{"id":8877,"date":"2022-07-06T16:09:09","date_gmt":"2022-07-06T16:09:09","guid":{"rendered":"https:\/\/www.itsan.org\/us\/?page_id=8877"},"modified":"2022-07-06T16:09:09","modified_gmt":"2022-07-06T16:09:09","slug":"coping-with-tsw-new","status":"publish","type":"page","link":"https:\/\/www.itsan.org\/us\/coping-with-tsw-new\/","title":{"rendered":"Coping with TSW New"},"content":{"rendered":"<div id='av_section_1'  class='avia-section av-av_section-e20ec1361547d950b6e2569930d6aa41 main_color avia-section-default avia-no-shadow  avia-builder-el-0  el_before_av_section  avia-builder-el-first  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-8877'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_three_fifth-6cf16d8efa18b29d6e9809b32ac86a1d\">\n.flex_column.av-av_three_fifth-6cf16d8efa18b29d6e9809b32ac86a1d{\nborder-radius:0px 0px 0px 0px;\npadding:15px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_three_fifth-6cf16d8efa18b29d6e9809b32ac86a1d av_three_fifth  avia-builder-el-1  el_before_av_two_fifth  avia-builder-el-first  first flex_column_div  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-41ea80664862d36f39d9ca8ce5da75ea\">\n#top .av-special-heading.av-av_heading-41ea80664862d36f39d9ca8ce5da75ea{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-41ea80664862d36f39d9ca8ce5da75ea .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-41ea80664862d36f39d9ca8ce5da75ea .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-41ea80664862d36f39d9ca8ce5da75ea av-special-heading-h1 blockquote modern-quote  avia-builder-el-2  el_before_av_textblock  avia-builder-el-first '><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >Coping with 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-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>This page is for people going through topical steroid withdrawal and is based on the experience of several thousand ITSAN forum members. These are trends and observations pulled directly from the experiences of those who have suffered or are suffering through withdrawal. Unfortunately, there are no absolutes or works-every-time tricks. It is our hope that in the future physicians will have better tools at their disposal to find answers and provide greater comfort to those who suffer.<\/p>\n<\/div><\/section><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_two_fifth-c8fc129dc35fd1ae2a1e410224d39ea8\">\n.flex_column.av-av_two_fifth-c8fc129dc35fd1ae2a1e410224d39ea8{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_two_fifth-c8fc129dc35fd1ae2a1e410224d39ea8 av_two_fifth  avia-builder-el-4  el_after_av_three_fifth  avia-builder-el-last  flex_column_div av-zero-column-padding  '     ><section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><span style=\"font-weight: 400;\"><a href=\"https:\/\/tswassist.com\/\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-6222\" src=\"https:\/\/www.itsan.org\/us\/wp-content\/uploads\/2022\/01\/tsw2.jpg\" alt=\"\" width=\"284\" height=\"82\" \/><\/a><br \/>\nLooking for recommendations for <\/span><span style=\"font-weight: 400;\">managing topical steroid withdrawal provided by the TSW community? <\/span><span style=\"font-weight: 400;\">TSW Assist provides a database of routines, products and therapies, recommended by people with topical steroid withdrawal. <\/span><span style=\"font-weight: 400;\">TSW Assist <\/span><span style=\"font-weight: 400;\">is not a hospital or a medical clinic. This website contains crowdsourced anecdotal solutions, and is not medical advice. All healing journeys are different and unique to each person.<\/span><\/p>\n<p><a href=\"https:\/\/tswassist.com\/\" target=\"_blank\" rel=\"noopener\">Learn More &gt;<\/a><\/p>\n<\/div><\/section><\/div>\n\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_section-8b133405dc89a1025f1be4246676e40e\">\n.avia-section.av-av_section-8b133405dc89a1025f1be4246676e40e{\nbackground-color:#f9f9f9;\nbackground-image:unset;\n}\n<\/style>\n<div id='av_section_2'  class='avia-section av-av_section-8b133405dc89a1025f1be4246676e40e main_color avia-section-large avia-no-shadow  avia-builder-el-6  el_after_av_section  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-8877'><div class='entry-content-wrapper clearfix'>\n<div class='flex_column_table av-av_one_third-67adf0f1abfc2242a214758f2160949a sc-av_one_third av-equal-height-column-flextable'>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_third-67adf0f1abfc2242a214758f2160949a\">\n.flex_column.av-av_one_third-67adf0f1abfc2242a214758f2160949a{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_third-67adf0f1abfc2242a214758f2160949a av_one_third  avia-builder-el-7  el_before_av_one_third  avia-builder-el-first  first flex_column_table_cell av-equal-height-column av-align-top av-zero-column-padding  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_icon_box-e14886514695500dcae1afa9b72e9ec2\">\n.iconbox.av-av_icon_box-e14886514695500dcae1afa9b72e9ec2 .iconbox_icon{\nbackground-color:#000000;\nborder:1px solid #a8a8a8;\n}\n<\/style>\n<article  class='iconbox iconbox_top av-av_icon_box-e14886514695500dcae1afa9b72e9ec2  avia-builder-el-8  avia-builder-el-no-sibling  main_color'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class=\"iconbox_content\"><header class=\"entry-content-header\"><a href='#preparing' title='What to Expect'  class=\"iconbox_icon heading-color\" aria-hidden='true' data-av_icon='\ue812' data-av_iconfont='entypo-fontello'><\/a><h3 class='iconbox_content_title '  itemprop=\"headline\" ><a href='#preparing' title='What to Expect' >What to Expect<\/a><\/h3><\/header><div class='iconbox_content_container '  itemprop=\"text\" ><div class=\"content-container\">\n<p style=\"text-align: center;\">Here\u2019s what to expect if you make the decision to withdraw from topical steroids.<\/p>\n<\/div>\n<div class=\"fusion-clearfix\" style=\"text-align: center;\"><\/div>\n<p style=\"text-align: center;\"><a class=\"fusion-read-more\" href=\"#preparing\" target=\"_self\" rel=\"noopener\">Learn More &gt;<\/a><\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><\/div><div class='av-flex-placeholder'><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_third-c8fc129dc35fd1ae2a1e410224d39ea8\">\n.flex_column.av-av_one_third-c8fc129dc35fd1ae2a1e410224d39ea8{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_third-c8fc129dc35fd1ae2a1e410224d39ea8 av_one_third  avia-builder-el-9  el_after_av_one_third  el_before_av_one_third  flex_column_table_cell av-equal-height-column av-align-top av-zero-column-padding  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_icon_box-da1071122e90f20d95941bc9a590dc59\">\n.iconbox.av-av_icon_box-da1071122e90f20d95941bc9a590dc59 .iconbox_icon{\nbackground-color:#000000;\nborder:1px solid #a8a8a8;\n}\n<\/style>\n<article  class='iconbox iconbox_top av-av_icon_box-da1071122e90f20d95941bc9a590dc59  avia-builder-el-10  avia-builder-el-no-sibling  main_color'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class=\"iconbox_content\"><header class=\"entry-content-header\"><a href='#itch' title='Dealing with the Itch'  class=\"iconbox_icon heading-color\" aria-hidden='true' data-av_icon='\ue8b4' data-av_iconfont='entypo-fontello'><\/a><h3 class='iconbox_content_title '  itemprop=\"headline\" ><a href='#itch' title='Dealing with the Itch' >Dealing with the Itch<\/a><\/h3><\/header><div class='iconbox_content_container '  itemprop=\"text\" ><div class=\"content-container\">\n<p style=\"text-align: center;\">The urge to scratch can be powerful when going through Topical Steroid Withdrawal. What can be done about the intense itching?<\/p>\n<\/div>\n<div class=\"fusion-clearfix\" style=\"text-align: center;\"><\/div>\n<p style=\"text-align: center;\"><a href=\"#itch\">Learn More<\/a><\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><\/div><div class='av-flex-placeholder'><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_third-c8fc129dc35fd1ae2a1e410224d39ea8\">\n.flex_column.av-av_one_third-c8fc129dc35fd1ae2a1e410224d39ea8{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_third-c8fc129dc35fd1ae2a1e410224d39ea8 av_one_third  avia-builder-el-11  el_after_av_one_third  avia-builder-el-last  flex_column_table_cell av-equal-height-column av-align-top av-zero-column-padding  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_icon_box-ecd9771fb3ff03b8210b9842a60df3fe\">\n.iconbox.av-av_icon_box-ecd9771fb3ff03b8210b9842a60df3fe .iconbox_icon{\nbackground-color:#000000;\nborder:1px solid #a8a8a8;\n}\n<\/style>\n<article  class='iconbox iconbox_top av-av_icon_box-ecd9771fb3ff03b8210b9842a60df3fe  avia-builder-el-12  avia-builder-el-no-sibling  main_color'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class=\"iconbox_content\"><header class=\"entry-content-header\"><a href='#survival' title='Survival Guide'  class=\"iconbox_icon heading-color\" aria-hidden='true' data-av_icon='\ue8bb' data-av_iconfont='entypo-fontello'><\/a><h3 class='iconbox_content_title '  itemprop=\"headline\" ><a href='#survival' title='Survival Guide' >Survival Guide<\/a><\/h3><\/header><div class='iconbox_content_container '  itemprop=\"text\" ><div class=\"content-container\">\n<p style=\"text-align: center;\">Recommendations, tips and tricks from TSW veterans to help you through Topical Steroid Withdrawal.<\/p>\n<\/div>\n<div class=\"fusion-clearfix\" style=\"text-align: center;\"><\/div>\n<p style=\"text-align: center;\"><a class=\"fusion-read-more\" href=\"#survival\">Learn More &gt;<\/a><\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><\/div><\/div><!--close column table wrapper. Autoclose: 1 -->\n\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_section-83d174640c9cf1677976227eb35b25b5\">\n.avia-section.av-av_section-83d174640c9cf1677976227eb35b25b5{\nbackground-color:#f9f9f9;\nbackground-image:unset;\n}\n<\/style>\n<div id='preparing'  class='avia-section av-av_section-83d174640c9cf1677976227eb35b25b5 main_color avia-section-large avia-no-shadow  avia-builder-el-13  el_after_av_section  el_before_av_one_full  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-8877'><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-15d750bd1b332b34c6e70b077ebbccdf\">\n.flex_column.av-av_one_full-15d750bd1b332b34c6e70b077ebbccdf{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-15d750bd1b332b34c6e70b077ebbccdf av_one_full  avia-builder-el-14  avia-builder-el-no-sibling  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-cb45893e43c231bab191f6c4ac3914f9\">\n#top .av-special-heading.av-av_heading-cb45893e43c231bab191f6c4ac3914f9{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-cb45893e43c231bab191f6c4ac3914f9 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-cb45893e43c231bab191f6c4ac3914f9 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-cb45893e43c231bab191f6c4ac3914f9 av-special-heading-h1 blockquote modern-quote  avia-builder-el-15  el_before_av_textblock  avia-builder-el-first '><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >What to Expect<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3 dir=\"ltr\" data-fontsize=\"24\" data-lineheight=\"30\">Before stopping topical steroid treatment<\/h3>\n<p dir=\"ltr\">Patients should work with a physician on a plan\u00a0for stopping use of topical steroids. \u00a0Having a plan in place will help you feel prepared and will help prevent unintended consequences.<\/p>\n<p>For instance, prolonged exposure to topical steroids on large areas of the body may cause certain individuals to develop adrenal suppression, hypothalamic-pituitary-adrenal\u00a0<a href=\"http:\/\/www.medpagetoday.com\/Dermatology\/Steroids\/777\" target=\"_blank\" rel=\"noopener noreferrer\">(HPA) axis suppression<\/a>\u00a0or other adrenal symptoms. Stopping topical steroids when the adrenal gland is severely depressed can be life threatening. An\u00a0<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/003695.htm\" target=\"_blank\" rel=\"noopener noreferrer\">ACTH test<\/a>, usually performed by an endocrinologist, can rule out these conditions. Stopping long term use of oral, injected, or inhaled steroids is NEVER recommended, unless under the direction of a doctor.<\/p>\n<p dir=\"ltr\">Going through Topical Steroid Withdrawal may require taking time off to recover. If you work, plan for time off work by looking into options for a leave of absence. If you are a parent or caregiver of someone going through TSW, you may need to take extended leave via the Family and Medical Leave Act (<a href=\"http:\/\/www.dol.gov\/whd\/fmla\/employeeguide.htm\" target=\"_blank\" rel=\"noopener noreferrer\">FMLA<\/a>). If you are a parent or caregiver and you have TSW Syndrome yourself, you may need to make arrangements for an alternate caregiver to take your place as you recover.\u00a0 College students may want to take a few semesters off or opt to take online courses until the later stages of recovery.\u00a0 For children and teenagers, it may be necessary to arrange for homeschooling or tutoring to allow for flexibility. In the United States, parents may be able to make a 504 plan which allows for adjustments and accommodations to a child\u2019s education.\u00a0Expect that work, responsibilities and regular routines will all need to shift so that you can recover.<\/p>\n<p dir=\"ltr\">Creating a plan in advance will alleviate the stress of finding last minute childcare or negotiating time off from work or school during a debilitating flare.<\/p>\n<\/div><\/section><\/p><\/div>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='after_section_3'  class='main_color av_default_container_wrap 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-8877'><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-15d750bd1b332b34c6e70b077ebbccdf\">\n.flex_column.av-av_one_full-15d750bd1b332b34c6e70b077ebbccdf{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-15d750bd1b332b34c6e70b077ebbccdf av_one_full  avia-builder-el-17  el_after_av_section  el_before_av_one_full  avia-builder-el-first  first flex_column_div av-zero-column-padding  '     ><section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3 dir=\"ltr\" data-fontsize=\"24\" data-lineheight=\"30\">During topical steroid withdrawal (TSW)<\/h3>\n<p dir=\"ltr\">Recuperating from TSW Syndrome is often extended and incapacitating. Many people experience painful symptoms and become covered in a full body rash or flushing that can last for weeks or months before clearing. Most have symptoms that are cyclical until the skin makes a full recovery.\u00a0 Some may not be able to participate in normal activities for many months. Work, school, and family life will be disrupted by extreme fatigue, itching and burning skin, and an erratic sleep schedule or insomnia. The appearance of the skin may also affect the desire to be seen in public.<\/p>\n<p dir=\"ltr\">The most important thing to remember is that the body is going through a very intense healing process. Arranging a less stressful schedule can be very beneficial and, in many cases, necessary. A supportive doctor can help navigate: infection prevention, pain and itch management, anxiety therapies, and use of immunosuppressants, as indicated.<\/p>\n<\/div><\/section><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_full-15d750bd1b332b34c6e70b077ebbccdf\">\n.flex_column.av-av_one_full-15d750bd1b332b34c6e70b077ebbccdf{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-15d750bd1b332b34c6e70b077ebbccdf av_one_full  avia-builder-el-19  el_after_av_one_full  el_before_av_one_full  first flex_column_div av-zero-column-padding  column-top-margin'     ><section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3 dir=\"ltr\" data-fontsize=\"24\" data-lineheight=\"30\">Recovery timelines<\/h3>\n<p dir=\"ltr\">The recovery time frame is individual, protracted, and not well understood. Some who used topical steroids a short time may have an extended withdrawal, while others who used a relatively long time may have a shorter withdrawal.\u00a0 In general, it is believed that the length of time topical steroids were used, the potency of the topical steroids, where the topical steroids were applied and continuous use have some bearing on withdrawal patterns. Some areas of the body (such as the eyelids, face and genitals) absorb at higher levels when topicals are applied. A history of oral or injected corticosteroids, such as prednisone, may also affect how long it takes to recover.<\/p>\n<p>Because of these variables, it is difficult to say exactly how long it will take to make a full recovery. Most people experience vast improvement within 12 to 24 months, while some require longer or shorter periods of time to fully recover. Exact recovery time is completely individual and nearly impossible to predict.<\/p>\n<\/div><\/section><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_full-826c1c0ca2001783299b013bb6b50dff\">\n.flex_column.av-av_one_full-826c1c0ca2001783299b013bb6b50dff{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-826c1c0ca2001783299b013bb6b50dff av_one_full  avia-builder-el-21  el_after_av_one_full  el_before_av_section  avia-builder-el-last  first flex_column_div av-zero-column-padding  column-top-margin'     ><section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><div class=\"fusion-text\">\n<h3 data-fontsize=\"24\" data-lineheight=\"30\">Frequently Asked Questions<\/h3>\n<\/div>\n<\/div><\/section><br \/>\n<div  class='togglecontainer av-av_toggle_container-8e0c6e39d39b619a829887bd54fff3ed  avia-builder-el-23  el_after_av_textblock  avia-builder-el-last  toggle_close_all' >\n<section class='av_toggle_section av-av_toggle-fee8d0126eb8ad449700ed46566b7fe8'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-1' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-1'>What are the most common symptoms of Topical Steroid Withdrawal Syndrome (TSWS)?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-1' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>These symptoms occur during withdrawal from topical steroids. You may not experience all of these symptoms, although some people do. You may start experiencing some of these symptoms within days of stopping topical steroids; other symptoms may take longer to occur, or may not occur at all. You might experience some of these symptoms throughout the entire time or only during flares.<\/p>\n<ul>\n<li><strong>Red, burning skin<\/strong>: Topical steroids work by constricting the blood vessels. Once you stop using topical steroids, the affected blood vessels become \u201cwide open\u201d and inflamed, creating flushing and a burning sensation. This typically appears within a week after stopping topical steroids but has been known to happen later on. It may cover a large area from the start or it may start as a small area, eventually spreading. One classic sign is a \u201cred sleeve\u201d that covers the arms and legs, stops at the wrist and ankles, sparing the palms of the hands and soles of the feet. It might take weeks for the red sleeve arm\/white palm to appear as the redness spreads.<\/li>\n<li><strong>Raw, painful skin<\/strong>: It may feel like a bad sunburn and may be sensitive to even the lightest touch.<\/li>\n<li><strong>Eczema-like rashes<\/strong>: These rashes may spread from an area of skin that was originally affected by eczema or happen anywhere on your body. You may experience hives, very, very dry skin that has the look and feel of plastic, itchy skin, deep cracks, or tiny cuts in the skin, even in areas where topical steroids were never used.<\/li>\n<li><strong>Edema<\/strong>: Swollen skin, swollen areas of the body, or retaining fluid. Hands and feet often swell during TSW.<\/li>\n<li><strong>Oozing skin<\/strong>: Ooze or serous exudate from the blood vessels may seep out of skin or form in small blisters (vesiculation). You may find a hard crust over your skin \u2013 this is ooze that has dried. This is not the body \u201cdetoxing\u201d but a leakage from the blood vessels due to their dilation. It is important to have your doctor differentiate the serous exudate crust from skin infections such as staph, MRSA or impetigo. Please seek medical care when in doubt.<\/li>\n<li><strong>Itchy skin<\/strong>: The itch is unbelievably intense and feels like it originates under the skin. There are thousands of nerve endings in each square inch of skin. The recovery process may cause symptoms described as pins and needles, numbness, pin pokes, zingers, sparklers, ants crawling, bee stings, jolts and moderate to intense skin pain.<\/li>\n<li><strong>Shedding or flaking skin<\/strong>: Many people find that they shed a lot of dry skin flakes. You may need to change bed linens and vacuum daily to keep up with the amount of skin flaking off.<\/li>\n<li><strong>Difficulty regulating body temperature<\/strong>: You may experience freezing hands, feet, or body and often get the chills; or you may feel very hot. Feeling chilled can be due to the skin losing heat during periods of flushing and redness. Cold intolerance can also be due to adrenal suppression caused by previous steroid use. Chills can also be caused by infection. It is important to have appropriate lab work done to rule out adrenal suppression or infection as a cause for the chills.<\/li>\n<li><strong>Enlarged lymph nodes<\/strong>: These are felt as lumps under the skin and can be in the neck, armpits, groin, behind the knees or around the ribs. The lymph system helps filter harmful pathogens, cancerous cells, cellular waste, and dead cells. Although swollen lymph nodes are common during TSW Syndrome, the potential for lymph nodes of an infectious or malignant origin should be discussed and ruled out by your doctor.<\/li>\n<li><strong>Thinning hair<\/strong>: Some sufferers find that they get bald or missing patches of hair on their heads or their eyebrows. This grows back as recovery progresses.<\/li>\n<li><strong>Eye irritation<\/strong>: Dryness, redness, soreness, photosensitivity, occasional blurry vision and excess mucus may be present during TSW Syndrome. Have your eyes thoroughly examined by an optometrist, especially if you have put topical steroids on your eyelids or near the eye in the past.<\/li>\n<li><strong>Decreased energy levels<\/strong>: Exhaustion, fatigue and burnout are very common symptoms during withdrawal.<\/li>\n<li><strong>Difficulty sleeping<\/strong>: Insomnia or difficulty maintaining a normal sleep schedule are normal during TSW. A doctor can help you manage this symptom.<\/li>\n<li><strong>Change in appetite<\/strong>: Loss of appetite with weight loss, or increased appetite with weight gain are typical during recovery.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-8dd2b68c1be2bbfebeef506f42bb00d8'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-2' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-2'>What is a flare?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-2' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>During a flare, your skin may experience an increase in the following: redness, sensitivity, intense itchiness, hives, cracking, swelling, or oozing. Your symptoms may continue to increase in severity for a period of time. Your skin may also seem stuck in a \u201cholding pattern\u201d of bad skin or at a plateau without improvement for a period of time.<\/p>\n<p>Flares can last anywhere from a few days to several months. When a flare eventually subsides and you enter a \u201cbreak\u201d, the skin becomes dry and flaky and you may shed a lot of dead skin. During a break, your skin may also feel tight, like plastic, or very rough. The redness may decrease in some places and oozing may decrease as well. You may be somewhat less itchy during a break.<\/p>\n<p>The cycle of flares followed by breaks usually occurs many times until you are fully recovered. You may notice a pattern to the flare\/break cycle. For example, skin may ooze during a flare, then become flaky and dry during a break. Some people may never have a true break and experience milder, long-term symptoms until fully healed.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-92a2a1dad674d7cd0720a0271547b39a'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-3' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-3'>Can I have withdrawal on only one part of my body?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-3' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>Yes. This is especially true with use on the face, or in the case of caregivers applying topical steroids to another person over time, without washing their hands afterwards. It is also common for people to have widespread withdrawal symptoms, despite using only a small amount of topical steroids on a small area of the body.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-183ef084ac18518b81537f8ea8e277d6'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-4' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-4'>Are my allergies getting worse? Are elevated lgE levels normal during TSW Syndrome?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-4' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>Elevated\u00a0<a href=\"https:\/\/www.aaaai.org\/conditions-and-treatments\/conditions-dictionary\/immunoglobulin-e-(ige)\" target=\"_blank\" rel=\"noopener noreferrer\">IgE<\/a>\u00a0and\u00a0<a href=\"http:\/\/www.mayoclinic.org\/symptoms\/eosinophilia\/basics\/causes\/sym-20050752\" target=\"_blank\" rel=\"noopener noreferrer\">eosinophils<\/a>\u00a0are normal during TSW and levels typically return to normal gradually with recovery. However, it is important to rule out other causes for elevated IgE and eosinophils with your doctor. Elevated IgE levels can alter the accuracy of\u00a0<a href=\"http:\/\/en.wikipedia.org\/wiki\/Radioallergosorbent_test\" target=\"_blank\" rel=\"noopener noreferrer\">RAST tests<\/a>\u00a0(allergy test done with a blood sample), and the extreme redness and sensitivity of the skin during TSWS can cause skin prick allergy testing to be inaccurate or impossible. For these reasons, allergy testing during Topical Steroid Withdrawal may not be valuable.<\/p>\n<p>The following may explain the\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15617870\/\" target=\"_blank\" rel=\"noopener noreferrer\">link between topical steroid use and elevated IgE levels<\/a>:<\/p>\n<blockquote>\n<p>\u201cThe therapy by corticosteroids influences the production of IgE, that is one of the key markers of the atopic diseases. Thus, therapy of patients with atopic dermatitis by topical corticosteroids within two weeks resulted in the elevation of spontaneous production of IgE by B-cells in vitro. The experiment has showed that corticosteroids are able to induce IgE production by B-lymphocytes when added to a culture in vitro. A synergy of IL-4 and corticosteroids in induction by B-cells of IgE production plays, probably, some role in the influence of corticosteroids on the course of atopic diseases.\u201d<\/p>\n<\/blockquote>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15617870\/\"><em>Source:<\/em><\/a><em>\u201cPrevalence of atopic diseases and the use of topical corticosteroids. Is there any connection?\u201d Alexander N. Pampura, Medical Hypotheses, 2005;64(3):575-8.<\/em><\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-ec2b1c776454dae8f17776dd0503caff'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-5' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-5'>Will I have eczema after I\u2019ve recovered from Topical Steroid Withdrawal Syndrome (TSWS)?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-5' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>This depends on how much of your condition was steroid-induced. It is possible to recover from TSW Syndrome and have no remaining eczema. It is also possible to recover from TSW Syndrome and still have eczema or other skin conditions. Topical Steroid Withdrawal is a way to manage TSW Syndrome and should not be mistakenly designated as a \u201ccure\u201d or treatment for healing underlying eczema. The majority of our forum members report that the state of their skin after withdrawal is preferable to the state of their skin while on topical steroid treatment, even if some of their underlying eczema remains unresolved. Post TSWS, the affected skin is typically no longer full-body, and the itching of eczema is more manageable than the burning and stinging experienced while on treatment. It is important to consider that topical steroids do not cure eczema \u2014 topical steroids suppress inflammation, giving the impression that eczema has \u201cgone away.\u201d<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-c7198b96e24cacbdbe00afba16b13dae'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-6' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-6'>Will getting some sun help? What about UVB light therapy?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-6' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>Sun is not promised to speed healing but is often found to help. It is only recommended for those in the later stages of TSWS after flares have stopped, and when the skin is dry, thicker, and not pink or red. You must be careful to avoid getting too much sun or getting too hot. Start with a short amount of time (10 minutes or less). Cool sun is recommended. Narrowband UVB light therapy (phototherapy) has also proven helpful for members in the later stages of TSWS, but is not recommended for those in the early stages of withdrawal.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-ce4f11dccf565bfaf2b8301223ea8aaa'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-7' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-7'>Is it normal to feel panicked or anxious?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-7' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>Many of those in withdrawal have felt this way. It is a difficult and long process that involves the largest organ of the body \u2013 the skin. It affects everything from one\u2019s appearance to the ability to function normally. Having a good support system with family and friends is vital. You can also find a lot of support through the ITSAN forum on\u00a0<a href=\"https:\/\/www.facebook.com\/groups\/ITSANSupport\/\" target=\"_blank\" rel=\"noopener noreferrer\">facebook<\/a>. It is important to talk with a counselor immediately if you feel depressed or suicidal.<\/p>\n<\/div><\/div><\/div><\/section>\n<\/div><\/p><\/div>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_section-a773aa5647ba83208f6364fba8e5e972\">\n.avia-section.av-av_section-a773aa5647ba83208f6364fba8e5e972{\nbackground-color:#f2f2f2;\nbackground-image:unset;\n}\n<\/style>\n<div id='itch'  class='avia-section av-av_section-a773aa5647ba83208f6364fba8e5e972 main_color avia-section-default avia-no-shadow  avia-builder-el-24  el_after_av_one_full  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-8877'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-ca4291fdb59e6888ec59c03447eedb72\">\n#top .av-special-heading.av-av_heading-ca4291fdb59e6888ec59c03447eedb72{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-ca4291fdb59e6888ec59c03447eedb72 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-ca4291fdb59e6888ec59c03447eedb72 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-ca4291fdb59e6888ec59c03447eedb72 av-special-heading-h1 blockquote modern-quote  avia-builder-el-25  el_before_av_textblock  avia-builder-el-first '><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >Dealing with The Itch<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>The itch is often the worst symptom for many people, because it is constant and impossible to satisfy.\u00a0 ITSAN co-founder<strong>\u00a0Kelly Palace<\/strong>, a former TSWS sufferer describes her experience:<\/p>\n<blockquote>\n<p>For me, itching has been the worst symptom in my recovery from Topical Steroid Withdrawal. It has brought me to my knees crying, praying, begging it to stop. The itching was so bad at one point that I bought medical protective \u2018mitts\u2019 (similar to boxing gloves) and had my husband cinch me in the gloves at night so I could not scratch. I \u2018won\u2019 every night by getting the gloves off in my sleep and violently scratching. The itch has made me wish I was dead. There were times when I itched 24 hours a day.<\/p>\n<\/blockquote>\n<p>Healing from Topical Steroid Addiction is the only thing that truly takes the itch away, but there are ways to manage it.<\/p>\n<\/div><\/section>\n<div  class='togglecontainer av-av_toggle_container-8e0c6e39d39b619a829887bd54fff3ed  avia-builder-el-27  el_after_av_textblock  avia-builder-el-last  toggle_close_all' >\n<section class='av_toggle_section av-av_toggle-52b8a62e5e6836d5b7419e63c4f4e241'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-8' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-8'>What causes such an intense itch?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-8' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>The neurological phenomenon of\u00a0<a href=\"http:\/\/www.newyorker.com\/magazine\/2008\/06\/30\/the-itch\" target=\"_blank\" rel=\"noopener noreferrer\">itch\u00a0is incredibly complex<\/a>. In the case of TSW, it is believed that the itch is caused by blood vessels and nerve endings of the skin beginning to regain proper function. Topical steroids cause the tiny blood vessels of the skin to shrink, or vasoconstrict, which relieves the discomfort of inflammation. When the body becomes resistant to treatment, the blood vessels widen, or vasodilate, causing the skin to flush and painfully burn and itch. Much like recovering from an extreme sunburn, the flushing, burning redness crosses over to tight, peeling skin. As the capillaries of the skin recover during Topical Steroid Withdrawal (TSW), many describe a deep, general, systemic itch.<\/p>\n<p>Palace states, \u201cThe itch experienced during Topical Steroid Withdrawal is different from the itch experienced by a person with eczema. This is a deep, healing itch. Thinking of the itch as a step in the healing process may help with acceptance and understanding that it will pass.\u201d<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-8aa1e2a56f533cac31ec0e12eef10d2f'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-9' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-9'>Will the itch ever stop?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-9' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>Yes, but it takes time. The itch becomes more tolerable at different stages of the withdrawal process. Some have reported that the itch is not as intense in the later months, when compared to the first few months of withdrawal. The itch may also become less widespread, concentrating in a few \u201ctrouble areas\u201d instead of across the whole body. \u201cI rarely itch now \u2013 probably like a normal person,\u201d says Palace.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-bbd7aa211924a0c43b6f72b75f2303d3'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-10' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-10'>Should I limit scratching?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-10' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>You will probably not be able to eliminate scratching. The itch is so intense that almost everyone scratches. \u201cI certainly scratched and satisfied the undeniable urge to do so, which would grip me until I twisted my whole body in spasms, trying to fight it off,\u201d said Palace.<br \/>\nAlthough you will need to scratch, you must do so carefully. It is extremely important that you do not do more damage to skin and set yourself back further with open wounds or a skin infection. Another risk of scratching with your nails is deformation of fingernails caused by scratching too much or too hard. It can also make your skin hurt or feel sore, which can be difficult to cope with when your skin is already very tight, dry, and painful.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-1fb4a70cbd028c0a09e1c80790297f8c'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-11' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-11'>Is there a safer way to scratch?<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-11' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>Since you will feel the urge to scratch (often undeniably), you should develop a \u201csafe scratch\u201d plan. This can help prevent wounds and infections.<\/p>\n<p>\u201cOver a year with lots of scratching, I never had a skin infection and rarely broke my skin open,\u201d says Palace. \u201cI came up with a safe way to scratch \u2013 I used a rubber comb. It does not break the skin but relieves the itch. I washed the comb with soap and hot water, then sterilized it with alcohol. I did this each morning and each night, so I wouldn\u2019t get an infection. Before I picked up the comb, I would say, \u2018Gentle, gentle, gentle!\u2019 just to remind myself I am only trying to relieve the itch, not gouge a hole in my skin.\u201d<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-av_toggle-389cf625b46b91f4cddd6122a15480bf'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-12' class='toggler   '  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-12'>Safe scratch plan<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-12' class='toggle_wrap  '  ><div class='toggle_content invers-color '  itemprop=\"text\" ><p>Here are some tips that you may want to incorporate into your \u201csafe scratch\u201d plan:<\/p>\n<ul>\n<li>Be mindful of scratching. Have a plan to stop before you are out of control. Sometimes scratching becomes a habit, so be mindful!<\/li>\n<li>Have a STOP pose. \u201cMine is pulling my hands off my body in the \u2018prayer\u2019 position. Then I count to 60 to see if I can stop scratching for 60 seconds. Usually if I can refrain for 60 seconds, I have won,\u201d Palace comments. \u201cSit on your hands until you feel more in control of the scratching, or cross your arms across your body and tuck your hands under your armpits.\u201d<\/li>\n<li>Realize the more you scratch, the more you itch. Scratching releases histamine, which causes itch. This is why you can start by scratching an itch on your ankle, then end up \u201cchasing the itch\u201d all over your body.<\/li>\n<li>Have an anti-scratch mantra, like \u201cBe gentle!\u201d or \u201cThis will pass. I am healing. This will pass.\u201d Palace suggests, \u201cI would chant \u2013 sometimes internally, sometimes aloud \u2013 \u2018This is my body healing. Nerves and blood vessels are healing. I am getting healthy, smooth skin.\u2019 I did this in my STOP pose.\u201d<\/li>\n<li>Be kind to yourself, a loving voice to your inner child. When you are scratching say to yourself, \u201cGentle, gentle, gentle\u201d.<\/li>\n<li>Keep fingernails clean, trimmed short, and filed smooth.<\/li>\n<li>Wearing cotton gloves to bed may help limit the damage done by scratching in your sleep. There are many websites for eczema patients that sell clothing products and accessories made of 100% natural fibers, including gloves. Some find that wrapping their arms and legs at night can help reduce sleep scratching.<\/li>\n<li>Have a scratch tool, something that is soft, clean, and does NOT break the skin. One option is a soft, rubber comb. Another option is a therapressure brush, or a surgical scrub brush.<\/li>\n<li>Temperature changes can help \u2013 put ice or an icepack on the itchy spot, take a cool bath, rinse your hands in cool water, or place a cold wash rag on the itchy spot. Some people find that heat from a warm bath or a hot water bottle can help in the same way.<\/li>\n<li>If moisturizer makes your skin feel better, apply to the area. If moisturizer does not provide relief, or is irritating, do not apply.<\/li>\n<li>You will shed flakes of skin throughout the healing process. Be careful that you don\u2019t start a \u2018scratch fest\u2019 while buffing off old skin.<\/li>\n<li>Have a \u201cwellness buddy,\u201d someone that you can promise you will not scratch or pick beyond what is reasonable. Then report to them. Having a partner or roommate as your \u2018wellness buddy\u2019 can be helpful because they can help you calm down when you are in the middle of a scratch fest.<\/li>\n<li>Distract yourself. Play a video game, type up an email, squeeze a stress ball or play with play-dough. Do something that keeps your hands busy.<\/li>\n<li>Antihistamines can help with the itch. Atarax, Zyrtec, and Benadryl can be prescribed at a higher-than-usual dose, if needed. Check with your doctor.<\/li>\n<li>Some find baths to be helpful and comforting. Just be careful baths are not too hot. Heat can feel comforting at first, but increased blood flow to the skin can induce burning and itching.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/section>\n<\/div>\n\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='survival'  class='avia-section av-av_section-807782a9fad90ab8de8cc88e0214d0c5 main_color avia-section-default avia-no-shadow  avia-builder-el-28  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-8877'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-4b329c32ef388361c73690ec15f36fd1\">\n#top .av-special-heading.av-av_heading-4b329c32ef388361c73690ec15f36fd1{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-4b329c32ef388361c73690ec15f36fd1 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-4b329c32ef388361c73690ec15f36fd1 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-4b329c32ef388361c73690ec15f36fd1 av-special-heading-h1 blockquote modern-quote  avia-builder-el-29  el_before_av_textblock  avia-builder-el-first '><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >Survival Guide<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>The purpose of this survival guide is to share tips that have helped veterans who have been or who are going through Topical Steroid Withdrawal Syndrome. \u00a0This is not to be taken as medical advice, just the personal experiences of other people who have been there. \u00a0We still don\u2019t know what can help speed up the withdrawal process, but these suggestions might help you keep as comfortable and healthy as possible during the process. Not everything will help everyone. Everyone\u2019s skin is different and there is no one thing or one product for everyone. Listen to your body and use what you find helps you the most. What one may love to use, another can not tolerate so spot test everything to avoid a full body irritation. \u00a0ITSAN highly recommends all TSWS sufferers find a supportive doctor to help them through the withdrawal process.<\/p>\n<p><strong>1. Moisturizers.<\/strong>\u00a0Some people cannot tolerate any moisturizer during withdrawal \u2013 especially in certain stages of withdrawal, but here are the moisturizers many of our forum members like to use. \u00a0Please spot test everything to make sure the skin can tolerate the moisturizers or soaps and remember to only try one new thing at a time. Also note that the skin may accept something for a while and then become irritated at another stage of withdrawal when the same product is applied. Most people find emollients, ointments or balms made with simple ingredients to be more comfortable than creams or lotions.<\/p>\n<\/div><\/section>\n<div  class='tabcontainer av-av_tab_container-0bacd910096d11a3cec6dfb538798966 top_tab  avia-builder-el-31  el_after_av_textblock  el_before_av_textblock ' role='tablist'>\n<section class='av_tab_section av_tab_section av-av_tab-f428eaf855df7e09b2104af68346ce09'  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\" >Ointments and Balms<\/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>Vaseline<\/li>\n<li>Lemongrass Balm and Zinc Balm (available on Etsy from The Home Apothecary)<\/li>\n<li>Jojoba oil<\/li>\n<li>Hemp oil<\/li>\n<li>Coconut oil<\/li>\n<li>Sunflower oil<\/li>\n<li>Palm shortening<\/li>\n<li>Egyptian magic (often available at Costco)<\/li>\n<li>Zinc oxide (Desitin)<\/li>\n<li>Sudocrem<\/li>\n<li>Castor oil<\/li>\n<li>Bee all natural products<\/li>\n<li>Medicine Mama\u2019s Bee Magic<\/li>\n<li>Manuka honey ( a natural anti-bacterial)<\/li>\n<li>Shea butter<\/li>\n<li>Renew lotion<\/li>\n<li>Olive oil<\/li>\n<li>Avocado oil<\/li>\n<li>Beef tallow<\/li>\n<li>Theraplex Emollient or Barrier Balm<\/li>\n<li>Balmond\u2019s Skin Salvation<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<section class='av_tab_section av_tab_section av-av_tab-3c8b9562e4767648eb87afe39714a4ee'  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\" >Soaps and Shampoos<\/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>Switch to non-detergent soaps and shampoos<\/li>\n<li>Dr. Bronner\u2019s mild baby soap<\/li>\n<li>\u201cFree and Clear\u201d Shampoo and Conditioner (by Vanicream)<\/li>\n<li>Vanicream Bar Soap<\/li>\n<li>Vanicream Liquid hand soap<\/li>\n<li>Shea butter soap bars<\/li>\n<li>Olive oil soap bars<\/li>\n<li>African black soap<\/li>\n<li>Dove<\/li>\n<li>Aveeno oatmeal soap<\/li>\n<li>Burt\u2019s Bees baby wash<\/li>\n<li>Coconut-based soaps (Kirk\u2019s)<\/li>\n<li>Apple Valley natural soap and shampoo bars<\/li>\n<li>Apple cider vinegar can also be used as a hair wash<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<\/div>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>2. Baths.<\/strong>\u00a0The skin can be so sensitive during TSW, some members can not tolerate being submerged in water, and instead prefer sponge baths or using wipes for personal cleansing. For those who get comfort from the tub, the following products can be added to the bath water. Be prepared to discontinue any of these measures if they cause further irritation or discomfort.<\/p>\n<\/div><\/section>\n<div  class='tabcontainer av-av_tab_container-0bacd910096d11a3cec6dfb538798966 top_tab  avia-builder-el-33  el_after_av_textblock  el_before_av_textblock ' role='tablist'>\n<section class='av_tab_section av_tab_section av-av_tab-9420091456af3fb0426ed00cac1d0c59'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab active_tab' role='tab' tabindex='0' data-fake-id='#tab-id-3' aria-controls='tab-id-3-content'  itemprop=\"headline\" >To prevent infection<\/div><div id='tab-id-3-content' class='tab_content active_tab_content' aria-hidden=\"false\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>Apple cider vinegar \u2013 Bragg Organic Apple Cider vinegar is especially recommended: 1\/2 cup to a full tub, as needed. Adjust amount of vinegar as tolerated.<\/li>\n<li>Bleach baths: 1\/2 cup plain, household bleach to full tub of water, 1-2 times weekly<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<section class='av_tab_section av_tab_section av-av_tab-cf6826f0ab8a8b54e4b9ba571e3f9cf1'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab' role='tab' tabindex='0' data-fake-id='#tab-id-4' aria-controls='tab-id-4-content'  itemprop=\"headline\" >To soothe or relieve itch<\/div><div id='tab-id-4-content' class='tab_content' aria-hidden=\"true\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>Aveeno Colloidal oatmeal bath (or make your own by putting rolled oats in a sock and placing it in bathwater )<\/li>\n<li>Epsom salt<\/li>\n<li>Dead Sea salt<\/li>\n<li>Pink Himalayan salt<\/li>\n<li>Baking soda<\/li>\n<li>Tea tree oil: 3-5 drops added to 1 cup bath salts, then added to tub water<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<section class='av_tab_section av_tab_section av-av_tab-7ec3ae6fd55515cc11e2df8d393d57c8'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab' role='tab' tabindex='0' data-fake-id='#tab-id-5' aria-controls='tab-id-5-content'  itemprop=\"headline\" >To help moisturize<\/div><div id='tab-id-5-content' class='tab_content' aria-hidden=\"true\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>Olive oil or other oils added to bath water (be sure to patch test first)<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<\/div>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>3. Wraps after moisturizer and baths.<\/strong>\u00a0Some members find relief from wrapping after bathing and moisturizing. Wraps (gauze and tape) are a great way to lock in the moisturizer and protect the skin while it heals. Other members find relief from dry wrapping. The pressure on the skin can sometimes distract you from the itch or help keep you from scratching.<\/p>\n<p>Suggested Wraps:<\/p>\n<ul>\n<li>Regular gauze and medical tape<\/li>\n<li>Tubular support bandages<\/li>\n<li>Viscopaste bandages<\/li>\n<li>Taping socks on feet or hands<\/li>\n<li>Cotton or other types of thin gloves<\/li>\n<li>Ballet tights<\/li>\n<\/ul>\n<p><strong>4. Antibacterial ointments.\u00a0<\/strong>Antibacterial ointments (such as neosporin) may help if superficial infection is suspected. Some people have also used colloidal silver sprays and certain essential oils to help prevent infection. NOTE: All serious infections should be checked by a doctor. Cellulitis can occur when bacteria gets under the skin and this can be very dangerous if not treated.\u00a0Prolonged use of topical antibiotics, especially on large areas, is not recommended as this can produce antibiotic-resistant infections.<\/p>\n<p><strong>5. Laundry.<\/strong>\u00a0It is important to select a laundry soap that will not irritated the skin. It is also recommended to cycle your washing machine with vinegar or bleach to prevent bacteria from growing.<\/p>\n<\/div><\/section>\n<div  class='tabcontainer av-av_tab_container-0bacd910096d11a3cec6dfb538798966 top_tab  avia-builder-el-35  el_after_av_textblock  el_before_av_textblock ' role='tablist'>\n<section class='av_tab_section av_tab_section av-av_tab-12a0db5c038971d372828e46269de9cd'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab active_tab' role='tab' tabindex='0' data-fake-id='#tab-id-6' aria-controls='tab-id-6-content'  itemprop=\"headline\" >Non-detergent laundry soap<\/div><div id='tab-id-6-content' class='tab_content active_tab_content' aria-hidden=\"false\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>Soap nuts<\/li>\n<li>Non-detergent soaps<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<section class='av_tab_section av_tab_section av-av_tab-1dec5c484f78e468f523bc8de3279020'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab' role='tab' tabindex='0' data-fake-id='#tab-id-7' aria-controls='tab-id-7-content'  itemprop=\"headline\" >Unscented dye-free detergents<\/div><div id='tab-id-7-content' class='tab_content' aria-hidden=\"true\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>ALL Free &amp; Clear<\/li>\n<li>Purex Free &amp; Clear<\/li>\n<li>Cheer Free<\/li>\n<li>Seventh Generation Free &amp; Clear<\/li>\n<li>Tide Free &amp; Gentle<\/li>\n<li>Downey Free &amp; Gentle<\/li>\n<li>Bounce Free &amp; Gentle dryer sheets<\/li>\n<li>All Free &amp; Clear dryer sheets.<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<\/div>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>6. Vacuum.<\/strong>\u00a0A good vacuum for clean up of shedding skin flakes. It may be helpful to have a small vacuum on hand just for this purpose, whether for use around the house or directly on sheets. Laundering sheets can be difficult if skin flakes are not vacuumed prior to laundering. \u00a0Spare sets of cotton sheets make it easier to change your bed often.<\/p>\n<p><strong>7. Cotton clothes.<\/strong>\u00a0100% cotton comfy clothes. Some recommendations:<\/p>\n<ul>\n<li>Eczema pajamas are very comfortable and they have mitten and feet covered to help prevent scratching, available at\u00a0www.eczemaclothing.com<\/li>\n<li>Hanna Anderson has a lot of organic 100% cotton clothes for adults and children.<\/li>\n<li>Carters and The Children\u2019s Place have nice 100% cotton clothes for children too.<\/li>\n<\/ul>\n<p><strong>8. Soft towels.<\/strong>\u00a0Towels and wash cloths for bath time. Some even like to use a slightly damp wash cloth in bed to wipe or rub skin as itching arises at night.<\/p>\n<p><strong>9. Blankets.<\/strong>\u00a0Comfortable, warm blankets. Many people report feeling cold or chilled during TSWS. This can be due to the skin losing heat during periods of flushing and heat loss. Altered thermoregulation can also be due to adrenal suppression caused by previous steroid use. Chills can also be caused by infection. It is important to have appropriate lab work done to rule out adrenal suppression or infection as a cause for the chills.<\/p>\n<p><strong>10. Cool.<\/strong>\u00a0\u00a0Many find comfort by keeping their cool and avoiding hot environments. Smoothies, popsicles and ice cubes are a nice cool treat that seems to cool the skin from the inside out. Ice packs are an essential everyday item for many.\u00a0Lots and lots of ice packs to help relieve itch and a cooler bag to keep ice packs cool when you leave the house.<\/p>\n<p><strong>11. Heat.<\/strong>\u00a0\u00a0A heating pad is helpful for aches and pains, and can be used to distract the nerves from the itch. Hot water bottles work well for this too. Some people find the heat of a bath or shower to be more soothing than cool temperatures.<\/p>\n<p><strong>12. Medications and supplements.<\/strong>\u00a0Consider discussing these\u00a0with your doctor:<\/p>\n<\/div><\/section>\n<div  class='tabcontainer av-av_tab_container-0bacd910096d11a3cec6dfb538798966 top_tab  avia-builder-el-37  el_after_av_textblock  el_before_av_textblock ' role='tablist'>\n<section class='av_tab_section av_tab_section av-av_tab-7545a5994499b17b03ab7aaab7e132c3'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab active_tab' role='tab' tabindex='0' data-fake-id='#tab-id-8' aria-controls='tab-id-8-content'  itemprop=\"headline\" >Medications<\/div><div id='tab-id-8-content' class='tab_content active_tab_content' aria-hidden=\"false\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>Antihistamines<\/li>\n<li>Sleep aides<\/li>\n<li>Pain killers<\/li>\n<li>Antibiotics<\/li>\n<li>Antibiotic ointment<\/li>\n<li>Anti-anxiety medications<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<section class='av_tab_section av_tab_section av-av_tab-76118168e3a7b42ecacb9d075a802754'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='tab' role='tab' tabindex='0' data-fake-id='#tab-id-9' aria-controls='tab-id-9-content'  itemprop=\"headline\" >Supplements<\/div><div id='tab-id-9-content' class='tab_content' aria-hidden=\"true\"><div class='tab_inner_content invers-color'  itemprop=\"text\" ><ul>\n<li>Omega 3 oils<\/li>\n<li>Vitamin C<\/li>\n<li>Vitamin D<\/li>\n<li>Probiotics<\/li>\n<\/ul>\n<\/div><\/div><\/section>\n<\/div>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>13. UV or sun.<\/strong>\u00a0UV therapy or sun exposure can be helpful in the later stages of TSW when the skin is no longer hot and red. \u00a0If getting sun, cooler sun in the early morning or early evening is best. When skin is no longer full body flushing, weeping, or open, prescription phototherapy (narrowband UVB light therapy) can be a good option to deal with itching and patchy skin.<\/p>\n<p><strong>14. Patch testing.<\/strong>\u00a0<a href=\"http:\/\/www.jacionline.org\/article\/S0091-6749(13)00840-3\/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">Patch testing<\/a>\u00a0the skin by dermatologist trained specifically to conduct contact dermatitis patch testing can help determine possible allergens or triggers that may be causing the skin to react. Note: This test requires the skin of the back to be steroid-free and clear prior to testing.<\/p>\n<p><strong>15. Essential oils.<\/strong>\u00a0Some members have found using essential oils to be helpful, especially for relaxing aromatherapy. Some oils are meant only for aromatherapy. It is important to consult a certified aromatherapist prior to use on the skin, as certain oils are considered \u201cwarm oils\u201d and may burn the skin. All oils used on the skin should be therapeutic grade, used in proper dilution with a carrier, and patch tested prior to use.<\/p>\n<p><strong>16. Domeboro.<\/strong>\u00a0Domeboro Solution mixed with water and kept in the refrigerator can help sooth the ooze and burn. It can also help dry the itch or oozing. Caladryl can also help with minor itch and oozing.<\/p>\n<p><b>17. Avoid triggers.<\/b>\u00a0Some members note that certain dietary or environmental factors make their itching and flaring worse. Discovering which triggers to avoid is individual and often done by trial and error. The most common dietary triggers reported by members include:\u00a0sugar, alcohol, chocolate,\u00a0nuts, eggs,\u00a0gluten, and\u00a0dairy. The most common environmental triggers include: pets, dust, grasses, pollen, and certain chemicals found in personal care or household products.<\/p>\n<p><strong>18. Car kit.<\/strong>\u00a0It seems like the car is a place that often brings out the itch, especially for the kids. Being hot in a car seat or just being bored is not fun. Have plenty of things to keep your kids busy in the car, such as an iPad, video games, books, Legos, coloring books and snacks. Ice packs can also be very helpful in the car.<\/p>\n<p><strong>19. Hands.<\/strong>\u00a0Keep your hands busy.\u00a0iPad, reading, movies, video games whatever you enjoy that will keep your mind and hands busy during the itch will help.<\/p>\n<p><strong>20. Leave guilt at the door.<\/strong>\u00a0Some individuals experience feelings of guilt for not being their\u00a0best self during withdrawal, or believing that they brought the\u00a0problem on themselves. Some parents have feelings of guilt, believing that by using steroids on their child they are somehow responsible for their TSWS symptoms. These feelings of guilt are understandable, but unwarranted. TSWS symptoms is only just starting to be recognized by the medical community. This is a learning process for all of us as patients and doctors.<\/p>\n<p><strong>21. Depression.<\/strong>\u00a0Topical Steroid Withdrawal Syndrome is very hard on everyone involved. If you feel depressed, please search out a good therapist or support system that can help you during withdrawal, and possibly even afterwards to deal with what many veterans describe as\u00a0 PTSD post-recovery aftermath.<\/p>\n<p><strong>22. Support groups.<\/strong>\u00a0Use the ITSAN support group! Bond with others going through TSW Syndrome. The people going through it get what you are going through and are very supportive and loving, so take advantage of the private\u00a0<a href=\"https:\/\/www.facebook.com\/groups\/ITSANSupport\/\" target=\"_blank\" rel=\"noopener noreferrer\">Facebook support groups<\/a>.<\/p>\n<p><strong>23. Expect the unexpected.<\/strong>\u00a0Flares can come out of nowhere for no known reason. A terrible day can be followed by a period of calm and comfort. And just when you think you may be getting through it, a late stage flare can knock you off your feet. Topical Steroid Withdrawal Syndrome is a roller coaster ride so be prepared for a lot of ups and downs.<\/p>\n<\/div><\/section>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_hr-4474f20d2389e2e5ecf918a02da5132e\">\n#top .hr.hr-invisible.av-av_hr-4474f20d2389e2e5ecf918a02da5132e{\nheight:50px;\n}\n<\/style>\n<div  class='hr av-av_hr-4474f20d2389e2e5ecf918a02da5132e hr-invisible  avia-builder-el-39  el_after_av_textblock  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n<section  class='av_textblock_section av-av_textblock-2de302bf1aa3cf4c9157dbe6f50ac7eb '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h5 data-fontsize=\"14\" data-lineheight=\"23\">This information is provided as a service to patients and parents of patients who have TSW Syndrome.\u00a0 It is not intended to supplement appropriate medical care, but instead to complement that care with guidance in practical issues facing patients and parents.\u00a0 Neither ITSAN, its Board of Directors, nor support group members and officials endorse any treatments or products reported here.\u00a0 All issues pertaining to the care of patients with TSW Syndrome should be discussed with a physician experienced in the treatment of TSW Syndrome.<\/h5>\n<\/div><\/section>\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-8877","page","type-page","status-publish","hentry"],"campaignId":"","_links":{"self":[{"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/pages\/8877","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=8877"}],"version-history":[{"count":2,"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/pages\/8877\/revisions"}],"predecessor-version":[{"id":22135,"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/pages\/8877\/revisions\/22135"}],"wp:attachment":[{"href":"https:\/\/www.itsan.org\/us\/wp-json\/wp\/v2\/media?parent=8877"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}