provoke flare-ups. Some patients uncover that environmental factors are significant culprits, ranging from dust mites to harsh chemical cleaning products. In one notable instance, Jay recounted how a patient experienced severe skin reactions due to the manufacturer’s perfume on a new leather sofa. Another patient said to have suffered flare-ups triggered by frequent exposure to printer ink at their job. I found Jay’s insights both profound and alarming.
Later in the day, I was fortunate to have lunch with Jay and Aliya. It became clear to me that CAP therapy was creating a profound movement within the TSW community. In our conversation, I asked Jay how I could help the community. He paused for a moment to think. He responded that he wanted people to learn as much as they could about understanding their external triggers in their environments. He shared that many patients left the clinic significantly improved after months of treatment, only to experience flare-ups upon returning to their home countries due to environmental factors at home or work. This underscores the need for more information and tracking around the long-term effectiveness of receiving ongoing CAP treatment.
CAP therapy can be beneficial for improving skin that has atrophied from long-term steroid use, focusing primarily on the skin cell regeneration, bacterial eradication, and micro-exfoliation. However, the underlying original skin conditions that were previously treated by topical steroids, such as eczema—which is often linked to genetic and environmental factors—may remain untreated by the CAP technology. This may explain why many people continue to experience flare-ups of their original skin condition after returning back to their homes and workplaces.
In my journey to find treatments and protocols for tapering off topical steroids, I learned that Jay’s CAP Therapy clinic in Bangkok only treats patients who have stopped using topical steroids completely. They do not treat patients who are still using topical steroids.
From Jason:
📖 After sharing my story, I’ve received a few heartfelt messages from the community asking me to elaborate on the finer details of journey of tapering off topical steroids. This has evolved into a book that I’ve been working on for a long time.
I hope that my story can help anyone who’s on a similar journey.
