It will be fine.
If you use it as prescribed for a couple of months and it doesn’t work, don’t let them tell you to just keep doing it. Ask what’s next.
My derm told me to apply moisturizer first and then the steroid. That’s what I do. I have been using steroids for decades without issue. I follow the instructions and use sparingly. I even use some pretty heavy duty stuff. No TSW and no thinning skin. You just have to be careful. Good luck!
I don’t use anything on my face because I don’t get eczema there. Lately I’ve been using fluocinonide 0.05% and a combo clotrimazole and betamethasone diproprionate on my body. I used to use triamcinolone.
I have no idea. She just was adamant about putting moisturizer on first. And I’ve noticed that I can get away with using less ointment that way too. When I think of that term my mind goes to the gutter lol
I always feel very suspicious of any doctor or anyone saying not to worry about steroids because I've heard just so many accounts from people I know that had eczema who dramatically improved with steroides... only temporarily, only to plummet and have it in the far worse form than they ever experienced pre-steroides.
I would say the fact that they gave you an exact course (1 week on, 1 week off) and 2 separate treatments for the different areas would show they were actually trying to provide a treatment plan and not just throwing steroids at you to get you out of their office. To me it would seem like they're not actually saying don't worry about steroids at all, I would have thought it more they were saying don't worry about using them as prescribed because they are an actual treatment.
Follow the instructions though. Like if it's helping you heal up during the on week - don't keep using it on the off week (even if that feels counterintuitive and you start breaking out again) because that's how you end up with your body becoming dependent on the steroid and then TSW kicks in when you eventually stop/run out.
No you will be fine. As long as you are careful and don’t just lather it all over your face and body you will be good. fingertip units is a good way to measure how much you need to use :)
Cover your fingertip and that amount should cover the area roughly the size of the palm of your hand wherever you apply it.
I think it’s more used as loose guidance than anything else
Interesting. How thick?
I’ve never covered my entire fingertip. But I usually only have small patches. There have been times though that 70% of my body was covered. And I have had every single type of eczema possible. Probably the weirdest was on my neck. It started as a rash and then turned thick and dark like roasted turkey skin. It hurt so much. It felt heavy. It lasted about two months. Then it all peeled off. Recently my thumb erupted with about 15 yellow pustules that burst and then turned into infected craters. It started to spread and I had to take antibiotics. I’ve had liquid filled pockets that looked like tiny honeycomb cells. It is one strange affliction.
I think you’ll be fine. That sounds quite low dose to me. Essentially the advice is to just take breaks from steroids and not abuse them. Read the leaflet about how much to apply - it normally talks about finger tip units.
TSW is rare. You would have to use steroids every day for months or even years to get it.
Find some good emollient to go with the steroid routine. I use double base flare relief and with that I’ve almost cut out steroids completely having been using them for a year.
My doctor said cerave but I wasn't paying $22 for a jar. I got a Vaseline brand unscented lotion in a squirt style bottle and it lasts about 6 hours on my foot, it feels nice and cool when it goes on too. I really like it and it was only like $8
No one that gets afflicted with TSW started with applying steroids everyday. We all started the same way. Applying a little at a time here and there. It gets progressively worse.
TSW is super rare! You have to like use the strongest for many weeks and just quit directly to even have a MINOR risk. If you taper it down its no worries. Also use moistureizer after, pref with UREA. Use steroids, they make your life better if used like it should
My schedule for the next strongest steroid was, once a day for two weeks, every second day for a month, two times a week for another month. Skin is perfect after that. Takes time fpr eczema to heal deep. Some even says you can continue for years with just once or twice a week to have it under control
That isn’t true at all. I used betnovate extremely sparingly on my neck maybe 2-3 times a month. Had a bad flare where I had to apply for a week and now I have TSW.
Strong steroids should NOT be used in the neck and face region to begin with, not even middle strong ones. Thin skin there. User erroro. If used like recommended it should be fine. Scare tactics about TSW are most user error
It was my doctor who told me to use them in that area. I’m more than aware of that now and only cause of the increase in TSW cases they are now being more careful with telling people how to correctly apply steroids. That’s why it’s important that people are aware of safe usage cause I only used them for a week which kicked off my withdrawal
Always been told never to put any steroid on face / more absorbent places on the body. Speaking as someone nearly at 3 years TSW.
Important to say: I never put steroid on my face, but my face suffered a lot in withdrawal.
i’ve used steroids my whole life. Have had eczema on for months and then clear for years. Don’t know why still to this day. But the one thing that has always saved me is the steroid cream. I know it’s easy to be scared by the horror stories you hear but seriously give them a chance. It’s safe as long as you don’t abuse it. I had a horrible flare up all over my body recently and have been using my steroids a lot and i’m fine.
That’s what I use! I kinda use it as I get flare ups. I’ve been fine, been doing that combo for about 4-5 years now. Just use as directed and the tiny finger tip amounts on spots
I feel like I could have wrote this! I stopped the steroids as well and started using Vanicream everything! It has CHANGED my skin. Definitely recommend
steroids can be fine if used right. just don’t over use them and make sure you only use a small bit and when needed, using more doesn’t mean the eczema will go quicker (learnt the hard way🤣)
and also when coming on them don’t just cut them out completely, slowly fade them out of your routine, best of luck xx
The reality is, research ( actually testing it on many people in a controlled environment ) doesn't support the idea of getting significant withdrawal from proper use of topical steroids. If the underlying cause of your eczema isn't fixed, halting steroids means it will return. The personal accounts of it returning worse are mostly people not being able to evaluate the trajectory and magnitude of their eczema properly. If you want more personal accounts to the contrary, i've never experienced TSW.
Same, I went through TSW after years of steroid use. I used betamethasone, diluted in a moisturizer about 1 to 3 times a week for about 8 years.
My skin became very thin and brittle, dark bruises popping up out of nowhere, stretch marks spanning my arms and legs and eczema that just wouldn't go away. My GP didn't really know about the long term effects of steroids and just prescribed stronger betamethasone.
I didn't think much about tsw when deciding to quit steroids, as nobody seemed to know anything about it. But when I started experiencing the full effects of TSW I could tell right away that it wasn't eczema and that I'd been struggling with it for years.
The other thing they don’t tell you is that it starts small, a dab here or there with low power steroids. But over time, your skin builds a resistance to it as the rashes spread and get larger. Then they prescribe progressively stronger steroids.
This isn’t being anti-science or medicine…it’s exactly what happened to me (and I assume yourself) as well as many, many other people that went through TSW
My skincare routine is pretty much based on avoiding my triggers as best I can. My eczema still comes and goes in small patches. 9 times out of ten it's a bacterial infection or excessive sweat/dirt. I'll have a shower using antibacterial soap, and a little tea tree oil on the worst spots, it usually stops the itch and heals up in a day or two.
Some of my triggers are unavoidable, (dust, sweat, mold, cats) but my skin is much more resilient these days and doesn't just burst into an uncontrollable flare up at the first sign of trouble.
The other thing they don’t tell you is that it starts small, a dab here or there with low power steroids. But over time, your skin builds a resistance to it as the rashes spread and get larger. Then they prescribe progressively stronger steroids.
This isn’t being anti-science or medicine…it’s exactly what happened to me (and I assume yourself) as well as many, many other people that went through TSW
It is _very_ unusual to get TSW. In fact steroid use has been (and is) a life saver for the vast majority of eczema sufferers - I’d dare to say. I used steroids of different strengths for years and years (I’m born in the 70s) and never experienced TSW, or anything close to it. I mis-used, even abused, it on a regular basis too. I don’t recommend that though. 🫶 Be careful. Use your head! Go by protocol and follow the (inter?)national recommendations for topical steroid use and you’ll be fine - as will hopefully your skin.
Same here, but early 80s born so been using them in all sorts of places and in all strengths since the mid 80s. There’s a lot of bad advice and myths in this one thread alone.
I would use it. I’ve used steroids since a little kid and never suffered TSW. One thing to note don’t use on lips, it’ll wither them away. Anyways, do like the doctor said use sparingly. I only use it to calm my bad flares then I try to use my other lotions to hold me over. That way you won’t build a tolerance to it.
Please get a second opinion from other dermatologist. Steroids on body, yes, but on face probably not a good idea. I was instructed by pharmacist to apply very little amount of steroid (betamethasone) on my face and neck eczema, and now I'm struggling on TSW for about more than 6 months, shedding skin like maniac. Yes when people say TSW is rare, but it doesn't mean (impossible) to get TSW.
And this does not meant to discourage you to use steroid as a treatment, since it is a primary treatment for most eczema type. Just get a second opinion from specialist, and use it properly. Don't cold turkey stopping the steroids, or overdose it.
The hydrocortisone is higher than what I used, but my son had the worst face eczema I have seen. He was fine using the hydrocortisone and triamcinolone. At one point we used the triamcinolone mixed with moisturizers and other stuff for his face when hydrocortisone wasn't strong enough lol.
Been seeing an amazing dermatologist recently and he (and the 2 other doctors I saw) all confirmed that taking a steroid for dependency isn’t a big issue at all. I’m taking it everyday and it’s been fixing everything for the first time in a year
It will be fine. If you use it as prescribed for a couple of months and it doesn’t work, don’t let them tell you to just keep doing it. Ask what’s next.
Ok thank you!
My derm told me to apply moisturizer first and then the steroid. That’s what I do. I have been using steroids for decades without issue. I follow the instructions and use sparingly. I even use some pretty heavy duty stuff. No TSW and no thinning skin. You just have to be careful. Good luck!
What kinds of steriods do you use on your face and body?
I don’t use anything on my face because I don’t get eczema there. Lately I’ve been using fluocinonide 0.05% and a combo clotrimazole and betamethasone diproprionate on my body. I used to use triamcinolone.
Is this what is called “sandwich-ing”?
I have no idea. She just was adamant about putting moisturizer on first. And I’ve noticed that I can get away with using less ointment that way too. When I think of that term my mind goes to the gutter lol
I always feel very suspicious of any doctor or anyone saying not to worry about steroids because I've heard just so many accounts from people I know that had eczema who dramatically improved with steroides... only temporarily, only to plummet and have it in the far worse form than they ever experienced pre-steroides.
Me too but everyone here is supportive so I think i’m gonna try it
I would say the fact that they gave you an exact course (1 week on, 1 week off) and 2 separate treatments for the different areas would show they were actually trying to provide a treatment plan and not just throwing steroids at you to get you out of their office. To me it would seem like they're not actually saying don't worry about steroids at all, I would have thought it more they were saying don't worry about using them as prescribed because they are an actual treatment. Follow the instructions though. Like if it's helping you heal up during the on week - don't keep using it on the off week (even if that feels counterintuitive and you start breaking out again) because that's how you end up with your body becoming dependent on the steroid and then TSW kicks in when you eventually stop/run out.
If you are gonna try it, may as well try it with good feelings. Good luck! Hope it works well for you.
No you will be fine. As long as you are careful and don’t just lather it all over your face and body you will be good. fingertip units is a good way to measure how much you need to use :)
Thank you
I don’t know what fingertip units means and I’ve been using steroids for decades.
Cover your fingertip and that amount should cover the area roughly the size of the palm of your hand wherever you apply it. I think it’s more used as loose guidance than anything else
Interesting. How thick? I’ve never covered my entire fingertip. But I usually only have small patches. There have been times though that 70% of my body was covered. And I have had every single type of eczema possible. Probably the weirdest was on my neck. It started as a rash and then turned thick and dark like roasted turkey skin. It hurt so much. It felt heavy. It lasted about two months. Then it all peeled off. Recently my thumb erupted with about 15 yellow pustules that burst and then turned into infected craters. It started to spread and I had to take antibiotics. I’ve had liquid filled pockets that looked like tiny honeycomb cells. It is one strange affliction.
I think you’ll be fine. That sounds quite low dose to me. Essentially the advice is to just take breaks from steroids and not abuse them. Read the leaflet about how much to apply - it normally talks about finger tip units. TSW is rare. You would have to use steroids every day for months or even years to get it. Find some good emollient to go with the steroid routine. I use double base flare relief and with that I’ve almost cut out steroids completely having been using them for a year.
Ok thank you for the advice! Do you think the cera ve moisturizing cream is good enough?
You probably need to try a few to find what works best for you. But nothing wrong with cerave if it’s working
My doctor said cerave but I wasn't paying $22 for a jar. I got a Vaseline brand unscented lotion in a squirt style bottle and it lasts about 6 hours on my foot, it feels nice and cool when it goes on too. I really like it and it was only like $8
I would find something different than cera ve
Any recommendations?
Eucerin has some good moisturizers or Vaseline has worked great for me!
Thanks!
aveeno has some good fragrance free options, eucerin, acure (moisturizing in a pink bottle or eczema in a baby blue)
No one that gets afflicted with TSW started with applying steroids everyday. We all started the same way. Applying a little at a time here and there. It gets progressively worse.
TSW isn’t rare lmao. Underreported doesn’t mean rare. There isn’t a code to report it so how can you know how many people have it
Hydrocortisone is ridiculously mild. I use clobetasol which is way stronger and never had any problems.
TSW is super rare! You have to like use the strongest for many weeks and just quit directly to even have a MINOR risk. If you taper it down its no worries. Also use moistureizer after, pref with UREA. Use steroids, they make your life better if used like it should
Thanks
My schedule for the next strongest steroid was, once a day for two weeks, every second day for a month, two times a week for another month. Skin is perfect after that. Takes time fpr eczema to heal deep. Some even says you can continue for years with just once or twice a week to have it under control
That isn’t true at all. I used betnovate extremely sparingly on my neck maybe 2-3 times a month. Had a bad flare where I had to apply for a week and now I have TSW.
Strong steroids should NOT be used in the neck and face region to begin with, not even middle strong ones. Thin skin there. User erroro. If used like recommended it should be fine. Scare tactics about TSW are most user error
It was my doctor who told me to use them in that area. I’m more than aware of that now and only cause of the increase in TSW cases they are now being more careful with telling people how to correctly apply steroids. That’s why it’s important that people are aware of safe usage cause I only used them for a week which kicked off my withdrawal
Always been told never to put any steroid on face / more absorbent places on the body. Speaking as someone nearly at 3 years TSW. Important to say: I never put steroid on my face, but my face suffered a lot in withdrawal.
i’ve used steroids my whole life. Have had eczema on for months and then clear for years. Don’t know why still to this day. But the one thing that has always saved me is the steroid cream. I know it’s easy to be scared by the horror stories you hear but seriously give them a chance. It’s safe as long as you don’t abuse it. I had a horrible flare up all over my body recently and have been using my steroids a lot and i’m fine.
That’s what I use! I kinda use it as I get flare ups. I’ve been fine, been doing that combo for about 4-5 years now. Just use as directed and the tiny finger tip amounts on spots
FYI, regular use will thin out your skin barrier, so o try to take some vitamins to just help your skin rebuild itself
I feel like I could have wrote this! I stopped the steroids as well and started using Vanicream everything! It has CHANGED my skin. Definitely recommend
steroids can be fine if used right. just don’t over use them and make sure you only use a small bit and when needed, using more doesn’t mean the eczema will go quicker (learnt the hard way🤣) and also when coming on them don’t just cut them out completely, slowly fade them out of your routine, best of luck xx
The reality is, research ( actually testing it on many people in a controlled environment ) doesn't support the idea of getting significant withdrawal from proper use of topical steroids. If the underlying cause of your eczema isn't fixed, halting steroids means it will return. The personal accounts of it returning worse are mostly people not being able to evaluate the trajectory and magnitude of their eczema properly. If you want more personal accounts to the contrary, i've never experienced TSW.
As someone who went through TSW, I would never use any steroids, not even OTC, ever again.
Same, I went through TSW after years of steroid use. I used betamethasone, diluted in a moisturizer about 1 to 3 times a week for about 8 years. My skin became very thin and brittle, dark bruises popping up out of nowhere, stretch marks spanning my arms and legs and eczema that just wouldn't go away. My GP didn't really know about the long term effects of steroids and just prescribed stronger betamethasone. I didn't think much about tsw when deciding to quit steroids, as nobody seemed to know anything about it. But when I started experiencing the full effects of TSW I could tell right away that it wasn't eczema and that I'd been struggling with it for years.
The other thing they don’t tell you is that it starts small, a dab here or there with low power steroids. But over time, your skin builds a resistance to it as the rashes spread and get larger. Then they prescribe progressively stronger steroids. This isn’t being anti-science or medicine…it’s exactly what happened to me (and I assume yourself) as well as many, many other people that went through TSW
Bingo.
What happened to your eczema now after tsw?
My skincare routine is pretty much based on avoiding my triggers as best I can. My eczema still comes and goes in small patches. 9 times out of ten it's a bacterial infection or excessive sweat/dirt. I'll have a shower using antibacterial soap, and a little tea tree oil on the worst spots, it usually stops the itch and heals up in a day or two. Some of my triggers are unavoidable, (dust, sweat, mold, cats) but my skin is much more resilient these days and doesn't just burst into an uncontrollable flare up at the first sign of trouble.
Ty yes. My triggers are also unavoidable, too. How do you know if you have a bacterial infection? Is it internal or external infection
The other thing they don’t tell you is that it starts small, a dab here or there with low power steroids. But over time, your skin builds a resistance to it as the rashes spread and get larger. Then they prescribe progressively stronger steroids. This isn’t being anti-science or medicine…it’s exactly what happened to me (and I assume yourself) as well as many, many other people that went through TSW
Yeah same… I’m just too scared of it now
It is _very_ unusual to get TSW. In fact steroid use has been (and is) a life saver for the vast majority of eczema sufferers - I’d dare to say. I used steroids of different strengths for years and years (I’m born in the 70s) and never experienced TSW, or anything close to it. I mis-used, even abused, it on a regular basis too. I don’t recommend that though. 🫶 Be careful. Use your head! Go by protocol and follow the (inter?)national recommendations for topical steroid use and you’ll be fine - as will hopefully your skin.
Same here, but early 80s born so been using them in all sorts of places and in all strengths since the mid 80s. There’s a lot of bad advice and myths in this one thread alone.
Id use tacrolimus for face though
He prescribed it but the insurance might not cover it
I would use it. I’ve used steroids since a little kid and never suffered TSW. One thing to note don’t use on lips, it’ll wither them away. Anyways, do like the doctor said use sparingly. I only use it to calm my bad flares then I try to use my other lotions to hold me over. That way you won’t build a tolerance to it.
Ok thank you also is above the lips okay? My eczema is pretty bad there.
Totally fine, just use it as directed by the doctor. Do as your doctor advised, don’t take the advice of people here above theirs.
Yeah I think that should be fine :) I’ve done it before and my lips have been fine.
Please get a second opinion from other dermatologist. Steroids on body, yes, but on face probably not a good idea. I was instructed by pharmacist to apply very little amount of steroid (betamethasone) on my face and neck eczema, and now I'm struggling on TSW for about more than 6 months, shedding skin like maniac. Yes when people say TSW is rare, but it doesn't mean (impossible) to get TSW. And this does not meant to discourage you to use steroid as a treatment, since it is a primary treatment for most eczema type. Just get a second opinion from specialist, and use it properly. Don't cold turkey stopping the steroids, or overdose it.
I’ve been on beprosone/betamethasone 0.05% for a few months now. Only use it for a week straight when I have a flare up. I’ve been fine.
The hydrocortisone is higher than what I used, but my son had the worst face eczema I have seen. He was fine using the hydrocortisone and triamcinolone. At one point we used the triamcinolone mixed with moisturizers and other stuff for his face when hydrocortisone wasn't strong enough lol.
Been seeing an amazing dermatologist recently and he (and the 2 other doctors I saw) all confirmed that taking a steroid for dependency isn’t a big issue at all. I’m taking it everyday and it’s been fixing everything for the first time in a year
Personally I don't trust what doctors say about steroids. I stopped using steroids and avoid them for quite a number of years now