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TCS Withdrawal & Red Skin Syndrome

woman with eczema and allergies applying TCS

Topical corticosteroids (TCS) are commonly prescribed to treat atopic dermatitis when other treatments fail. But they’re often used too often (or for too long), which can result in topical steroid withdrawal (also known as ‘red skin syndrome’).

Synthetic cortisone medications (corticosteroids) simulate cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. The production of corticosteroids in the body is usually controlled by a “feedback mechanism,” involving the adrenal glands, the pituitary gland and brain, known as the “hypothalamic-pituitary-adrenal axis” (HPAA) (1)

 

What is red skin syndrome?

woman applying cortisone cream to skin which can cause red skin syndrome

Topical corticosteroids can provide temporary relief from chronic inflammation, pain and irritation of the skin. However, TCS can be a complicated treatment.

When topical steroids have been overused or taken long term they cause a prolonged decrease in HPAA function in the body. So, when application stops the adrenal glands take some time to return to their normal patterns of secretion. This can cause withdrawal symptoms, known as ‘red skin syndrome’.

Red skin syndrome symptoms include:

  • Swelling, redness, burning, stinging and skin sensitivity within one-to-two weeks of stopping the steroid (particularly prevalent with eczema-like skin conditions such as atopic or seborrheic dermatitis).
  • Papules (pimple-like bumps), nodules (deeper bumps) or pustules (small, fluid-filled bumps) with redness. These symptoms are more likely to appear when TCS is used for cosmetic purposes, or for acne-like disorders.

Before ceasing TCS treatment, check out the ITSAN website  for a more thorough symptom list.

 

Are some people more susceptible than others?

mother holding baby who are both susceptible to red skin syndrome

Women who have used TCS at moderate to high doses over a 12-month period will be more susceptible to TCS withdrawal. In this case, symptoms will be usually present on the face and genital areas.

Although withdrawal symptoms are less common in children, skin absorption is higher in infants. So, consult your health care practitioner regarding appropriate dosage and use.

 

Seven tips to manage red skin syndrome …

cream on womans leg in shape of love heart

  1. Watch your dose – Avoid using TCS on a daily basis for more than two to four weeks, especially on more sensitive areas. Following this, the frequency of treatment should be reduced to twice a week (as required) and gently reduced before completely ceasing.
  2. Consult your practitioner, regularly– Keep a close eye on your treatment plan by organising regular follow ups with your healthcare provider.
  3. Lay off the repeats– Do not request multiple refills of your prescription without consulting your healthcare practitioner.
  4. Work with a Naturopath– treating the inflammatory drivers contributing to your symptoms should reduce your need for TCS.
  5. Know your skin triggers – Keep a food and activity log to help pinpoint what your triggers are. Common skin irritants include salicylate, sugars, wheat, dairy, amines, yeast, dust, dust mites and moulds. Keep in mind that some food reactions can be delayed up to 48 hours and only occur when over certain amount of the food in consumed.
  6. Get into a routine– Keep skin healthy and hydrated with a skin care routine that uses cortisone-free calming and non-irritating products.
  7. Try Positive Association Technique (PAT) – At HWA, our Naturopaths use a form of muscle testing (kinesiology) to help pinpoint your individual triggers. Following this, we perform a natural allergy treatment called Positive Association Technique (PAT), which aims to reduce your reactions and symptoms.

 

Natural Allergy Treatment

At Health & Wellness Australia & Auckland (HWA), our Naturopaths use a form of muscle testing (kinesiology) to help pinpoint the substances triggering your child’s allergy symptoms. Following this, we perform a natural allergy treatment called Positive Association Technique (PAT), which aims to reduce their reactions and symptoms.

PAT is a non-invasive holistic therapy, which:

  • draws on acupressure and kinesiology techniques
  • aims to re-train your body
  • may reduce your reactions to food and environmental substances that may be causing or exacerbating your symptoms.

Some cases can be complex, so our Naturopaths may also recommend supplements and herbs, and provide lifestyle advice to help you achieve the best long-term results.

Get in touch

  • Call us on 1300 853 023 / 09 479 5997 (NZ) to chat to our friendly staff
  • Send our PAT Naturopaths a question HERE
  • Request a Free PAT Information E-PACK HERE

 

Please note that this blog contains general information only. Always consult your health care professional before making any changes to your diet or lifestyle.

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