Healing Stages of Topical Steroid Withdrawal featured image

局部类固醇戒断 (TSW) 的愈合阶段是什么?

Updated May 4, 2024


Hey there brave souls, battling through the ups and downs of Topical Steroid Withdrawal (TSW)!

Let’s talk about this itchy roller coaster ride, shall we? TSW is like that break-up with a long-term partner - the topical corticosteroids. You’ve relied on them, maybe even loved them a bit, but now it’s time to part ways because you’ve realized they’re not so good for you in the long run. Kind of like that ex who made you laugh but also ate all your favorite snacks…

Just like any break-up, you’ll experience some withdrawal symptoms. If this was a rom-com, it would be the part where you eat a tub of ice cream while looking at old photos. Only instead of ice cream and photos, you’re dealing with skin redness, itching, and burning sensations.

But hang in there! This is just a healing process. It’s a journey and each stage brings you closer to healthier skin, much like each day post-breakup brings you closer to healing your heart. In this article, we'll take you step by step through the various stages of healing on your tsw journey.

So, let’s get ready to uncover the natural remedies that can soothe your symptoms and guide you towards a healthier, steroid-free future.

Dermeleve banner

What is Topical Steroid Withdrawal (TSW)?

Understanding TSW

A person examining their red and inflamed skin from TSW

Topical Steroid Withdrawal (TSW), also known as Red Skin Syndrome, is a condition that occurs when individuals stop using topical corticosteroids after prolonged or excessive use. Topical steroids are commonly prescribed to treat various skin conditions, but prolonged use can lead to dependency and withdrawal symptoms when discontinued. The duration of topical steroid withdrawal can vary, lasting from days to weeks.

TSW is characterized by a rebound effect where the skin worsens after the topical steroid is stopped. It is important to note that TSW is a different condition from the underlying skin condition itself, such as atopic dermatitis or eczema

TSW is a particularly frustrating condition, as it is often the result of trying to remedy an existing condition. Not only does that original ailment get treated, but an entirely A new set of symptoms may appear during the treatment for topical steroid withdrawal, including skin redness, itching, and burning sensations. These can completely overshadow the original issue. It's really a catch-22. 

Topical steroid addiction usually occurs after the prolonged use of topical corticosteroids. ITSAN provides resources and support for individuals facing this challenge. However, many patients aren't aware of the risks associated with these medications.

A bottle of topical steroid skin cream

Even worse, while they may not be aware of the risk of extended use of the topical steroid treatment, these patients may be aware that corticosteroids often take a long time to work. This is due to the fact that symptoms can vary widely among individuals, affecting timelines. We're talking using topical steroids for long periods of  days, and even weeks.

So it stands to reason that there is a direct conflict of interest for the patient. Applying topical steroids to the skin requires an extended period of time to start working, while simultaneously increasing the risk of going through topical steroid withdrawal to the longer the patient has used topical steroids.

Without knowing about alternative, safer options like Dermeleve®, patients may find themselves having to make an excruciating choice between waiting for a long time for relief after the topical steroid was applied, and discontinuing topical steroids in order to prevent experiencing inflamed skin from topical corticosteroid withdrawal.

Symptoms of TSW

The symptoms of TSW can vary from person to person, but commonly include intense redness, burning, itching, flaking, and dry skin.

As the skin goes through the healing process, it may exhibit different stages of TSW, which we will discuss in detail later. The severity of symptoms can also vary, depending on the duration and potency of topical steroid use.

It is important to be mindful of the withdrawal process and seek support from dermatologists and the TSW community for guidance and understanding.

Impact of TSW on Eczema

For individuals with pre-existing eczema, TSW can have a significant impact on their condition. While topical steroid creams are often used to manage flare-ups and alleviate symptoms of eczema, prolonged use can lead to a phenomenon known as steroid addiction. This can result in a worsening of eczema symptoms and a vicious cycle of using more topical steroids to treat the worsening condition. Remember; the duration of topical steroid withdrawal symptoms can vary, extending for days to weeks.

While the original topical steroids were used to help strengthen the skin and allow that skin to heal, the use of topical steroids themselves can cause another stage of discomfort and pain. The patient often thinks that they need to use a larger amount of topical steroids for a longer period on time to manage these new symptoms. 

Without awareness about TSW, these patients with TSW don't realize that it's the daily topical steroids themselves that can quickly go from one stage of a sign of healing to being the very cause of their worsening symptoms. This can lead to a vicious cycle of over-reliance on these steroids, exacerbating the skin condition rather than alleviating it.

Understanding TSW and its impact on eczema can help individuals find alternative ways to manage their skin condition.

What are the Healing Stages of TSW?

During the topical steroid withdrawal healing stages, the skin might feel rough - when wounds begin to contract and new cells are being formed. This roughness indicates that beneath the surface, an intense healing process is taking place.

Stage 1: Inflammation and Redness

During the first stage of TSW, individuals may experience intense inflammation and redness of the skin.

Inflammation and redness from TSW

This is often the beginning of every flare and a pivotal part in the intense healing process. As people with TSW stop using topical steroids, particularly those of high potency, they may experience a rebound effect in the body. This is due to the skin reacting to the sudden discontinuation of steroid application, especially if you’ve been using the steroids for a long time.

Inflammation is a natural response of the body’s largest organ, the skin, to protect itself. In this stage, the blood vessels in the skin where the topical steroid was used dilate, leading to swelling of the skin and giving it a red and swollen appearance. The membrane of the skin becomes hyperactive, causing an increase in blood flow to the region. It is important to keep the skin moisturized and avoid scratching to prevent further damage and irritation. 

Stage 2: Flaking and Dry Skin

As the healing process continues, the skin may start to flake and become dry. This stage is characterized by the shedding of old skin cells and the renewal of new ones. The skin flakes may be more prominent in areas where topical steroid creams were frequently applied

Flaking skin from TSW

This stage can also be marked by other visual symptoms such as peeling skin.

It is important to gently exfoliate the skin and apply moisturizers to alleviate dryness and promote the regeneration of healthy skin.

Stage 3: Oozing and Weeping

In the final stage of TSW, some individuals may experience weeping and oozing skin. This stage is a sign that the skin is detoxifying and releasing toxins and exudate, a fluid made of cellular protein and water that protects the wound from infection and keeps it moist to facilitate healing. The process will continue until the inflammation subsides.

Oozing and weeping skin from TSW

The oozing and weeping may be accompanied by intense itching and discomfort. It is important to keep the affected areas clean and dry, and avoid scratching as it can exacerbate the symptoms. Applying ice packs or cold compresses can provide temporary relief from itching and reduce inflammation.

While this stage can be challenging, it’s crucial to remember that it’s part of an important process where the body is working to heal itself from the effects of long-term topical steroid use.

How Can TSW Be Assisted?

Early recognition = early treatment.

Recognizing TSW early can assist in managing symptoms and can also reduce further complications that might necessitate time off work or disrupt daily life. It’s important for those experiencing these effects of steroid withdrawal syndrome to keep their skin moisturized to help soothe irritation and prevent further peeling of the skin. Despite the discomfort, scratching should be avoided as it can lead to further damage and delay the healing process.

Supportive Measures during TSW

During the healing stages of TSW, it is important to provide supportive measures to assist the body in its recovery process. This can include maintaining a healthy diet, getting enough rest, and managing stress levels.

Eating a nutrient-rich diet can help promote overall skin health and boost the body's healing capabilities.

Adequate sleep and stress management techniques can also reduce inflammation and improve the body's response to the healing process.

Moisturizing and Soothing Techniques

Moisturizing the skin is crucial to alleviate the effects of tsw such as dryness and promote healing.

Person applying aloe vera gel to soothe their skin.

Using natural moisturizers that are free from irritants and allergens can help soothe the skin and prevent further damage. Calming ingredients like aloe vera, chamomile, oatmeal, and emollient products can be incorporated into skincare routines to provide relief and support the healing process. It is important to avoid products that contain fragrances, dyes, or other potential irritants.

Possible Treatment Options

While there is no specific treatment for TSW, certain treatments may be recommended by dermatologists to manage symptoms and support the healing process for the largest organ of the body. These can include topical immunomodulators, antibiotics to prevent secondary infections, or systemic medications in severe cases. It is essential to consult with a dermatologist experienced in TSW to determine the most appropriate treatment options based on individual needs and circumstances.

The Journey of TSW

What to Expect During TSW

Going through TSW can be a challenging journey both physically and emotionally. It is important to have realistic expectations and understand that everyone's healing process may differ. The journey may involve ups and downs, and it is essential to practice self-care and seek support from loved ones and the TSW community. Connecting with others who are going through similar experiences can provide valuable insights, tips, and encouragement.

Coping with Withdrawal Symptoms

Withdrawal symptoms during TSW can be intense and overwhelming. It is important to find coping strategies that work best for individual comfort and provide relief from symptoms.

Meditation can help soothe the effects of topical steroid withdrawal.

This can include taking cool baths or showers to soothe the skin, applying wet wraps to alleviate itching, and practicing relaxation techniques like meditation and deep breathing to manage stress. Finding distractions and engaging in activities that bring joy and relaxation can also contribute to overall well-being during the healing process.

Seeking Help from Dermatologists and TSW Community

TSW community members sharing and supporting each other.

Seeking help from dermatologists who are knowledgeable about TSW is crucial in managing the condition effectively. Dermatologists can provide guidance, monitor progress, and recommend appropriate treatment options. Additionally, connecting with the TSW community, either through support groups, online forums, or social media platforms, can provide a sense of belonging and understanding. Sharing experiences and learning from others can offer valuable insights and emotional support throughout the healing journey.

Tips for Managing Eczema And Other Skin Conditions without Topical Steroids

How to Treat Topical Steroid Withdrawal Naturally

Individual moisturizing their skin with natural coconut oil.

For individuals with eczema, psoriasis, shingles or other conditions who want to avoid or reduce their reliance on topical steroids, natural remedies can be explored. Natural ingredients like coconut oil, shea butter, and calendula have moisturizing and anti-inflammatory properties that can help soothe and heal the skin.


A steroid-free anti-itch treatment like Dermeleve® can be used on the skin of any area of the body, without any of the risks.

Tube of Dermeleve® with plants in the background.

Not only does Dermeleve® work faster than corticosteroids, it also lasts longer. And because it's free of the steroids than cause TSW, it can be used as long as you want, as frequently as you want. 

Lifestyle Changes to Reduce Flare-ups

Making certain lifestyle changes can significantly reduce eczema flare-ups and minimize the need for topical steroids. This can include keeping the skin well-moisturized, wearing soft and breathable clothing, avoiding excessive heat and sweating, and practicing stress management techniques.

It is important to establish a skincare routine that includes gentle cleansing and moisturizing to maintain the skin's barrier function and minimize the risk of flare-ups.

Additionally, avoiding triggers such as certain foods, harsh detergents, and environmental irritants can also help manage eczema flare-ups and reduce the need for topical steroids.

Supporting Skin Health during Eczema Treatment

In addition to avoiding triggers and making lifestyle changes, it is important to support overall skin health during eczema treatment. This can be achieved by maintaining a healthy diet rich in essential nutrients like vitamins A, C, and E, as well as omega-3 fatty acids. These nutrients can help strengthen the skin's barrier function and reduce inflammation.

Exercise can help with TSW

Additionally, staying hydrated, getting regular exercise, and practicing good sleep hygiene can contribute to overall skin health and enhance the effectiveness of eczema treatment.

Dermeleve banner

Wrap Up

In the rollercoaster that is Topical Steroid Withdrawal (TSW), brave souls embark on a journey reminiscent of a heart-wrenching breakup - bittersweet and challenging.

We've unpacked the highs and lows, from the initial sting of inflammation to the hopeful promise of healing stages. Just like reminiscing over a tub of ice cream, understanding TSW requires a mix of patience and care. While topical steroids might have been that comforting, yet sneaky, partner, there are a plethora of gentle alternatives awaiting your embrace.

Among them is the promising Dermeleve®, a relief companion without the drama of steroids. And as we metaphorically share that last scoop of ice cream and bid adieu, remember that the road to skin recovery is filled with options. Be it natural moisturizers, lifestyle tweaks, or a dab of Dermeleve®, your skin deserves all the love and care in the world. Here's to smoother, healthier horizons, one day at a time. Cheers!



Q: What is Topical Steroid Withdrawal (TSW)?

A: Topical Steroid Withdrawal (TSW) is a condition that occurs when individuals discontinue the usage of potent topical corticosteroids after prolonged use, leading to a range of withdrawal symptoms.

Q: What are the common symptoms associated with TSW?

A: Symptoms of TSW include redness, itching, and a burning sensation on the affected area of skin.

Q: How long can TSW symptoms last?

A: TSW symptoms can last for weeks to months, and in some cases, even years before fully resolving.

Q: How can TSW be managed naturally?

A: Managing TSW naturally involves stopping the use of topical steroids, allowing the skin time to heal, using gentle skincare products, and exploring natural remedies such as aloe vera.

Q: Are there resources available to help individuals going through TSW?

A: Yes, there are resources such as the National Eczema Association and online communities that provide support and information for those managing topical steroid withdrawal.

Q: What are some ways to prevent TSW?

A: To help prevent TSW, it is important to use topical steroids as prescribed by a doctor, avoid overusing high-potency topical corticosteroids, and give the skin breaks in between treatments.

Q: Is it common for females to experience TSW?

A: Yes, TSW can occur in both males and females, but it is reported to be more common in females.

Q: What is topical steroid withdrawal (TSW)?

A: Topical steroid withdrawal (TSW) occurs when individuals stop using potent topical steroids after prolonged usage, leading to withdrawal symptoms.

Q: What are common symptoms associated with TSW?

A: Symptoms of TSW include redness, itching, burning, and flaking of the skin in the area where the topical steroids were applied.

Q: How long does TSW typically last?

A: TSW can last for weeks to months, and in some cases, it may persist for many years depending on the individual's situation.

Q: What are natural ways to manage topical steroid withdrawal?

A: Natural ways to manage TSW include using aloe vera, skincare products, giving the skin time to heal, and seeking support from resources to help during the TSW journey.

Q: Is it common for females to experience TSW?

A: Yes, TSW is more common in females, but it can affect individuals of any gender who have used potent topical steroids.

Q: Can stopping the use of topical steroids suddenly trigger TSW?

A: Yes, abruptly stopping the usage of high-potency topical corticosteroids can lead to TSW, and it is advised to gradually taper off the medication under a doctor's supervision.

Q: How can a doctor help prevent or manage TSW?

A: A doctor may provide guidance on tapering off topical steroids, recommend alternative treatments like protopic or dupilumab, and suggest ways to alleviate TSW symptoms.

Q: What is TSW?

A: TSW stands for Topical Steroid Withdrawal, which refers to the process of discontinuing the usage of topical corticosteroids and experiencing withdrawal symptoms as a result.

Q: How long does TSW last?

A: TSW can last anywhere from months to many years, depending on individual cases and the severity of the withdrawal symptoms.

Q: What are the common symptoms of TSW?

A: Common symptoms of TSW include redness and itching of the skin, which may be very uncomfortable for individuals experiencing this withdrawal.

Q: Can TSW be treated naturally?

A: Yes, TSW can be treated naturally using methods such as aloe vera, which may be helpful in reducing redness and itching of the skin during the withdrawal process.

Q: How can I support someone going through their TSW journey?

A: Supporting someone going through TSW involves understanding their experience with withdrawal symptoms, being patient with them, and acknowledging the challenges they face during this process.

Q: Are there any ways to avoid TSW?

A: One way to avoid TSW is to be cautious with the usage of topical steroids and to follow the recommendations of healthcare professionals when using them, especially for individuals with eczema or psoriasis.

Q: Can TSW be triggered by conditions other than eczema or psoriasis?

A: Yes, TSW can also be triggered by conditions like atopic dermatitis, seborrheic dermatitis, and other skin-related issues that require the use of topical corticosteroids.