Monthly Archives: November 2012

What happened when I left topical steroids behind?

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My update on red skin syndrome:

I have no idea if these are the side-effects of topical steroid (TS) withdrawal. I haven’t experienced oozing or a whole lot of burning, as other people have noted in their blogs. Perhaps it’s because I was on 0.2% hydroval or that my dreaded skin isn’t as addicted as it could have been when I decided to stop. So here are the out of ordinary things that happen during the 10 days I stopped TS:

Day 1 – My neck is very unhappy. It’s red, dry, and very flaky. I noticed red pimple like dots along my upper thighs, stomach and lower arms

Day2 – My eyelids have become flaky and dry. I managed to keep my neck well moisturized but it’s still red. It’s very hard to sleep because my neck is very itchy

Day3- I woke up to dry eyelids and a stiff and red wrist

Day4 – Dry flaky eyelids. Neck is pink, flaky and dry. A few red dots along my arm

Day5 to 8 – I will be completely honest and confess that I got lazy

Day9 – My neck is behaving well today. It’s a bit red but it is keeping in moisture pretty good and isn’t shedding skin like crazy. (lol, I just realized I called my own neck, “it”). I also took a bleach bath at night and it really made a noticeable difference in the redness on my neck. Hopefully, this is working for others as well

Day10 – My neck is behaving well today. It stayed pretty moisturized throughout the day at least until night hit. At night I had a really dry itch on my neck. Scratch scratch

Day11 – My neck hurts from turning. It feels so thin, I feel like my skin will break open and bleed. It’s along the front of my neck. It is also very sensitive today. It could be because I only had 3 hours of sleep

In my opinion, there does seem to be a basis for topical steroids addiction based on the red dots and itchy dry eye lids, which only popped up a day or 2 following my withdrawal. I can’t be 100% sure that I’m suffering the effects of topical steroids withdrawal, but hopefully this will help someone who is as confused as I am and experiencing something similar without the oozing.

I will continue to update readers! Hopefully this is a case of topical steroid addiction and not just a bad case of eczema because at least with the former, you have a chance of getting better by stopping steroids.

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Red Skin Syndrome or Just Paranoia?

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Do you have eczema that seems to be getting worse over time? Or do you find that you need stronger and stronger medication? If so, this article might help you!

Recently I came across red skin syndrome, otherwise known as Topical Steroid Addiction. It appears to be a legitimate but not well-recognized syndrome. There are a few articles, mostly by the same doctor, published in dermatology journals. According to ITSAN.org, long-term usage of topical steroids can lead to addiction. Some symptoms they listed include:

1)      “Topical Steroids (TS) stopped working on your eczema, you needed stronger ones to get the same result”

2)      “When you stopped using TS you turned red, your skin burned, felt hot, swelled, and oozed, etc.”

3)      “You had ‘uncontrollable’ spreading eczema”

4)      “You could NOT identify any allergies/irritants that were causing the problem after many tests.”

5)      “You did a skin biopsy that showed spongiotic dermatitis, or nothing of note.”

6)      “You used TS regularly for a period of time that would make one become addicted (weeks to decades).”

http://www.itsan.org/forum-and-faqs.html

When I did further research it was as though all the pieces fell into place. I suspect that I have red skin syndrome but I can’t be sure. I’ve been using steroids sparingly for the past 6 years. I try my best not to use it when my skin is doing well because I’m worried about the side effects of thinning skin and wrinkles. However, I found that over time, I was depending more and more on it for these frequent flares on my neck. I began to suspect that the worsening eczema on my neck could be signs of red skin syndrome. Looking  back there seems to be a series of clues that suggest red skin syndrome as the culprit.

A)    The only areas that I have used TS is on my neck and occasionally on the folds of my elbows and wrists. I never used TS  behind my knees due to laziness and the fact that I don’t really wear shorts. Surprisingly, the back of my knees are the only area where my eczema has gotten better and rarely flare-up anymore.

B)     My brother also has eczema. However, he never used TS. His eczema is less severe and frequent and only seems to appear when he has exams. Even so, it goes away quickly.

C)     Elidel used to work really well for my neck and it completely got rid of the redness there. However, about a year ago it effectiveness stopped. There’s was a persistent redness on my neck even after application.

D)    My neck has problems absorbing most moisturizers.

E)     According to a Japanese author on Red Skin Syndrome, another possible sign is that Vaseline burns the skin. While this hasn’t happened to me, I find that Vaseline makes my neck itchy sometimes, especially when my skin is flaky.

F)      I also noticed that the eczema on my neck began as a small patch, but over the years it has spread to my entire neck and is now slowly inching its way towards my chin.

G)    My neck can shed skin like crazy if I’m not constantly moisturizing.

H)    I had an allergy test performed recently. I have been in no contact with any of my known allergens. I know my allergy is not triggering my eczema because I usually get hay fever when my allergen is present. I thought it might be dryness, but I don’t think that it is always the case because I’m really good at keeping my skin moisturized with my current regime.

I)       When I look at pictures of people with red skin syndrome, I say that’s me! Except I don’t have red skin spread throughout my entire body. According to the Japanese author, it is possible for it to be localized in one area if you have used TS only in that area.

Last week I decided to stop using topical steroids to see if I would get some of the withdrawal symptoms that are supposed to appear after stopping TS. Surprisingly, I did or maybe it is a coincidence? Either way, I’m not using steroids anymore.

I’m really confused as to whether I’m just over thinking this. Has anyone else suffered or been diagnosed with red skin syndrome? Do you think this is a legitimate disease? Please share!

Can Humidifiers Help with Eczema?

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As you know living in a dry climate or turning up the heat during winter can dry out your skin further aggravating your eczema. Since I’ve gotten the humidifier, I wake up with less flaky skin, especially in the winter. Also, for a while I’ve been waking up with crusty eyes, but it stopped with the humidifier. Personally, I think this is a luxury item and won’t have a significant improvement on your quality of life. It will only help to reduce dryness which can make your eczema worse but it won’t eliminate it completely.

For more details on my experience with a humidifier and choosing one below:

One morning I woke up, mouth parched with the skin on my neck flaking off like snowflakes, only not so pretty. With the winter coming, I decided that I had to buy a humidifier. However, my past experience with my last humidifier was horrid. I had bought one from Canadian Tire for ~$30. It was a cool mist humidifier with a reusable filter and a fan. It ended up being a huge mistake. First of all, to prevent bacteria growth I had to clean the sloppy tank on a daily basis with an antibacterial solution. To make matters worse, the longer I used it, the more I found myself waking up with a sore throat. To top of it off, I’ve had crusty white mould growing in my room. The hydrostat was largely inaccurate and because it didn’t decalcify the tap water, there was white filmy calcium deposit wherever the mists landed and inside the water tank. The filters were nasty looking even after I had cleaned them.  It was such a horrible experience that I swore I would never buy another humidifier again.

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When winter hit again, I got desperate once again and looked up the best humidifiers on the market. Ones that kept coming up were the Air-O-Swiss humidifiers. I was hesitant at first because they were expensive but I was desperate so I quickly bought the AOS Ultrasonic U650 warm & cold mist humidifier and never looked back. These humidifiers are superior to drugstore brands for many reasons:

1)      They come with an ionic stick that will prevent bacteria growth for one year. This means you never have to disinfect. I was skeptical at first, but I haven’t woken up to a sore throat.

2)      They come with a demineralization cartilage that removes calcium deposits

3)      You can have both cool and warm mist in one machine, although the warm mist is not steaming hot so it won’t necessarily warm up the room in the winter

4)      No fan, no noise. Ultra quiet

5)      Ultrasonic means that it breaks water droplets into finer size droplets allowing it a greater chance to be evaporated into the air rather than dropping onto the ground

6)      If you’re allergic to dust, the humidity binds to the dust causing it to fall to the ground making it easier to vacuum.

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The only bad thing is that tilting the machine will cause the water to spill and sometimes even onto the cord if you are not being careful. Maintenance can be expensive long-term. They suggests buying E Cal to remove calcium deposits in the tray ($~10 Cad for 3 packages) but you can use white vinegar. Also, you can purchase 3 packages of refills ($30) for the demineralization cartilages rather than a single new cartilage ($20).

This is just one humidifier that I tried. I’m sure that any other humidifier out there can do the same job. Just make sure to choose one that decalcifies the water if you don’t want to use distilled water, and one that has some way of killing off germs in the tank. Good luck!

Reduce Eczema with Diluted Bleach Bath

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The bad news is that there is no cure for eczema, possibly never will be. The good news is that there is a way to reduce your dependence on topical steroids. The treatment is called the diluted bleach bath.

The bleach bath was introduced to me by my family doctor. This treatment is by no means a cure but in about a month of treatment I noticed that I was using less topical steroids and that my flare-ups were less severe and frequent. This is really important because topical steroids have been shown in a few studies to decrease collagen synthesis, in humans. Collagen is responsible for keeping our maintaining skin elasticity to minimize wrinkles. One can only imagine the consequences of long-term usage.

How does the bleach bath work? The human skin is normally occupied by a flora of bacteria. However, skin taken from eczema patient’s show higher levels of bacteria (Staph) compared to individuals without eczema. The bacteria are believed to release toxins onto the skin which can further aggravate your eczema. Taking a bleach bath, which is basically chlorine, frequently will help to reduce bacterial levels in the skin.

Instructions:

1)      Measure 1/2 a cup of ~ 6% bleach. This is for a bath tub that is almost 4/5 full. Also check the concentration of your bleach. It should be a percent value. You will need to adjust the volume of bleach you add based on this value.

2)      If you are buying bleach make sure nothing additional is added to it. I made the mistake of almost purchasing Javex bleach with fibregard for clothes rather than normal bleach

3)      If you touch the bleach, wash your hands right away or else your hand will burn for hours.

4)      Never dump your bleach into the tub because it could splash back and hit your eye

5)      Don’t inhale the fumes, but of course you know this

6)      Soak in the bath for 10 to 20 minutes. Occasionally dip your face into the tub, eyes closed, if facial eczema is an issue.

7)      Remember to rinse off the bleach with clean water when your done. If you leave the bleach on it will dry out your skin and irritate it. I had an itch attack because I had forgotten once

8)   In some places on the internet, it says that you should not take a bleach bath for more than twice a week. My doctor recommended every second day, which I have been following and it seems to be working

How long does it take? Personally, it took about 2 weeks before I noticed that I was using less and less topical steroids. I also began to notice that my skin was better on days where I had taken a bleach bath in the morning. It has been 2 months since I have been taking a bleach bath and I’ve only had a severe flare-up twice. This is one of the most effective treatments for reducing redness next to topical steroids.

The reason I’m writing about this is because I felt that there was plenty of people on the internet saying that they have tried it on their kids but you don’t hear much about adults trying it. In addition, the study showing that the bleach bath was effective only used children in their sample.

Lastly, I encourage you try it because my family doctor said that it has worked really well for many of his patients. Please let me know how the bleach bath worked for you!

Welcome to my new eczema blog!

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I’m a medical student who has been dealing with adult-onset eczema for the past 6 years. It began with an itch on my neck during a stressful exam week that gradually spread to my entire neck, folds of elbows/knees, and my wrists over the years. Over the years, I found my eczema getting worse. At times I wished that I could replace my skin altogether with problem free skin. Gross but a life-time of eczema does that to someone. The reason I choose to write this blog is because when I went to look for tips on eczema online, it was not easy to find a very detailed or personal experience. I wasn’t sure who was writing behind the blog and whether to trust their advice. There is not reason you should trust mine either but should you read it anyways I hope you find it useful! Lastly, I hope that my blog would be useful to someone with eczema who is suffering from dry skin that has trouble absorbing most lotions, lives in a very dry environment, and has or is thinking about taking the acne drug Accutane.