No Moisturising Treatment (NMT) for Topical Steroid Withdrawal

What is No Moisturising Treatment?

Dr. Kenji Sato, based at Hannan Chuo Hospital in Japan, pioneered the No Moisturizing Treatment (NMT) subsequent to rigorous observation of his TSW inpatients on a 24-hour basis. Widely regarded in the medical community as an authoritative figure challenging the prolonged use of topical steroids, Dr. Sato’s approach has garnered attention. Tokuko Kameda, a former patient of Dr. Sato, translated the tenets of NMT into English following her complete recovery from TSW via this treatment protocol. Ms. Kameda’s translation aims to disseminate this knowledge to TSW patients globally. Specifically, this therapeutic regimen was developed for patients initially diagnosed with eczema, subsequently treated with topical steroids, which later culminated in a topical steroid addiction. These individuals have ceased steroid use and are presently experiencing TSW.

dr kenji sato


Dr. Kenji Sato developed the treatment 30 years ago after he observed some of his inpatients suffering from Topical Steroids Withdrawal. It is a treatment that follows strict and specific a lifestyle change which involves completely removing the use of all creams, lotions, moisturisers and sprays from your skin care routine. If you are looking to go into No Moisturising Treatment, it is strongly advised that you consult with a medical practitioner beforehand.

The No Moisturising Treatment, also known as No Moisturising Therapy, and No Moisture Treatment, allows the body to regain its full use of cortisol without any artificial additives. Since there is a severe syntactic strain on the skin after using topical steroids cream for an extended time frame, the body’s production of cortisol begins to get affected. The No Moisturising treatment allows the body to regain this part of the body’s function.

No Moisturising Treatment entails the abstinence of creams on the skin. It also involves limiting the amount of water consumed for the process to continue. It is important to remember that all bodies are different and the healing process can vary. Some people have noted seeing improvements in the skin from the third week, while others take a longer time for a desirable result to be noticed.


The No Moisturising Treatment routine

Certain rules need to be followed in ensuring the full completion of the No Moisturising Treatment:

  1. It is essential that there is no use of any moisturiser and steroid cream or gel on the skin
  2. Exercising daily is essential for at least one hour if the No Moisturising Treatment is to be effective.
  3. Showering is only recommended once in three days for two minutes, and no soaps or shampoos are allowed.
  4. Rest is absolutely crucial. At best, sleep by 10 pm daily so you can feel refreshed and energized
  5. Eating a healthy nutritious diet that is filled with lipids and proteins.

Throughout online support groups and Facebook groups, many sufferers with topical steroid withdrawal are attempting to participate in their own version of NMT, that suits their lifestyle and fluctuating condition.
For example, showering once every three days may not be feasible for an individual who works in a public facing job.
Another example is a person who follows the NMT protocol on their body, but still applies moisturisers on their face.
The challenge with this is that it no longer becomes a strict protocol, and diminishes the true value of the NMT protocol.

More information can be found on Dr. Mitsuko Satou‘s videos. Dr. Mitsuko Satou is a Japanese paediatrician who works alongside Dr. Kenji Sato treating TSW patients.


Photos of Tokuko’s skin condition from Oct 29 to Dec 17, 2015 at Hannan Chuo Hospital in Osaka, Japan

NMT no moisturiser treatment



NMT no moisturiser treatment leg



Challenges and desperation of hybrid NMT

According to Tokuko, NMT is a strict protocol must be followed without any deviation. The strict adherence of this protocol can present lifestyle challenges due to the severe physical appearance of the skin during the healing period.

The widespread information about NMT through social media has resulted in TSW sufferers trying their own hybrid variations of NMT from home, without medical supervision. Though many report significant results in skin healing, many also report increased bacterial infection, fungal infection, insomnia, extreme discomfort, anxiety, and depression. Medical supervision is paramount.

The lack of standardised diagnoses and treatment of topical steroid withdrawal in some countries, has resulted into a subset of sufferers and carers attempting NMT and seeking medical advice from other sufferers based on their photos, rather than the advice of medical professionals. When skin infections occur, this can further perpetuate the severity of their condition – both physically and mentally.


Considerations for approaching No Moisturising Treatment

People who have healed from topical steroid withdrawal by NMT will tell you it is not easy to follow through with this treatment.  Preparation and education is important if you want to start and finish the treatment to get the expected results. The following may help you on your NMT and TSW journey.

  • You will definitely get flare ups. Flare ups can be painful and comes in the similitude of a nasty sunburn. Some people have varying flare outbreaks during NMT. Consistency and perseverance is the most important factor. It is common for the skin to start glowing in a matter of days after the flare ups.
  • Sleep may be challenging and uncomfortable because of the state your skin. A consistent night ritual, sleep pattern and naps during the day can definitely help,
  • Apply plain gauze on oozing skin if it starts to smell. The skin may smell it oozes then begins to dry and turn into scabs
  • Avoid long exposure to the sun
  • NMT is extremely difficult and the visual appearance of the skin throughout this treatment can affect the mental health of the sufferer
  • NMT for TSW can be complex and medical support can be required, especially when signs of bacterial or fungal infections arise

IMPORTANT: Although many TSW sufferers have success in participating in their own versions of NMT at home, we are not suggesting that you try NMT. This is a specialised protocol that requires the support of a medical professional.


Can anyone try No Moisturising Treatment?

It is crucial to consult with your doctor before trying any new treatment for your skin. As NMT does produce many success stories for TSW, it is recommended to be sure about the compatibility of the treatment to your body. Skin infections are also important to consider when considering NMT. According to Tokuko, NMT is  not advised that pregnant women or children under 6 months.



Can you continue NMT if you get sick?

NMT does not support you neglecting your health; therefore, you should stop the treatment when you notice signs of sickness. When a person is sick, the body needs as many fluids as possible to be able to recover. Again, before starting the treatment, it is crucial to consult with your doctor and confirm if your body can withstand the treatment without any adverse reactions.


Feedback from the TSW Community

Based on the the ongoing data collection of methods to manage the skin related symptoms of topical steroid withdrawal, No Moisturising Treatment is trending in efficacy within the TSW community. More research and studies are required for topical steroid withdrawal as there is no current medical cure or protocol.

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