Topical steroids are the most common treatment for eczema.
They are also addictive and will cause you to become dependant on them.
Not in the way that cigarettes or morphine or cocaine are addictive, they don’t make you feel good. They make you look good. Or rather, they make you look normal, like a human being that has skin that does what it is supposed to do, i.e. keep your insides in and the outside out without cracking open from dryness, breaking into open sores and blisters and itching like a thousand mosquito bites. Topical steroids can take all of that away. You smear on a thin layer as per your doctors instructions, it stings for a few minutes but it’ll stop soon. Over the course of a few days your open wounds dry up, the skin flakes and peels and underneath there is new skin that feels thin and shiny, but smooth nonetheless.
Repeat this cycle. Eventually the topical steroid you are applying will have less and less effect. It’s called tachyphylaxis and happens with a lot of drugs. You get a stronger one from your doctor, it works well until your skin gets used to that too. Repeat this as well, within a few years you can work yourself up to a potent class IV steroid and find it doing very little to control your broken painful skin.
This is an extreme case. But basically if you find that when you stop using topical steroids and your “eczema” worsens considerably, and displays very uneczema like symptoms such as burning, turning red, oozing plasma or swelling, you probably don’t have eczema anymore, you’re going through topical steroid withdrawal. Your skin is crying out for the anti inflammatory properties of steroids that have been used to control it for so long, that it doesn’t know how to deal with inflammation without it anymore.
Topical steroid dependence is not really a condition, any more than quitting cigarettes is a condition. It’s simply a drug that has been overused and caused a very fucking unfortunate side effect. To help your skin overcome topical steroid dependance, you will need to stop using them. Some people do this cold turkey, some people taper off the steroids. I stopped cold turkey for 2 months and it was hell, my skin worsened to a stage where I couldn’t go to work or even leave the house, it consumed my every hour with burning, itching and broken skin. My skin burned so much I couldn’t sleep, I would lie in bed and sweat. I could hardly bear to do everyday things like brush my teeth or blow dry my hair - because bending my arm meant the inside of my forearm touched, causing an excruciating burning.
I had to go back onto steroids, and I decided to taper down the strength and wean myself off them instead. I started using a cream called Atopiclair, which contains an ingredient called hyaluronic acid, which acts as an anti inflammatory but without the side effects of steroids. I’ve only been off the steroids for five weeks now, but I haven’t had the instant intense reaction that I had last time, in fact my skin is probably better than it was WITH steroids during the last four years.
To give you an idea, this is what those four years looked like: I outgrew eczema at 15, but with uni and stress it came back on my eyelids and all over my fingers. I used to wake up everyday with my eyelids crusted shut, I had to peel the dry skin off them to open them. The inner corners of my eyes had cracked, like someone had taken a knife to the corner of each eye and made a tiny cut inwards towards my nose. They stung all day and every time I scratched them they would crack open again. My fingers felt like someone had taken the same knife and just cut tiny incisions all over the insides of my fingers, the nail bed, the fingertip. It hurt to wash my hands, it hurt to have a shower, I struggled with zipping and buttoning up clothes, it hurt to grip the steering wheel of my car.
So you can see why I was using topical steroids, and you can see why I became so desperately hooked to their ability to make my skin ‘normal’. I needed to be able to use my hands. I needed my face to look normal. I used to squeeze a tiny bit of weak steroid onto my fingertips and stand in the bathroom staring in the mirror, working up the courage to apply it to my eyelids. When I finally did, it burned like a mofo and I would stand with my hands clenched on the vanity, knuckles white, waiting for the pain to subside. Then I would apply an even stronger steroid all over my fingers and hands.
My eczema fluctuated in severity with this routine. Bad skin mean I spent a few days on steroids. Upon improvement I would stop. Repeat.
I’m writing this because I think a lot of people have eczema that isn’t really eczema anymore, it’s dependant skin that is becoming less and less responsive to corticosteroids. I want more people to question their doctors about whether slathering a potent drug on their skin indefinitely is a good treatment.
If you would like more info you can start here: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
Please also do your own research. Speak to doctors but don’t believe every word they say. At the end of the day, if your skin doesn’t have eczematous symptoms anymore, and you find yourself using more and more topical steroids to keep it feeling “normal”, your skin is probably already addicted and needs to come off steroids so that you can start healing properly.
Apologies for doing zero design blogging. Four day long weekend for Easter and I spent most of it at home battling my skin. My elbow eczema and my shoulder eczema is slowly joining up in the middle. Fucks sake.
It’s so tempting to think I could just ask mum to write me a prescription for some cortisone and I could be rid of this in days, but I just can’t stand being reliant on them anymore. I’ve been googling the word eczema and every possible treatment I’ve ever heard of. Trawling through blogs of other people going through topical steroid withdrawal for tips. I’ve been relying on steroids on and off to have “normal” skin my whole life.. that’s twenty three years worth of damage. Who knows how long it’ll take for my skin to get back to normal.
My neck is slowly getting better, but my legs are so bad I’m not even willing to put a photo up. I’ve been wearing cotton gloves to sleep but I can still scratch myself to a bloody pulp with them on. I read a blog where a woman wore boxing gloves to sleep.. maybe it’s worth a try. I’m pretty fucking desperate right now.
I know I don’t have it that bad. My hands are normal after three years of swollen flaking sausages for fingers. At least my eczema is in patches and not all over my body. At least my face is spared, just minor flaking and scarring on my eyelids. I scroll through the eczema tag on here and see everyone’s photos and I just want to hug you all because I know how painful it is to just have a shower, I know what it feels like to wake up in the middle of the night just wanting to rip your skin off. I know what it’s like not wanting to leave the house because you look hideous and you leave a trail of fucking flaking skin everywhere.
I guess I’m trying to talk myself into not giving up on this steroid withdrawal phase. I hope there will be a day I have beautiful smooth skin but without the steroids.
The weather in Sydney is flirting with all the seasons. The last few days have been rainy and cold, I even had to drag out a hoodie today. Summer in Sydney is usually short shorts and half a shirt when I’m home.
Which of course means my skin hasn’t been able to figure out what the fuck is going on and my eyelid eczema is in full swing, peeling, dry and painful. After a shower, I stand in front of the mirror with a tiny dab of 1% hydracortisone on my fingertips, gathering the courage to smear it around my eyes. The burn hits me unprepared every time, as my eyes water with the pain and I stand with both hands clenched on the vanity waiting for it to subside.
Every time I swear I’m done with the steroids, I end up coming back to them. There’s just no relief without turning to them. Nothing that works as fast or as reliably. I’ll be paying for it soon though. Just like where I repeated used steroids on the eczema on my hands, the skin became thickened and rough. It takes months to smooth out, go back to normal. Then I have a single flare up and within a day my fingers are swollen, painful to bend, making zips, buttons and driving a chore.
I’m sure I could be putting in a better effort to maintain my skin.. I could eat right, exercise, change my sheets more often, clean more often. To be honest, I get what I ask for by not looking after my environment.