{"id":26,"date":"2021-05-12T23:51:28","date_gmt":"2021-05-12T23:51:28","guid":{"rendered":"https:\/\/itsan.net\/?page_id=26"},"modified":"2025-10-29T10:07:50","modified_gmt":"2025-10-29T10:07:50","slug":"what-is-tsw-syndrome","status":"publish","type":"page","link":"https:\/\/www.itsan.org\/us\/what-is-tsw-syndrome\/","title":{"rendered":"What is TSW Syndrome?"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-j4eta-fb82a23b6c15faaba0839ee9d3bdddcc\">\n.flex_column.av-j4eta-fb82a23b6c15faaba0839ee9d3bdddcc{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-j4eta-fb82a23b6c15faaba0839ee9d3bdddcc av_two_third  avia-builder-el-0  el_before_av_one_third  avia-builder-el-first  first flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-ipg5m-befce87b5dc2026b29eab8aa4b5eb8ca\">\n#top .av-special-heading.av-ipg5m-befce87b5dc2026b29eab8aa4b5eb8ca{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-ipg5m-befce87b5dc2026b29eab8aa4b5eb8ca .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-ipg5m-befce87b5dc2026b29eab8aa4b5eb8ca .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-ipg5m-befce87b5dc2026b29eab8aa4b5eb8ca av-special-heading-h1 blockquote modern-quote  avia-builder-el-1  el_before_av_textblock  avia-builder-el-first '><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >What is TSW Syndrome?<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-ic222-bcb049e687249c7c39e20b8a46e92049 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Topical Steroid Withdrawal Syndrome (TSWS), also known as Topical Steroid Addiction (TSA) or Red Skin Syndrome (RSS), is a debilitating condition that can arise from the use of topical steroids to treat a skin problem, such as eczema. This condition can also arise from topical steroid use in individuals with no prior skin condition; such as with cosmetic use for skin bleaching or to treat acne, or in the case of caregivers who neglect to wash their hands after applying topical steroids on someone else.<\/p>\n<p>Topical steroids are also called topical corticosteroids, glucocorticosteroids, and cortisone. They come in many different preparations including creams, ointments, oils, gels, and lotions. Some are sold over-the-counter; others require a doctor\u2019s prescription.<\/p>\n<p>Topical Steroid Withdrawal Syndrome is characterized by red, itchy, burning skin that can appear after ceasing topical steroid treatments, or even between treatments. Topical steroids are effective for a period of time to treat the skin condition. As time passes, however, applying topical steroids results in less and less clearing. The original problem escalates as it spreads to other areas of the body. This \u201cprogression\u201d is often mistaken for worsening eczema, contact dermatitis, an infection, or an allergic reaction. However, a cluster of non-skin related symptoms also emerge, constituting a syndrome \u2014 not solely a skin condition. TSW Syndrome comes with severe secondary complications, requiring multiple daily interventions for a protracted period of time. Many sufferers are bedridden and housebound for months to years before symptoms abate.<\/p>\n<p>TSW Syndrome is an iatrogenic condition, which means it is a condition caused inadvertently by a medical treatment. Not everyone who uses topical steroids will develop TSWS. It is unclear why some individuals experience TSWS secondary to topical steroid therapy and why others do not.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-hs6pa-bd3e80bd80d44216120851a11e2d48d3\">\n#top .av-special-heading.av-hs6pa-bd3e80bd80d44216120851a11e2d48d3{\npadding-bottom:10px;\ncolor:#000000;\n}\nbody .av-special-heading.av-hs6pa-bd3e80bd80d44216120851a11e2d48d3 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-hs6pa-bd3e80bd80d44216120851a11e2d48d3 .special-heading-inner-border{\nborder-color:#000000;\n}\n.av-special-heading.av-hs6pa-bd3e80bd80d44216120851a11e2d48d3 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-hs6pa-bd3e80bd80d44216120851a11e2d48d3 av-special-heading-h3 custom-color-heading blockquote modern-quote  avia-builder-el-3  el_after_av_textblock  el_before_av_textblock '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >Why is TSW Syndrome sometimes called <span class='special_amp'>\u201c<\/span>Topical Steroid Addiction<span class='special_amp'>\u201d<\/span> or <span class='special_amp'>\u201c<\/span>Red Skin Syndrome<span class='special_amp'>\u201d<\/span>?<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-gu5be-adc01be309d0b8f3e2e87d35ccee68de '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>The terms Red Skin Syndrome (RSS), Topical Steroid Addiction (TSA), and Topical Steroid Withdrawal (TSW) are often used interchangeably, and sorting out the acronyms can get a little confusing.\u00a0Each\u00a0of these terms has a slightly different meaning, so some background can be helpful.<\/p>\n<p>ITSAN uses the term Topical Steroid Withdrawal Syndrome (TSW Syndrome) as the umbrella term for the condition and its many phases. We defer to medical consensus on naming, and hope for such consensus to emerge in the near future.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-gnnd6-fc4b4428daef425149f509d74e2146bf\">\n#top .av-special-heading.av-gnnd6-fc4b4428daef425149f509d74e2146bf{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-gnnd6-fc4b4428daef425149f509d74e2146bf .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-gnnd6-fc4b4428daef425149f509d74e2146bf .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-gnnd6-fc4b4428daef425149f509d74e2146bf av-special-heading-h3 blockquote modern-quote  avia-builder-el-5  el_after_av_textblock  el_before_av_textblock '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >Topical Steroid Addiction (TSA)<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-fjmjq-100de7288d9cd37478623c9c49f19cb9 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>The term\u00a0\u201c<a href=\"http:\/\/www.merriam-webster.com\/dictionary\/addiction\" target=\"_blank\" rel=\"noopener noreferrer\">addiction<\/a>\u201d is used to describe a situation that includes both 1) increased tolerance to a given substance and 2) well-defined physiological symptoms upon withdrawal. \u201cTopical Steroid Addiction\u201d describes the origin of TSW Syndrome, in which the body develops tolerance to topical steroid therapy\u2014 requiring more of the drug to be used to achieve the previous therapeutic benefit, and causing the skin to \u201crebound\u201d upon withdrawal. The medical term for becoming tolerant or resistant to treatment is \u201c<a href=\"https:\/\/www.lexico.com\/en\/definition\/tachyphylaxis\" target=\"_blank\" rel=\"noopener noreferrer\">tachyphylaxis<\/a>.\u201d<\/p>\n<p>The \u201c<a href=\"http:\/\/en.wikipedia.org\/wiki\/Rebound_effect\" target=\"_blank\" rel=\"noopener noreferrer\">rebound effect<\/a>\u2019 or \u201crebound phenomenon\u201d is defined as the emergence or re-emergence of symptoms that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage. In the case of re-emergence, the severity of the symptoms is often worse than pretreatment levels.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-f6p9q-af570e398fdee909fe096615674f2ba9\">\n#top .av-special-heading.av-f6p9q-af570e398fdee909fe096615674f2ba9{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-f6p9q-af570e398fdee909fe096615674f2ba9 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-f6p9q-af570e398fdee909fe096615674f2ba9 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-f6p9q-af570e398fdee909fe096615674f2ba9 av-special-heading-h3 blockquote modern-quote  avia-builder-el-7  el_after_av_textblock  el_before_av_textblock '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >Red Skin Syndrome (RSS) <\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-efm9q-91fa913ba452cb4e2dc5f3daf22a21e9 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Red Skin Syndrome (RSS) or Red Burning Skin Syndrome (RBSS) is a term which refers to the vasodilation of capillaries of the skin as a steroid withdrawal symptom, causing full body redness or flushing as well as painful burning and stinging. \u201cRed\u201d in this sense means inflamed. Not every skin tone will look \u201cred\u201d when inflamed, so this term is not universally descriptive.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-e66ge-c1df6a76aa6487c8b293fc1e2940c05b\">\n#top .av-special-heading.av-e66ge-c1df6a76aa6487c8b293fc1e2940c05b{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-e66ge-c1df6a76aa6487c8b293fc1e2940c05b .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-e66ge-c1df6a76aa6487c8b293fc1e2940c05b .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-e66ge-c1df6a76aa6487c8b293fc1e2940c05b av-special-heading-h3 blockquote modern-quote  avia-builder-el-9  el_after_av_textblock  el_before_av_textblock '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >Topical Steroid Withdrawal (TSW)<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-dk45y-1c60678beee708c665851aeed0f17708 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>\u201c<a href=\"http:\/\/en.wikipedia.org\/wiki\/Drug_withdrawal\">Withdrawal<\/a>,\u201d in reference to medication, is defined as a group of symptoms that occur after stopping or reducing intake of a drug. \u201cTopical Steroid Withdrawal\u00a0Syndrome\u201d refers to the symptoms that occur when\u00a0someone ceases topical\u00a0steroid use, reduces potency, applies topical steroids to\u00a0fewer\u00a0areas of the body, or applies them less often. Weaning, stepping down or ceasing use can all cause varying degrees of withdrawal symptoms.\u00a0\u00a0The cluster of shared symptoms during withdrawal is why TSW Syndrome is known as a \u201c<a href=\"https:\/\/www.lexico.com\/en\/definition\/syndrome\">syndrome<\/a>.\u201d<\/p>\n<p>In the ITSAN community, the term \u201cTSW\u201d is also used to reflect\u00a0the treatment name and\u00a0time frame of the withdrawal phase. For example, \u201c6 months TSW\u201d refers to the time that has passed since ceasing topical steroid treatment\u00a0and beginning topical steroid withdrawal.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-cy2ey-ad366da24c366962e6a88411e3762f6a\">\n#top .av-special-heading.av-cy2ey-ad366da24c366962e6a88411e3762f6a{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-cy2ey-ad366da24c366962e6a88411e3762f6a .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-cy2ey-ad366da24c366962e6a88411e3762f6a .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-cy2ey-ad366da24c366962e6a88411e3762f6a av-special-heading-h3 blockquote modern-quote  avia-builder-el-11  el_after_av_textblock  el_before_av_textblock '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >What are the most common symptoms of TSW Syndrome?<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-cgpq2-dbdc858f2981569fac228cb3b44c63ed '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>The symptoms of TSWS fall into two categories: symptoms that appear while using topical steroids and those that appear after discontinuing topical steroid use \u2013 even when just taking a break between treatments.<\/p>\n<\/div><\/section><br \/>\n<div  class='tabcontainer av-bhtbi-7675122a4d62e1f0a37dddd0b5bda9b9 top_tab  avia-builder-el-13  el_after_av_textblock  el_before_av_heading ' role='tablist'>\n<section class='av_tab_section av_tab_section av-b04qu-e08d5925ad21b83c347e91171cb05164'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab active_tab' role='tab' tabindex='0' data-fake-id='#tab-id-1' aria-controls='tab-id-1-content'  itemprop=\"headline\" >Before discontinuing topical steroids<\/div><div id='tab-id-1-content' class='tab_content active_tab_content' aria-hidden=\"false\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>\u2018Rebound\u2019 redness between applications<\/li>\n<li>Rashes spreading and developing in new areas of the body<\/li>\n<li>Intense itching, burning, stinging<\/li>\n<li>Failure to clear with usual course of treatment, requiring a higher potency topical steroid\u00a0to achieve progressively less clearing.<\/li>\n<li>Increased allergic response<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<section class='av_tab_section av_tab_section av-ag88e-e4d1083c230727e65d2765d80c2c6165'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab' role='tab' tabindex='0' data-fake-id='#tab-id-2' aria-controls='tab-id-2-content'  itemprop=\"headline\" >After discontinuing topical steroids<\/div><div id='tab-id-2-content' class='tab_content' aria-hidden=\"true\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>Skin flushing bright red,\u00a0<a class=\"fusion-modal-text-link\" href=\"\/wp-content\/uploads\/2021\/05\/sunburn2.jpg\" rel=\"noopener\" data-toggle=\"modal\" data-target=\".fusion-modal.sunburn\">resembling a sunburn<\/a><\/li>\n<li>Visible and measurable\u00a0<a class=\"fusion-modal-text-link\" href=\"\/wp-content\/uploads\/2021\/05\/shedding-2.jpg\" data-toggle=\"modal\" data-target=\".fusion-modal.shedding\">flaking of skin<\/a>\u00a0\u2013 appears to be \u2018snowing\u2019<\/li>\n<li>Oozing exudate<\/li>\n<li>Skin cycling between oozing, swelling, burning, and flaking<\/li>\n<li><a class=\"fusion-modal-text-link\" href=\"\/wp-content\/uploads\/2021\/05\/red.jpg\" data-toggle=\"modal\" data-target=\".fusion-modal.red_sleeves\">Red sleeves<\/a>: (arms\/legs become red and inflamed, sparing palms\/soles)<\/li>\n<li>Thermoregulation altered (feeling too cold or too hot)<\/li>\n<li>Hypersensitivity of the skin to water, movement, moisturizer, fabrics, temperature, etc.<\/li>\n<li>Nerve pain, sometimes described as \u201csparklers\u201d or \u201czingers\u201d<\/li>\n<li><a class=\"fusion-modal-text-link\" href=\"\/wp-content\/uploads\/2021\/05\/enlarged.jpg\" data-toggle=\"modal\" data-target=\".fusion-modal.lymph\">Enlarged lymph nodes<\/a><\/li>\n<li>Edema<\/li>\n<li>Eye dryness and irritation<\/li>\n<li>Skin atrophy (often manifesting as \u201c<a class=\"fusion-modal-text-link\" href=\"\/wp-content\/uploads\/2021\/05\/ele.jpg\" data-toggle=\"modal\" data-target=\".fusion-modal.elephant\">elephant wrinkles<\/a>\u201c)<\/li>\n<li><a class=\"fusion-modal-text-link\" href=\"\/wp-content\/uploads\/2021\/05\/hair.jpg\" data-toggle=\"modal\" data-target=\".fusion-modal.hair_loss\">Hair loss<\/a>: (head and\/or body)<\/li>\n<li>Insomnia and altered body clock<\/li>\n<li>Appetite changes<\/li>\n<li>Fatigue<\/li>\n<li>Emotional fluctuations, depression, anxiety<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-9n5s6-31e395c1e84db52caf36a588bfd8bab8\">\n#top .av-special-heading.av-9n5s6-31e395c1e84db52caf36a588bfd8bab8{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-9n5s6-31e395c1e84db52caf36a588bfd8bab8 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-9n5s6-31e395c1e84db52caf36a588bfd8bab8 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-9n5s6-31e395c1e84db52caf36a588bfd8bab8 av-special-heading-h3 blockquote modern-quote  avia-builder-el-14  el_after_av_tab_container  el_before_av_textblock '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >What are treatment options?<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-98cra-c2804ce4da73d1bee6cf554b3ba8a020 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Since TSW Syndrome is an iatrogenic condition caused by the use of topical steroids, proper management of the condition requires cessation of topical steroid treatment. In addition, a supportive doctor can help his or her patient navigate comfort measures, infection prevention, pain\/itch management, anxiety therapies, sleep aids, and\/or other appropriate medical interventions, as indicated.<\/p>\n<p>The time period required to recover from TSWS is individual, but is usually protracted and measured in months to years. As of this publication, there have been no proven medications or methods of treatment that speed up or quickly cure TSWS. Available physician treatments address physical and emotional comfort, function and infection control. This condition resolves over time, and resolution of withdrawal symptoms varies on a case-by-case basis. However, many people report complete, long-term clearance and relief of associated symptoms once the withdrawal phase is complete.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-8vygm-4271a398172fbf2f20f2411b0bbe202f\">\n#top .av-special-heading.av-8vygm-4271a398172fbf2f20f2411b0bbe202f{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-8vygm-4271a398172fbf2f20f2411b0bbe202f .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-8vygm-4271a398172fbf2f20f2411b0bbe202f .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-8vygm-4271a398172fbf2f20f2411b0bbe202f av-special-heading-h3 blockquote modern-quote  avia-builder-el-16  el_after_av_textblock  el_before_av_textblock '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >What can I do if I suspect I have TSW Syndrome?<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-87efm-490d38ba6a1495228d00206383eb53e8 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>It is important to consult your doctor to discuss the possible risks of ceasing topical steroids. While adrenal suppression and HPA axis suppression generally resolve by ceasing topical steroid therapy, caution must be exercised. Stopping topical steroids when the adrenal glands are\u00a0<em>severely depressed<\/em>\u00a0can risk adrenal crisis, which is life-threatening. Your doctor can run tests to determine cortisol levels and adrenal function prior to cessation of topical steroids and can continue follow-up during your withdrawal. Reading relevant research from scholarly, peer-reviewed journals will help you learn more about this condition. Finding a support group or joining online communities may offer additional support.<\/p>\n<p>ITSAN.org is a resource for doctors, patients, and caregivers. \u00a0Seek medical advice directly from your doctor.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-q1iq-350d8d051f5d00849c0878d629a4ca5d\">\n#top .hr.hr-invisible.av-q1iq-350d8d051f5d00849c0878d629a4ca5d{\nheight:50px;\n}\n<\/style>\n<div  class='hr av-q1iq-350d8d051f5d00849c0878d629a4ca5d hr-invisible  avia-builder-el-18  el_after_av_textblock  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-6wdge-48f8c334e3163e93b10d5249909f8b66 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h5 data-fontsize=\"12\" data-lineheight=\"21\">This information is provided as a service to patients and parents of patients who have TSWS. \u00a0It is not intended to supplement appropriate medical care, but instead to complement that care with guidance in practical issues facing patients and parents. \u00a0Neither ITSAN, its Board of Directors, nor support group members and officials endorse any treatments or products reported here. \u00a0All issues pertaining to the care of patients with TSWS should be discussed with a physician experienced in the treatment of this skin disorder.<\/h5>\n<\/div><\/section><\/p><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-6hraq-c495f5808907fcf9ae0ea31300d39b3a\">\n.flex_column.av-6hraq-c495f5808907fcf9ae0ea31300d39b3a{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-6hraq-c495f5808907fcf9ae0ea31300d39b3a av_one_third  avia-builder-el-20  el_after_av_two_third  el_before_av_section  avia-builder-el-last  flex_column_div av-zero-column-padding  '     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src=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/2.jpg\" width=\"800\" height=\"522\" title='' alt=''  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/2.jpg 800w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/2-300x196.jpg 300w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/2-768x501.jpg 768w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/2-705x460.jpg 705w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/2-450x294.jpg 450w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/div><\/li><li  class='avia-slideshow-slide av-5oasy-094680393963cfec7f3107e28d97f490__2  slide-3 slide-odd'><div data-rel='slideshow-1' class='avia-slide-wrap '   ><img decoding=\"async\" class=\"wp-image-35 avia-img-lazy-loading-not-35\"  src=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/3.jpg\" width=\"800\" height=\"522\" title='' alt=''  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/3.jpg 800w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/3-300x196.jpg 300w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/3-768x501.jpg 768w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/3-705x460.jpg 705w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/3-450x294.jpg 450w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/div><\/li><li  class='avia-slideshow-slide av-5oasy-094680393963cfec7f3107e28d97f490__3  slide-4 slide-even'><div data-rel='slideshow-1' class='avia-slide-wrap '   ><img decoding=\"async\" class=\"wp-image-36 avia-img-lazy-loading-not-36\"  src=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/4.jpeg\" width=\"800\" height=\"522\" title='' alt=''  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/4.jpeg 800w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/4-300x196.jpeg 300w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/4-768x501.jpeg 768w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/4-705x460.jpeg 705w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/4-450x294.jpeg 450w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/div><\/li><li  class='avia-slideshow-slide av-5oasy-094680393963cfec7f3107e28d97f490__4  slide-5 slide-odd'><div data-rel='slideshow-1' class='avia-slide-wrap '   ><img decoding=\"async\" class=\"wp-image-37 avia-img-lazy-loading-not-37\"  src=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/5.jpg\" width=\"800\" height=\"522\" title='5' alt=''  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/5.jpg 800w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/5-300x196.jpg 300w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/5-768x501.jpg 768w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/5-705x460.jpg 705w, https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2021\/05\/5-450x294.jpg 450w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/div><\/li><\/ul><div class='avia-slideshow-arrows avia-slideshow-controls' ><a href='#prev' class='prev-slide ' aria-hidden='true' data-av_icon='\ue87c' data-av_iconfont='entypo-fontello'  tabindex='-1'>Previous<\/a><a href='#next' class='next-slide ' aria-hidden='true' data-av_icon='\ue87d' data-av_iconfont='entypo-fontello'  tabindex='-1'>Next<\/a><\/div><div class='avia-slideshow-dots avia-slideshow-controls'><a href='#1' class='goto-slide active' >1<\/a><a href='#2' class='goto-slide ' >2<\/a><a href='#3' class='goto-slide ' >3<\/a><a href='#4' class='goto-slide ' >4<\/a><a href='#5' class='goto-slide ' >5<\/a><\/div><\/div><br \/>\n<section  class='av_textblock_section av-25z1i-54b2d0db557b501b8fa671bc572f9489 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>The\u00a0<a href=\"https:\/\/books.google.com\/books?id=xxDHpPGHFvAC&amp;pg=PA51&amp;lpg=PA51&amp;dq=rebound+flare&amp;source=bl&amp;ots=0INnCSbvJy&amp;sig=usZqVhy1g4TmQcU-4C-y3n80mrk&amp;hl=en&amp;sa=X&amp;ei=Y1IQVZK7O9fVoATAlYGIBw&amp;ved=0CCYQ6AEwAQ#v=onepage&amp;q=rebound%20flare&amp;f=false\" target=\"_blank\" rel=\"noopener noreferrer\">Textbook of Atopic Dermatitis<\/a>\u00a0on rebound flare and TSWS:<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1k1ou-1ff5190781f0232df2317368b2a45411\">\n.av_promobox.av-1k1ou-1ff5190781f0232df2317368b2a45411{\ncolor:#0a0a0a;\nbackground:#f6f3f3;\nborder-color:#b5b5b5;\n}\n<\/style>\n<div  class='av_promobox av-1k1ou-1ff5190781f0232df2317368b2a45411 avia-button-no  avia-builder-el-23  el_after_av_textblock  el_before_av_icon_box '><div class='avia-promocontent'><\/p>\n<div class=\"fusion-testimonials classic fusion-testimonials-1\" data-random=\"1\" data-speed=\"11111\">\n<div class=\"reviews\">\n<div class=\"review no-avatar\">\n<p><q class=\"fusion-clearfix\">\u2026 short term treatment of a flare of AD (atopic dermatitis) with topical corticosteroids is very effective while their long term use can lead to problems such as flare rebound and steroid addiction. Rebound flare after the discontinuation of topical corticosteroids is not uncommon. It occurs both in the context of an underlying skin disease, such as AD, and also in normal skin after prolonged application of topical corticosteroids.<\/q><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"fusion-testimonials classic fusion-testimonials-2\" data-random=\"1\" data-speed=\"11111\">\n<div class=\"reviews\">\n<div class=\"review no-avatar\">\n<p><q class=\"fusion-clearfix\">An extreme form of rebound flare following the discontinuation of topical corticosteroids is the \u201cred burning skin syndrome\u201d. . . . Patients initially developed pruritus followed by burning and erythema. Further application of topical corticosteroids led to an exacerbation of the condition, described as corticosteroid addiction.<\/q><\/p>\n<\/div>\n<h5>Source: page 51, Textbook of Atopic Dermatitis, edited by: Sakari Reitamo, Thomas A. Luger, Martin Steinhoff, published by: Informa Healthcare, London England, 2008<\/h5>\n<div class=\"review no-avatar\"><\/div>\n<\/div>\n<\/div>\n<p>\n<\/div><\/div><br \/>\n<article  class='iconbox iconbox_left av-wa7m-fbdc47572c7e7fe172ceac6dd612f262  avia-builder-el-24  el_after_av_promobox  avia-builder-el-last '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class=\"iconbox_content\"><header class=\"entry-content-header\"><div class=\"iconbox_icon heading-color\" aria-hidden='true' data-av_icon='\ue81f' data-av_iconfont='entypo-fontello'><\/div><h3 class='iconbox_content_title '  itemprop=\"headline\" >Other names for TSWS<\/h3><\/header><div class='iconbox_content_container '  itemprop=\"text\" ><p>Topical Steroid Withdrawal Syndrome\u00a0is an emerging diagnosis, and has been described using a number of different terms. Click the link to see an example where each term is used:<\/p>\n<ul>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25378953\" target=\"_blank\" rel=\"noopener noreferrer\">Topical Steroid Addiction (TSA)<\/a><\/li>\n<li><a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-4362.1979.tb01905.x\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Steroid Addiction<\/a><\/li>\n<li><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0738081X02003656\" target=\"_blank\" rel=\"noopener noreferrer\">Corticosteroid Addiction<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4171914\/\" target=\"_blank\" rel=\"noopener noreferrer\">Topical Corticosteroid Addiction (TCS Addiction)<\/a><\/li>\n<li><a href=\"http:\/\/journals.lww.com\/nursing\/Citation\/2007\/09000\/Facing_up_to_withdrawal_from_topical_steroids.46.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Steroid Addiction Syndrome<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25592622\" target=\"_blank\" rel=\"noopener noreferrer\">Topical Corticosteroid Withdrawal (TCS Withdrawal)<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25592622\" target=\"_blank\" rel=\"noopener noreferrer\">Topical Corticosteroid Withdrawal Syndrome (TCS Withdrawal Syndrome)<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4228634\/\" target=\"_blank\" rel=\"noopener noreferrer\">Topical Steroid Damaged Facies (TSDF)<\/a><\/li>\n<li><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0738081X02003656\" target=\"_blank\" rel=\"noopener noreferrer\">Red Burning Skin Syndrome<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12046812\" target=\"_blank\" rel=\"noopener noreferrer\">Steroid Dermatitis<\/a><\/li>\n<li><a href=\"http:\/\/dermatologytimes.modernmedicine.com\/dermatology-times\/news\/modernmedicine\/modern-medicine-news\/topical-corticosteroid-addiction-may-be-b?page=full\" target=\"_blank\" rel=\"noopener noreferrer\">Steroid-Induced Dermatitis (SID)<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3654273\/\" target=\"_blank\" rel=\"noopener noreferrer\">Steroid Dermatitis Resembling Rosacea<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19445310\" target=\"_blank\" rel=\"noopener noreferrer\">Steroid- Induced Rosacea-like Dermatitis (SIRD)<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=steroid-induced+rosacea-like+eruption\" target=\"_blank\" rel=\"noopener noreferrer\">Steroid-induced Rosacea-like Eruption<\/a><\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21220878\" target=\"_blank\" rel=\"noopener noreferrer\">Topical Corticosteroid-Induced Rosacea-like Dermatitis (TCIRD)<\/a><\/li>\n<\/ul>\n<p>ITSAN uses the term\u00a0Topical Steroid Withdrawal Syndrome (TSWS)\u00a0as the umbrella term for the condition and its many phases. We defer to medical consensus on naming, and hope for such consensus to emerge in the near future.<\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><\/p><\/div>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_1'  class='avia-section av-av_section-743bd6ff43a4587bf9f0aebe780ca7f4 main_color avia-section-default avia-no-shadow  avia-builder-el-25  el_after_av_one_third  el_before_av_section  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-26'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_full-abf61815a02831d116b1aaa4a1b0ed13\">\n.flex_column.av-av_one_full-abf61815a02831d116b1aaa4a1b0ed13{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-abf61815a02831d116b1aaa4a1b0ed13 av_one_full  avia-builder-el-26  el_before_av_one_fifth  avia-builder-el-first  first flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-2c248cbc472501bfc3a6249e279d6b57\">\n#top .av-special-heading.av-av_heading-2c248cbc472501bfc3a6249e279d6b57{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-2c248cbc472501bfc3a6249e279d6b57 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-2c248cbc472501bfc3a6249e279d6b57 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-2c248cbc472501bfc3a6249e279d6b57 av-special-heading-h2  avia-builder-el-27  el_before_av_textblock  avia-builder-el-first '><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >Video: Overview of TSW<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-av_textblock-0aafccd1a3281e26ed01b2390ce67e93 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Dr. Heba Khaled (BDS BSc (Hons)) authored this atlas from a medical and patient perspective explaining how TSW develops, presents, and resolves. Dr. Khaled is a dentist from a medical family, but her understanding of TSW is personal \u2013 she is an ITSAN member who began her own withdrawal in 2017.<\/p>\n<\/div><\/section><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_fifth-abf61815a02831d116b1aaa4a1b0ed13\">\n.flex_column.av-av_one_fifth-abf61815a02831d116b1aaa4a1b0ed13{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_fifth-abf61815a02831d116b1aaa4a1b0ed13 av_one_fifth  avia-builder-el-29  el_after_av_one_full  el_before_av_three_fifth  first flex_column_div av-zero-column-padding  column-top-margin'     ><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_three_fifth-bcbccfb99e46414d45aa0af1bd0708c7\">\n.flex_column.av-av_three_fifth-bcbccfb99e46414d45aa0af1bd0708c7{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_three_fifth-bcbccfb99e46414d45aa0af1bd0708c7 av_three_fifth  avia-builder-el-30  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div av-zero-column-padding  column-top-margin'     ><div  class='avia-video av-av_video-c58bd154b3c1917eaf18553f555c3aa0 avia-video-16-9 av-no-preview-image avia-video-load-always av-lazyload-immediate av-lazyload-video-embed'  itemprop=\"video\" itemtype=\"https:\/\/schema.org\/VideoObject\"  data-original_url='https:\/\/youtu.be\/x4ypA9w81f0'><script type='text\/html' class='av-video-tmpl'><div class='avia-iframe-wrap'><iframe loading=\"lazy\" title=\"An Overview of TSW (Topical Steroid Withdrawal)\" width=\"1333\" height=\"1000\" src=\"https:\/\/www.youtube.com\/embed\/x4ypA9w81f0?feature=oembed&autoplay=0&loop=0&controls=1&mute=0\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div><\/script><div class='av-click-to-play-overlay'><div class=\"avia_playpause_icon\"><\/div><\/div><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_fifth-bcbccfb99e46414d45aa0af1bd0708c7\">\n.flex_column.av-av_one_fifth-bcbccfb99e46414d45aa0af1bd0708c7{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_fifth-bcbccfb99e46414d45aa0af1bd0708c7 av_one_fifth  avia-builder-el-32  el_after_av_three_fifth  avia-builder-el-last  flex_column_div av-zero-column-padding  column-top-margin'     ><\/div>\n\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_2'  class='avia-section av-av_section-743bd6ff43a4587bf9f0aebe780ca7f4 main_color avia-section-default avia-no-shadow  avia-builder-el-33  el_after_av_section  avia-builder-el-last  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-26'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_full-abf61815a02831d116b1aaa4a1b0ed13\">\n.flex_column.av-av_one_full-abf61815a02831d116b1aaa4a1b0ed13{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-abf61815a02831d116b1aaa4a1b0ed13 av_one_full  avia-builder-el-34  el_before_av_one_fifth  avia-builder-el-first  first flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-6d28e1d10ef378b2a295a8d0484b7493\">\n#top .av-special-heading.av-av_heading-6d28e1d10ef378b2a295a8d0484b7493{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-6d28e1d10ef378b2a295a8d0484b7493 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-6d28e1d10ef378b2a295a8d0484b7493 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-6d28e1d10ef378b2a295a8d0484b7493 av-special-heading-h2  avia-builder-el-35  el_before_av_textblock  avia-builder-el-first '><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >Preventable: Protecting our Body\u2019s Largest Organ<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-av_textblock-0aafccd1a3281e26ed01b2390ce67e93 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><div class=\"fusion-text\">\n<p>Documentary by ITSAN member Briana Banos explaining the causes of TSW Syndrome, exploring treatment options, and exposing the lived experience of the TSW Syndrome sufferer.<\/p>\n<\/div>\n<\/div><\/section><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_fifth-abf61815a02831d116b1aaa4a1b0ed13\">\n.flex_column.av-av_one_fifth-abf61815a02831d116b1aaa4a1b0ed13{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_fifth-abf61815a02831d116b1aaa4a1b0ed13 av_one_fifth  avia-builder-el-37  el_after_av_one_full  el_before_av_three_fifth  first flex_column_div av-zero-column-padding  column-top-margin'     ><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_three_fifth-bcbccfb99e46414d45aa0af1bd0708c7\">\n.flex_column.av-av_three_fifth-bcbccfb99e46414d45aa0af1bd0708c7{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_three_fifth-bcbccfb99e46414d45aa0af1bd0708c7 av_three_fifth  avia-builder-el-38  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div av-zero-column-padding  column-top-margin'     ><div  class='avia-video av-av_video-f7d2e05f34279d0567acf29e17588d0d avia-video-16-9 av-no-preview-image avia-video-load-always av-lazyload-immediate av-lazyload-video-embed'  itemprop=\"video\" itemtype=\"https:\/\/schema.org\/VideoObject\"  data-original_url='https:\/\/youtu.be\/RMbtf3C8BZk'><script type='text\/html' class='av-video-tmpl'><div class='avia-iframe-wrap'><iframe loading=\"lazy\" title=\"PREVENTABLE: PROTECTING OUR LARGEST ORGAN - DOCUMENTARY\" width=\"1500\" height=\"844\" src=\"https:\/\/www.youtube.com\/embed\/RMbtf3C8BZk?feature=oembed&autoplay=0&loop=0&controls=1&mute=0\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div><\/script><div class='av-click-to-play-overlay'><div class=\"avia_playpause_icon\"><\/div><\/div><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_fifth-bcbccfb99e46414d45aa0af1bd0708c7\">\n.flex_column.av-av_one_fifth-bcbccfb99e46414d45aa0af1bd0708c7{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_fifth-bcbccfb99e46414d45aa0af1bd0708c7 av_one_fifth  avia-builder-el-40  el_after_av_three_fifth  avia-builder-el-last  flex_column_div av-zero-column-padding  column-top-margin'     ><\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"give_campaign_id":0,"footnotes":""},"class_list":["post-26","page","type-page","status-publish","hentry"],"campaignId":"","_links":{"self":[{"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/pages\/26","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/comments?post=26"}],"version-history":[{"count":23,"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/pages\/26\/revisions"}],"predecessor-version":[{"id":22333,"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/pages\/26\/revisions\/22333"}],"wp:attachment":[{"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/media?parent=26"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}