We welcome guest blogger Harriet Hammond to Balmonds, to talk about her personal experience of Topical Steroid Withdrawal (aka TSW, RSS or red skin syndrome). In the first of her blogs for us, she explains the theory and practice of No Moisture Treatment (NMT) as a healing strategy for TSW. 

Congratulations! You have discovered Topical Steroid Withdrawal: the process of coming off steroid creams that are no longer helping, or even exacerbating, your skin troubles. So you know about it… but now what? With TSW still being largely unknown and unrecognised among the majority of the medical community, the vacuum of knowledge has been filled by the experience and research of others who have been through it. 

Having trawled through Facebook groups (Topical Steroid Withdrawal-Red Skin Syndrome Support Group, ITSAN Red Skin Syndrome Support Group, NMT (No Moisturizing Treatment) Education Group), Instagram posts (#topicalsteroidaddiction #tsa #topicalsteroidwithdrawal #tsw #redskinsyndrome #thisisnoteczema) I often felt I was flitting from one rumoured solution to another, often contradictory, method to make my journey easier. I spent hundreds on alternative therapies (hypnotherapy, acupuncture, reflexology) and supplements (the list reads like a shopping list for a first year Hogwarts student in a potions class) and most of these – though not all - can, quite frankly, get in the bin. It turns out that, for me, one of the best things you can do is… nothing!

This is a strategy known as No Moisture Treatment (NMT).

What is it?

Not moisturising and following a strict set of rules to allow the skin to dry and boost the body’s own healing powers, it will learn how to regulate itself and not drag out the TSW journey for longer.

The Science

Probably counter-intuitive to all of us with eczema or dry skin who had the “you must moisturise to protect your skin barrier” message drilled into us since we were dry-skinned tots, but TSW is a different beast.

Here’s the regime to follow:

• Limit showering and bathing – once or twice a week, around a minute long. Keep water cool, not hot
• Use no moisturisers, either applied to skin or natural moisture inducers such as heavy blankets and clothing
• Limit fluid intake to around 1 litre (depending on your weight); this reduces ooze, avoiding losing too much protein through the skin
• Ensure you are eating enough protein for skin repair
• Exercise for 30 minutes a day; this boosts your metabolism and accelerates skin regeneration
• Go to sleep at 9:30pm to get sleep between 10pm-2am which is when growth hormones are at work

The Experience

It’s pretty brutal. There’s no sugar coating it. I’d say to do NMT properly, you need to prepare for it and have support. You might need someone at home to help you with preparing food, helping you get out and exercise and keep your head in the game. Not moisturising can reduce redness and the burning feeling, reducing fluid intake can make your mouth so dry you look at a dirty puddle like it’s a Tango Ice Blast. Your skin will ooze, scab up, shed and after a few cycles, softer skin will start to emerge. Get some strategies in place and stay strong. If you have a wobble, don’t beat yourself up, just get back on the wagon.

Harriet Hammond charts her TSW journey here.