Tag Archives: side effects

1 Year Update

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Wowowowowow! Can’t believe it’s been a year! I was wondering if this milestone would ever come around, but here I am – healthy and well. My progress has amazed me and I’m grateful. Though there is some more healing to be had, the worst is behind me and I can get back to the other shenanigans in my life. Christmas and New Years Eve were a delight. I spent it with family and my wonderful boyfriend.

The last little bout of progress has been positive overall. The good news is that the second flare I had back in November died down fairly quickly. I was itch-less for the bulk of December. Some of it has returned though not nearly as intense as the beginning of withdrawal. If I scratch, I get strange burny-tingly sensations all over that’s pretty dang satisfying and makes the itching go away for a good long while. Ahh!

Despite this minor flare that I’m experiencing, I’ve learned that healing isn’t perfect. It doesn’t mean that you won’t have any symptoms later on, but that they progressively dissipate and you begin feeling them less and start to forget about it – slowly but surely. I might say that I’m 90% healed and at the end-tail of this!

Here are a few pictures I took today. Just wanted to show you what healing at 1 year looks like for Leizel and give others reference to others with similar usage history as me (Clobestasol Propionate very lightly and diluted with petroleum jelly over last 3 years of use (Jan 2010-Dec 2012); 1 week course every 3-4 months. Since age 6, mild topicals (class 4 & 5) very infrequently to Dec 2012).

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My right wrist got a little more scratching action these last few weeks

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Left wrist

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Perioral dermatitis much improved. Dark pigmentation is fading. This was the worst area for me as it was difficult to eat, smile, and other mouth-oriented activities. See previous posts for comparison.
It’s worth mentioning that my perioral skin is improved when I use EczeHerbal ointment and calendula cream consistently. I stopped using it out of laziness for a couple weeks and went back to itchy, ozziness.Image

So yooou seeeee, things are feeling/looking better! If you’re reading this and are close to the 1 year mark and are feeling uncertain about your progress, please know that my usage/dosage was fairly modest and was withdrawing off and on for 3 years before I stopped topical steroids (TS) completely last year when I realized that my worsening “Eczema” was actually no longer Eczema but something entirely different. I didn’t think I’d be as healed as I am now. Your body is working at its pace to heal itself. Don’t underestimate your body’s healing powers. Take care of it and it will take care of you. May this New Year be a year of healing and growth.

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Happy New Year from K and me!

Part 1: Reasons to Say No to Corticosteroids

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1. Your body stops producing its own anti-inflammatory defense mechanisms the more steroids it receives.

The steroids that your doctor offers you are a synthetic form of anti-inflammatory agents that your body naturally produces within your adrenal glands. Your adrenal glands are responsible for keeping your skin calm through its production of corticosteroids, along with the production of many other very important things within your body’s ecosystem. The adrenals are susceptible to malfunction as you become dependent on steroids.

Sometimes your skin/body becomes overwhelmed and is given steroids to speed its anti-inflammatory response. Initially, the cream/ointment will help with the inflammation and keep it at bay when another flare arises. The big issue with this is the body begins to depend on the synthetic feed of steroids for its supply of anti-inflammatory agents, which often results in dependency of the prescribed creams, ointments, pills and injections. The adrenal glands cease to produce its own corticosteroid as it understands that the body is receiving it elsewhere. In a sense, the adrenals become lazy.

I’ve used this analogy before… It’s similar to how your mom does your laundry for you. No matter how many times you tell her, “No, no mother, I’ll do it because I can,” she continues to do it despite the fact that you’re a grown, able adult. Eventually, you know she’s just going to do it anyway, so you stop checking if there’s any dirty laundry as you assume that laundry is no longer your responsibility. Like mom, the steroids are the easy, simple solution to fixing your laundry. And like you, your adrenals just lay back, relax and watch. This dependency often means that our bodies’ natural anti-inflammtory response is impaired as it no longer sees a need to add to the already mass amounts of steroids you’re ingesting through your permeable skin.

The even bigger issue is that your body begins to ask for more steroids more frequently and/or in stronger potencies. What happens when you’ve reached the strongest ointment? You go to pills until you’ve adapted to that dosage. The next step is injections. What about after injections?

Steroid dependency or addiction is marked by this need to increase the dosage. Often, we will continue to increase because our bodies have not yet recovered from this addiction.  Without knowledge of Steroid Addiction, many people continue their prescribed course of steroids as their body/skin is in an “excited state” of abnormal vasodilation, releasing high accumulated amounts of nitric oxide and is unable to withstand allergens without synthetic or natural steroids. It takes months to years for the adrenals to function normally again.

2. Steroids do not heal your dermatitis, but conceal a larger issue.

Steroid creams treat the inflammation of dermatitis on a superficial level. Applying steroids on the skin (or worse, ingesting it via injections and pills) is covering a messier issue with a bandaid. Unfortunately, this “See no evil, be no evil” approach that most modern professionals use on a daily basis is the core issue in the most commonly used treatment of dermatitis. Making the symptoms go away momentarily and continuously will satisfy some, but do not give you a chance to figure out what could be influencing your symptoms. Treating the symptoms and not the core issue is shortsighted and vain at best.

Atopic skin types are sensitive and need to learn about their triggers. There are common triggers like rough fabrics (i.e., wool) and allergens (dust mites, pollen, dander, etc.). Some of you may have food allergies or are sensitive to foods with higher amounts of histamine (we take anti-histamines to calm allergic reactions). Your health deserves a chance and learning more about what your body reacts is going to save your body and sanity.

A Little Rant and Literature

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I think that it’s important that anyone using corticosteroids know about the possibility of addiction, especially since it’s likely that their doctors know about the influence on the HPA axis (Hypothalamic–Pituitary–Adrenal axis — pretty much your adrenal glands which produce your body’s natural corticosteroids), though not its extent of influence.

But first – a rant. From the stories I’ve read from ITSAN members, it’s unfortunate how complacent so many derms and MDs are with the the medical knowledge they attained in school insofar that they’re willing to turn down medical literature written by other doctors offered by patients in their practises. This is where I get aggravated…

The fact is that doctors are people too, so I can understand why someone would be hesitant to read medical literature that has not yet been widely accepted. The ironic thing is that it takes individual doctors to create awareness, so who’s waiting for who? There’s also the issue of pharmaceutical sway on doctors.

There’s enough people who say that it’s illegal for doctors to accept payment from drug companies for prescribing their product, but where there’s loopholes, there’s advantages. Dr. Irene Abramovich in West Hartford, CT was paid large amounts of money by Janssen Pharmaceuticals to speak on their behalf. $47,000 in 2010 for “speaking and travel.” Abramovich was also the state’s top prescriber of Invega in 2010 and 2011, and in the top five for Zyprexa in 2008 and 2009. See: http://www.articles.courant.com/2012-07-30/health/hc-doctor-prescribers-20120730_1_second-highest-prescriber-top-medicaid-prescribers-pharmaceutical-companies

Oh, but she’s a psychiatrist right? What else is she going to do? She’s just doing her job, you say? Get out of here and don’t talk to me… Here’s some lit I found on steroid addiction. Read and evaluate for yourself.

Adrenal Suppression From Topical Corticosteroids Surprisingly High

By By Alicia Ault. Reviewed by Zalman S. Agus, MD. I think what’s most interesting about this article is that the panelists of this meeting looked at honest, raw data of side effects from studies done and made judgements based on that information, rather than generalizations of its benefits.

Topical corticosteroid addiction may be to blame when ‘rash’ defies treatment

By Paula Moyers. This article is interesting as it describes how my eczema has progressed to a tee with the use of steroids. I was on a mild steroid since age 6 (26 now) and started more serious dosages about 7 years ago. The most dramatic change happened 3 years ago when I was using it to control allergic skin reactions to cat dander.

Eyelid Dermatitis to Red Face Syndrome to Cure – Clinical experiences in 100 cases

By Dr. Marvin Rapaport. Luckily I still have access to Western University’s journal database, so I was able to get a hold of Dr. Rapaport’s article on the relationship between perioral and facial eczema and steroid use. Hopefully, I don’t get slaughtered for sharing Rapaport’s academic work freely. Dr. Rapaport is not the greedy type who writes scripts of an extra buck anyway (I wouldn’t be here if he was!).

Rebound Vasodilation From Long-Term Corticosteroid Use

By Dr. Marvin Rapaport. This is a short one going over how steroids affect the nerve endings, thus how and why we itch so badly after coming off steroids. This “rebound” is a symptom of withdrawal from steroids.

Corticosteroid Addiction and Withdrawal in the Atopic

By Dr. Marvin Rapaport. This goes over how steroid addiction and withdrawal progresses over time. The great news here is that we may be able to have near-normal skin (and life!) once our bodies have expelled the steroids completely out of our system. Before I started Clobestol, my skin was 95% normal, barely flaring or itching.

Serum Nitric Oxide Levels in Red Patients

Another one by Dr. Marvin Rapaport. He distinguishes between true eczema patients and steroid-induced eczema patients by looking at nitric oxide levels in individuals. Very interesting as he’s able to quantify what true eczema looks like.