When I started TSW Assist in 2021, the first problem I wanted to tackle was: How can I crowdsource collective insights on managing the symptoms of Topical Steroid Withdrawal?
Across Facebook groups and online forums, I noticed the same questions being asked daily about specific products, routines, and methods. The answers were often repetitive, offering similar insights. When I experienced TSW, these online spaces were both helpful and overwhelming, requiring endless sifting through anecdotal approaches.
Through a simple, detailed survey, we gathered collective insights on what people found helpful for their condition. These insights remain available on the website (not medical advice).
Connecting People to Health Professionals
The next question I wanted to address was: How can I connect sufferers with healthcare professionals who recognize and support TSW?
TSW is an iatrogenic illness with no established medical cure or protocol. The community desperately needed support from health professionals willing to acknowledge TSW and offer assistance—whether through medical leave notes, validation via diagnosis, pain management, counselling and other supportive health practices.
In 2023 and 2024, I spoke with dozens of health professionals who reached out through the website. Surprisingly, most were asking me for guidance on how to help their TSW patients. Unfortunately, I had no medical expertise to offer beyond directing them to the anecdotal insights and to listen deeply to their patient’s stories.
This was eye-opening—the demand for TSW support was strong on both the patient and healthcare side.
A Hybrid Skin Condition – It’s Not Just TSW
From my own experience, I knew that TSW was not a standalone condition. It was a mix of steroid-induced skin atrophy, acute withdrawal symptoms, and uncontrolled eczema.
Survey results also reflected this. The majority of people experiencing TSW also had eczema, making it even harder to distinguish between the two conditions. This hybrid nature adds another layer of complexity when it comes to treatment and recovery.
You can see the survey insights here: Initial Skin Condition Before Using Topical Steroids
Cold Turkey vs. Tapering
When people experience steroid-induced skin atrophy and withdrawal symptoms after long-term use, quitting topical steroids becomes a common choice. However, there are two main paths in the community:
1. Tapering
The standard medical advice is to taper off steroids gradually. For many—including myself—this was extremely difficult.
Here are some community insights on tapering off topical steroids.
2. Cold Turkey
The majority of the TSW community chooses to quit steroids abruptly. Within days or weeks, their skin and overall health decline rapidly as they endure withdrawal head-on. Their suffering has been widely shared on social media, driving awareness and recognition of TSW worldwide.
TSW is no longer a stigma or hidden condition—it is now a global phenomenon with a community demanding recognition and support. Many who have endured the cold turkey path have healed after months or years of withdrawal. These TSW Warriors share their journeys to inspire hope in others.
At the heart of both approaches—whether tapering or cold turkey—is the same goal: healing.
Why I’m Stopping TSW Assist
The majority of the TSW community has chosen the cold turkey path. I personally quit topical steroids cold turkey many times. It was brutal. I was bedridden and isolated myself.
In the end, I actually went back on topical steroids aggressively, then tapered off slowly.
That might be triggering for a community that is largely anti-steroid, but it was my personal choice. By integrating different health approaches, I was able to approach TSW in a controlled way —mitigating and bypassing the devastating withdrawal effects.
As much as I want to help the cold turkey community, it’s no longer my place. The symptom management insights remain on TSW Assist, but cold turkey TSW overlaps with so many other factors—eczema, HPA-axis dysfunction, adrenal crisis, anti-pharmaceutical perspectives, alternative healing modalities, metabolic health considerations, chronic inflammation management, and the psychological impact of long-term withdrawal.
The cold turkey TSW community has grown into a global network of some of the strongest people I know. Many have become my dear friends over the years.
For almost four years, I worked on TSW Assist at night and on weekends outside of my day job and family time. It was a passion project driven by a deep desire to help others. However, I no longer have the capacity to grow this website and continue finding insights into the complexities of cold turkey TSW. So, I’ve decided to stop running the survey for TSW Assist.
It was an ambitious project that successfully solved the problem of crowdsourcing symptom management insights. Beyond the survey, conversations in TSW communities continue, with hot topic discussions on Cold Atmospheric Plasma (CAP), Cyclosporine, and Dupixent being the most common topics.
I Wrote a Book on Tapering
Over the past year, I’ve been writing a book, and it is now available on Amazon.
Taper is my personal, chronological journey of fully tapering off topical steroids after 20 years of daily use. With the help of a diverse team of health professionals, I was able to approach TSW in a controlled way —mitigating and bypassing the devastating withdrawal effects.
It is a collection of my insights, learnings, and reflections on the global tidal wave that is TSW. There’s also a chapter on my experience visiting the famous CAP Clinic in Bangkok, written from a researcher’s perspective.
This book is dedicated to anyone living in fear and anxiety of TSW. Healing is absolutely possible.
Although the survey is now closed, the insights remain available on the website. I will occasionally write articles sharing what has been helpful based on my own experiences and observations. If there are universities or research groups that would like to use TSW Assist to find more insights, please feel free to email me.
Thank you to everyone who has been part of this journey. The TSW community is one of the most resilient I have ever seen. I wish you all strength, healing, and peace on your paths forward.
I’m taking a break for now, but this not a goodbye!
— Jason
