Healing TSW Naturally – The Nuances of Eczema and TSW

Picture of Jason Vergara

Jason Vergara

Jason has worked in the Australian tech space over the past decade. With a recent focus on disabilities, he is passionate about human-centred technology that creates access to healthcare. Jason is the author of Taper: A Journey Through Eczema and Topical Steroid Withdrawal

The idea of “healing TSW naturally” is a question often posed in communities of those dealing with Topical Steroid Withdrawal (TSW). But what does healing naturally mean? For most, it refers to the use of non-pharmaceutical methods or products—typically those derived from natural ingredients such as plants, minerals, or other earth-based compounds.

This concept stems from a desire to avoid synthetic or pharmaceutical treatments, particularly among those who feel their condition has been worsened by the use of pharmaceutical topical steroids. However, healing TSW naturally is more complex than simply turning to natural products. It invites a broader discussion about TSW itself and its connection to eczema, the most common underlying skin condition for many TSW sufferers.

 

What Does “Healing Naturally” Mean?

When discussing natural healing, there is often a focus on using non-pharmaceutical methods to address symptoms or conditions. The term “natural” generally refers to remedies derived from herbs, plants, essential oils, minerals, or lifestyle changes. The idea is to avoid synthetic medications, which some believe may only address symptoms rather than the root cause of the condition. For many going through TSW, natural healing is about allowing the body to rebalance itself without relying on topical steroids or other pharmaceuticals that can further complicate the healing process.

But what makes this question even more complicated is that when we talk about healing TSW, we may also be talking about healing eczema. This brings us to a crucial distinction that many in the community are aware of but is not always discussed openly.

The Nuances of Healing TSW vs. Healing Eczema

TSW is a result of withdrawing from topical steroids, but it often goes hand-in-hand with a return of the original condition: eczema. So, the question of how to heal TSW naturally can actually be broken down into two parts:

  1. How to heal TSW naturally? – focusing on managing the symptoms of steroid withdrawal.
  2. How to heal eczema naturally? – addressing the root skin condition that may have been suppressed for years by steroid use.

While both are related, they are not the same. Healing eczema naturally is a different conversation from healing TSW naturally, though they share some overlapping strategies.

When someone starts experiencing TSW, they often face a hybrid of the two conditions. They are not only battling withdrawal symptoms like burning, swelling, and flaking, but also the return of their underlying eczema, which can look worse than ever because the skin may have been reliant on topical steroids for so long.

 

Diagnosis for TSW

There is no widely agreed-upon set of diagnostic criteria for topical corticosteroid withdrawal. However, recent literature has identified key features that include:

  • Frequent and prolonged use of topical steroids on the affected area.
  • Frequent and prolonged use of topical steroids on sensitive areas like the face or genitals.
  • Symptoms such as burning, itching, and rapid development of redness (erythema) within days to weeks after discontinuing topical steroids.
  • Commonly associated factors like a history of atopy, especially atopic dermatitis, prior use of oral prednisone for skin issues, skin sensitivity, excessive skin shedding, oozing skin, swelling (especially around the eyes or ankles), and specific skin changes like “elephant wrinkles” on the elbows and knees (extensors) or the “red sleeve sign.”

Suggested Diagnostic Criteria for TSW: A Starting Point for Discussion and Future Research

Dr. Belinda Sheary, an Australian medical doctor renowned for her extensive publications on TSW since 2016. According to Dr. Sheary, TSW can be considered when the following essential criteria are fulfilled, the diagnosis becomes more likely when more of the key diagnostic criteria are also present.

 

Essential Criteria

  1. History of long-term regular topical corticosteroids (TCS) use (months to years) where TCSs were initially effective, but over time, either increased amounts or potencies (or both) were required to reduce severity of skin symptoms
  2. Itch
  3. Erythema

 

Key Diagnostic Criteria

  1. History of atopy, especially atopic dermatitis
  2. History of TCS use on the face, especially potent TCSs
  3. History of oral prednisone use for skin symptoms
  4. Burning pain on the skin
  5. Skin sensitivity to previously tolerated skin products
  6. Excessive skin exfoliation (“shedding”)
  7. Oozing skin
  8. Edema, especially of the eyelids or ankles
  9. “Elephant wrinkles” of the extensor elbows and anterior knees
  10. “Red sleeve” sign

Additional Supporting Features That May Be Present

  1. Sleep disturbance
  2. Mood disturbance
  3. Skin pain, other than burning pain
  4. Papules and pustules
  5. Headlight sign

 

How to Heal Eczema Naturally?

Before diving into natural remedies for TSW, let’s explore what healing eczema naturally entails. After all, if TSW is part of a longer-term eczema problem, addressing the eczema may ultimately help with the healing process of TSW as well. Here are several natural methods often used for managing eczema:

1. Dietary Changes

There is growing evidence that diet can impact skin health, particularly for those with inflammatory conditions like eczema. Research has shown that eliminating common triggers such as dairy, gluten, and processed sugars can reduce flare-ups in some people. In contrast, adding anti-inflammatory foods such as fish (high in omega-3s), high-protein foods, and fermented foods like kimchi or kefir can support skin health.

2. Moisturizing with Natural Oils

Many people with eczema have found relief using natural oils instead of conventional moisturizers. Coconut oil, shea butter, avocado oil, and jojoba oil are also popular choices for keeping the skin hydrated without synthetic ingredients.

3. Probiotics

Another potential natural solution is taking probiotics, which support gut health. Since there is a known link between gut health and skin health, taking a daily probiotic may help manage eczema symptoms from the inside out.

4. Traditional Chinese Medicine (TCM) and Acupuncture

Acupuncture and herbal medicine, staples of Traditional Chinese Medicine (TCM), have been used to treat eczema for centuries. TCM views eczema as a manifestation of imbalance within the body and aims to treat both the symptoms and the root cause. Acupuncture, in particular, may help reduce inflammation and relieve itching, while Chinese herbs, such as licorice root or Chinese skullcap, are thought to help detoxify the body.

5. Naturopathy

Naturopathy often involves a combination of dietary changes, herbal medicine, and lifestyle adjustments to help manage eczema. Natural remedies such as evening primrose oil, fish oil supplements, or vitamin D can support skin health.

 

How to Heal TSW Naturally?

Healing TSW naturally is more complex and nuanced. It is an iatrogenic syndrome and more research is needed. The skin is going through a massive detoxification process and can be extremely sensitive to even natural products. Healing TSW is not just about treating the skin; it’s about managing a wide range of systemic symptoms that can come with withdrawal.

Some people experience chronic-fatigue, insomnia, anxiety, and depression during TSW, which makes the healing journey much more involved than eczema alone.

Here are a few approaches that people in the TSW community have found helpful to manage some symptoms, although more research is needed in this area.

1. Cold Compresses and Ice Packs

When the skin burns, using cold compresses or ice packs can help reduce inflammation and offer temporary relief. This method is often reported as a quick fix for itching and burning sensations, which are common in the early stages of TSW.

2. Dead Sea Salt Baths

Dead Sea salt baths are thought to soothe the skin and help reduce inflammation. The high magnesium content in these salts may support the skin’s barrier function. Some anecdotal reports suggest that regular salt baths can help reduce the itch and tightness associated with TSW.

4. No Moisture Treatment (NMT)

The No Moisture Treatment (NMT) is a controversial method that involves avoiding all moisturizers and allowing the skin to heal on its own. The theory is that the body will naturally regulate its moisture levels, and introducing external moisturizers may prolong the healing process. However, this approach is difficult and not well-studied, with anecdotal success and mixed results. It requires strict medical supervision in a clinical setting. This method is only applicable for people who have stopped all usage of topical steroids entirely, rather than tapering off.

ℹ️ Related Post: Cold Turkey Vs Tapering Off Topical Steroids

 

5. Traditional Chinese Medicine (TCM)

Just like for eczema, TCM can be applied to TSW. Herbal formulas designed to detoxify the body may help speed up the withdrawal process, while acupuncture can relieve some of the more uncomfortable symptoms, such as burning and itching.

6. Naturopathy

Naturopaths may recommend lifestyle changes, such as dietary adjustments or supplements, to support the body’s natural healing process. They may also suggest specific herbs or vitamins to help reduce inflammation, support detoxification, or soothe the skin.

 

Pharmaceutical Considerations

In the contrast of healing TSW “naturally”, it’s also important to address what it means to heal "unnaturally." TSW, being an iatrogenic condition—meaning it is inadvertently caused by the topical steroid medications meant to treat the eczema —has understandably led to a strong anti-pharmaceutical sentiment within the TSW community. This frustration is not just directed toward topical steroids but often extends to all pharmaceutical interventions. Many who suffer from TSW feel deeply let down by conventional medicine, and the resulting disillusionment can lead to outright rejection of pharmaceutical treatments, even when some may be beneficial in certain cases.

The emotional and psychological complexities of living with TSW, including feelings of betrayal by the medical system, often shape a firm opposition to any form of pharmaceutical medicine.

This resistance can cloud constructive discussions about the potential benefits of certain medical treatments. While it’s crucial to respect the reasons for this mistrust, it is also important to recognize that some pharmaceutical options are discussed within the TSW community as potential treatments, even if they remain controversial. Medications like Dupixent (dupilumab) and cyclosporine, for instance, are often considered by those struggling with severe cases of TSW or eczema, as these drugs can target immune system pathways involved in the inflammatory process.

Although these treatments can be helpful for some, they are not without risks, and the decision to use them requires careful consideration. In online forums, discussions about these options are often heated, reflecting the tension between seeking relief and fear of medication.

Ultimately, navigating the use of pharmaceutical treatments within the TSW community requires a balanced, informed approach, recognizing both the valid concerns and the potential benefits.

 

Is Healing TSW Naturally Possible?

Healing TSW naturally is not a straightforward process, and it can be tempting to look for a one-size-fits-all solution. But the truth is, healing TSW—and eczema, for that matter—is highly individualized. Natural healing methods can be effective, but they require patience, research, and a willingness to explore various options safely. Always consult a healthcare provider when trying new treatments, even natural ones, to ensure they are appropriate for your specific situation. Although not defined as natural healing, non-steroidal pharmaceutical medications to treat eczema are being considered and discussed within online communities.

The distinction between healing eczema and TSW is crucial, and while the lines can sometimes blur, understanding the nuances of each can guide you toward the right path. Ultimately, a natural approach is about working with your body, rather than against it, to achieve long-term health.

 

Picture of Jason Vergara

Jason Vergara

Jason has worked in the Australian tech space over the past decade. With a recent focus on disabilities, he is passionate about human-centred technology that creates access to healthcare. Jason is the author of Taper: A Journey Through Eczema and Topical Steroid Withdrawal

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