SCARY Topical Steroid Side Effects Including TSW (NEW RESEARCH)

SCARY Topical Steroid Side Effects Including TSW (NEW RESEARCH) | Dr. Ian Myles

Рет қаралды 2,679

Ай бұрын

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Complete transcript + original post: www.skinterrupt.com/344
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Topical Steroid Withdrawal (aka. TSW and also sometimes called red skin syndrome online), is one of the many topical steroid side effects (which are usually prescribed for chronic skin conditions like eczema and psoriasis).
Because topical steroids are the standard of care for these conditions, many people unfortunately end up using them for extended periods of time - sometimes without any breaks and with increasing potency).
And some go on to develop TSW, which is a horribly debilitating condition with symptoms that can drag on for years after stopping all steroid exposure.
So when I heard that Dr. Ian Myles was looking into TSW, I had to get him on the show to explain his new paper (if you haven’t read it yet - it’s complex) that’s awaiting the peer-review process.
Dr. Ian Myles did his undergrad at Colorado State University, received his M.D. from the University of Colorado, then trained in internal medicine at The Ohio State University prior to beginning fellowship training in allergy and clinical immunology at NIH. He became a commissioned officer in the United States Public Health Service Commissioned Corps and has supported several US and international missions.
Dr. Myles received his MPH from George Washington University before becoming the head of the Epithelial Therapeutics Unit to evaluate the efficacy and safety of a topical, live bacterial treatment for eczema.
LINKS DISCUSSED IN THIS EPISODE:
• Find Dr. Ian Myles online here - www.niaid.nih.gov/research/ian-myles-md-mph
• TSW PAPER WE DISCUSSED - www.medrxiv.org/content/10.1101/2024.04.17.24305846v1.full
• Dr. Myles’s TSW deep dive on KZfaq (@ianmyles1349) - kzfaq.info/get/bejne/irl2nK6d16-ohX0.html
• Healthy Skin Show episodes on Topical Steroid Withdrawal - www.skinterrupt.com/?s=topical+steroid+withdrawal
• Healthy Skin Show ep. 279: Chemical That Triggers Eczema (Oh My!) w/ Dr. Ian Myles - www.skinterrupt.com/279
• Healthy Skin Show ep. 328: Client Case Study: Severe Eczema On Feet + Body - www.skinterrupt.com/328
IN THIS EPISODE:
00:00 Introduction
03:39 Study about topical steroid withdrawal (TSW)
07:21 Niacin and TSW connection
14:08 How topical steroids impact your cells’ powerplants (aka. mitochondria)
16:44 Which type of steroids may be to blame
24:35 What may be driving TSW symptoms in your brain
33:25 Thoughts on oral and topical berberine for TSW skin
46:41 Final thoughts
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ABOUT JENNIFER FUGO, MS, CNS:
Jennifer Fugo, MS, LDN, CNS is a clinical nutritionist empowering adults who’ve been failed by conventional medicine to beat chronic skin and unending gut challenges. Because she’s overcome a long history of gut issues and eczema, Jennifer has empathy and insight to help her clients discover missing pieces and create doable integrative plans.
She holds a Master’s degree in Human Nutrition from the University of Bridgeport and is a Licensed Dietitian-Nutritionist and Certified Nutrition Specialist, and is the host of the Healthy Skin Show.
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#tsw #topicalsteroidwithdrawal #topicalsteroidsideeffects

Пікірлер: 35

@jenfugo Ай бұрын

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@K-bob_45 29 күн бұрын

My 2 cents. I think I’m going through TSW and have been for about 3 years. I was using ultravate very sparingly for years. Maybe once a month or once every two months. Not frequently. Then it seemed to lose efficacy. Tried an oral steroid and got the full body effects. That lasted for months. Dr told me to start using triamcinolone and to use as much as a tube per month. Used it liberally for about a year and then it turned into the temp disregulation and crazy peeling. Finally got wise and tried to ween off. Went to the doctor for something unrelated and got an accidental dexamethozone shot. That had me homebound for about 5 months. I’m definitely of the opinion that orals and injections make it worse.

@lottielens5187 28 күн бұрын

I’ve been in very severe Tsw for 16 months now. This is so affirming and good to hear. I’d love to be part of research!

@MarietjieMienie 29 күн бұрын

My son is 27 months into TSW - it is horrible. He stopped using the steroid creams because it didn't stop him from itching anymore. He had shingles at the same time, and tje shingles stills flare up after 27 months. He is not using anything at the moment ans suffers everyday. Dr Marvin Rappaport has been treating patients with TSW for 35 years. Thank you for your study on this horrible "disease". It is comforting to know that doctors are at last recognising TSW.

@jenfugo 29 күн бұрын

It absolutely is a horrible, drug-induced condition and this paper is hopefully a start in the right direction for more research on the matter. While many in the community have a "give it time" type of attitude, there are definitely experts out there like Dr. Myles who want to find ways to help speed up the healing process and make the journey easier (and with better education and warnings about the medication itself).

@shira1176 24 күн бұрын

Oh muy God ,, I Hope 🙏

@jen_doe Ай бұрын

So glad there is finally more research on this topic!

@jenfugo 29 күн бұрын

It's much needed! Hopefully others will continue digging deeper

@delphinelambese2492 Ай бұрын

Thanks you so much, both of you 🥹🙏🏾✨

@jenfugo Ай бұрын

I'm so glad you found the discussion helpful!

@ElenaSilva-dy3qq 27 күн бұрын

Should we try and lower our intake of b3 then?

@eliiiizaaa 7 күн бұрын

Wondering if taking berberine can also be helpful for those that are in the later stages of TSW? Most of my symptoms are gone but my natural face and neck colour hasn't returned and I've been pink/red since my journey started.

@TheStyleAlert Ай бұрын

I started taking berberine weeks ago and my TSW has gotten better. Not sure if it was just a coincidence, but now I’m 😮shocked it may have been what helped me! berberine is an antimicrobial which kills SIBO. maybe that’s why it helps? Because surely intestinal bacteria is a cause of skin issues Berbarine is also anti-inflammatory and antifungal and anti biofilm

@jenfugo 29 күн бұрын

I'm glad to hear that you found berberine helpful with your condition. Berberine has many activities -- though I'd mainly focus on it's capacity to help better regulate blood sugar as well as being generally antimicrobial. Because I use berberine in clinical practice, I would be extremely careful here -- it will not "kill" SIBO, but it can help reduce certain unfriendly bacteria in the GI tract (though I do know that Dr. Allison Siebecker recommends it as one of her protocols for SIBO), but often has to be combined with other herbs to be effective and at doses that are many times higher than what Dr. Myles is suggesting. And in my 8 years of clinical practice, I haven't ever seen it be wildly effective as an anti-fungal herb nor do I ever use it for biofilm busting -- that's just not what it's really known or "good" for. I love the enthusiasm for herbs (as I also love using them with clients), but I think many of the claims people make online are way overblown and make them sound like they are nearly magical. This was one of the reasons that Dr. Myles and I wanted to have this conversation because there are a lot of things written online about berberine that we inevitably knew people would read online once the paper was pre-printed. We wanted to offer a more patient-friendly, balanced approach. I hope this adds some perspective to what you've researched!

@AnthromancerOfficial 5 күн бұрын

@@jenfugo you are refreshing, professional, and I'm so glad I found your work

@user-dj6ur9pq5v 26 күн бұрын

Aloha, My son who is 16m is suffering from TSW. He is currently on vit D3 (Carlson) & Baby Probiotics (Klaire Labs) to help with his condition and Focusing on gut health rn. Child was Exposed to steroid on & off for a duration of 5 months, starting at 9m old. Child was prescribed by Dr. Oral prednisone for croup, hydrocortisone, triamcinolone acetonide, antibiotics for ear infection. How can we treat TSW in babies? What will be a safe ratio to soak in berberine?

@EmsThaBreaks441 27 күн бұрын

Is Berberine equivalent to Turmeric? Interesting research - one would like to see a reaction video from Rappaport or Lio. (Again one cannot believe this sort of research has not been done considering the number of labs doing research).

@MegaTaylor24 Ай бұрын

My daughter is going through TSW and we finally realized ( about 2 months ago) that this was not her normal Eczema; her Eczema changed a little over a year and a half ago. We just thought it was getting worse. Her Dermatologist did not recognize the term at all and dismissed our theory on what was going on with her. Just so you know, since early last year she has gone through Dupixent, Rinvoq and she just stopped Adbry. We will hopefully get her into LLUMC they have an extensive Dermatology dept. that studies TSW. However, the Niacin you are talking about makes sense!!! When I was going through Menopause I started to take Niacin (which was recommended for hair loss) and my HOT FLASHES went through the roof, I stopped immediately. My daughter is not taking Niacin directly; however, she is taking Flaxseed, Quercetin has D3, Bromelain, Vit C and Zinc. She is hopefully on her journey out of this horrible disorder.

@jenfugo Ай бұрын

I'm glad that you figured out what was going on with your daughter! It is such a challenge at least here in the US to find derms that believe in TSW partly because there is no diagnostic criteria (which Dr. Peter Lio and other doctors are working on). I wanted to mention in regards to the niacin and flushing -- the form of niacin is what specifically matters so you (and your daughter) should necessarily be afraid of niacin found in multivitamins or food. There is a specific form of niacin that causes the flushing which may be the issue here -- that the kynurenine pathway and mitochondrial complex 1 are on overdrive increasing this pool of niacin that maybe responsible for flushing. I think a lot still has to be fleshed out with this data to truly understand it further since this is an initial investigation with a small sample size of individuals.

@kimbrumfield6564 Ай бұрын

My daughter is living this nightmare too! She was prescribed steroids for 20 years for what we were told was chronic eczema. She is 22 and in TSW after the steroids stopped working. She spent the last 4.5 years on the Aron Regimen, which we thought was better because it was diluted. Level 8 AR has destroyed her face and was probably the cause of her perioral dermatitis to begin with. She is attempting No Moisture Treatment and Red Light Therapy in hopes of speeding up the healing process. It is brutal to say the least. I am horrified that I did not know this could happen. It truly is "eczema on steroids!"

@MegaTaylor24 Ай бұрын

I will be praying for your daughter. It is so hard as a parent to see your children go through this. I totally understand. My daughter is 24 and she too will be starting red light therapy hopefully within the next couple of weeks.

@kimbrumfield6564 29 күн бұрын

Our daughters need us! They will heal. All of these internal supplements are supportive, but do not thicken the skin. I am only aware of 2 treatments that can do that, red light therapy or cold atmospheric plasma therapy. RLT is easily accessible. CAP is only offered in Bangkok, Singapore, and the UK.

@kennethjones8653 Ай бұрын

Would this work for Grovers Disease. Suffering with this badly for 3 years

@jenfugo Ай бұрын

Unfortunately not that I know of. They are very different conditions. Did you check out the other episode I did on Grover's?

@kennethjones8653 29 күн бұрын

@@jenfugo Thank you Jennifer. I will keep looking. Trying some Red light therapy. Hopeful. Thanks again Ken Jones

@peachkey2 29 күн бұрын

Could the mitochondrial side effect of TSW have any relation to all the food intolerances/sensitivities that come with TSW as well? Or are these two different processes that are unrelated? What I can eat has become such a huge issue for me during my "battle" with TSW that I wonder if this new discovery could also lead to more understanding of why certain foods suddenly have a dramatically effect on this skin condition. Maybe something to do with the absorption of certain foods being changed or an abnormal build up occurring.

@jd2024- 26 күн бұрын

I’ve been allergic to everything too don’t even know what to remove or keep in anymore it’s so frustrating

@peachkey2 26 күн бұрын

@@jd2024- Everyone is different so I don't know what would help you exactly, but I think something that could be universal is sugar being an issue. Especially after hearing about how steroids change how the body processes glucose (I think it came from one of these podcasts about steroids but I honestly can't remember anymore), I think it is best to cut back on processed sugar and simple carbs whenever possible.

@jd2024- 26 күн бұрын

@@peachkey2 that’s true I did hear about sugar and berberine used to treat TSW

@mnayak9348 5 күн бұрын

Berberine has lowering sugar capacity so cut on carb may help TSW May work same like berberine ?