Eczema & Topical Steroid Withdrawal – How Does TCM Help?

WE COMBINE THE WISDOM OF TRADITIONAL CHINESE MEDICINE, MODERN TECHNOLOGY, AND PATIENT-CENTERED CARE FOR YOU TO THRIVE IN TODAY’S FAST-PACED WORLD. Share Eczema is one of the most common skin conditions. In Singapore, the prevalence of eczema is one of the highest in the world with 1 in 10 adults known to have eczema [1]. As for eczema among children, research done locally found a higher rate of 2 in 10 children [2]. The impact of eczema on an individual is not only limited to one’s physical health, such as skin discomfort and pain but can also affect one’s mental and emotional health. Daily battles with the condition can be traumatic and many eczema patients struggle with self-esteem issues. Over at Oriental Remedies Group (ORG), we have helped many eczema and Topical Steroid Withdrawal patients manage their condition. We strive to help patients manage their eczema better and improve their quality of life to #BeTheBestYouCanBe. In this article, we help you understand the causes of eczema and share some treatment options that can help alleviate symptoms and reduce flare-ups. What is Eczema? Eczema refers to a group of conditions that causes inflammation and irritation of the skin. There are several different kinds of eczema, the most common one is known as Atopic Dermatitis. In mild cases of eczema, the skin will be dry and sensitive. In more severe cases, the skin will itch intensely and flaking occurs. Oozing, crusting, bleeding and infections can also occur [3]. Eczema is known to occur due to an overactive immune system. This results in abnormal responses to internal and external triggers. Internal triggers include poor liver function, high-stress levels and adrenal glands imbalances. External triggers include environmental factors (dust, weather, exposure to water, use of cosmetics etc.) and diet (high inflammatory foods, allergy-causing foods It is important for eczema sufferers to identify and avoid allergens as they can cause or worsen eczema flare-ups. Some common examples of allergens include dairy products, nuts, wheat, shellfish, foods high in chemical additives and alcohol. It is also important to note that causes of eczema flare-ups are different for each individual, and similarly so for the intensity of the flare-ups. More recently, the importance of gut health and the relationship between poor gut health and skin issues is increasingly gaining public attention. Our gut contains trillions of strains of bacteria and microbes, called the gut microbiome. The gut microbiome helps maintain balance in our body systems. However, when there is dysregulation in the gut microbiome such as in the case of a leaky gut, skin issues will arise. Research has shown a link between leaky gut and Atopic Dermatitis [4][5]. “There seem to be three major reasons why patients seek alternative medicine for atopic dermatitis: First, we simply don’t yet have a cure for this disease. Second, we can’t yet clearly explain why this disease occurs. While doctors try hard to describe factors that play a role in atopic dermatitis, such as cytokines and inflammatory cells, we still can’t pinpoint the root of the disease. Third, the outcomes of conventional atopic dermatitis treatments are not always consistent, and sometimes they are perceived as being unsafe.” — Peter Lio, M.D What is Topical Steroid Withdrawal, Topical Steroid Addiction and Red Skin Syndrome? Topical corticosteroids is one of the most widely and inexpensive drugs used in dermatology to manage eczema. They work by reducing inflammation in the body and are like the corticosteroids made biologically by the adrenal glands. Topical Steroid Withdrawal (TSW) is a term used to refer to symptoms that arise in the days and weeks after an individual stops topical steroid usage. The symptoms include but are not limited to more pronounced burning, stinging or painful skin, a “red sleeve” pattern on the arms and legs that may be accompanied by swelling, and new areas of eczema that have never appeared before. It has been suggested that topical steroid withdrawal is associated with the use of medium to high potency topical and/or oral steroids, but there have been exceptions to this as well. Given that topical steroid withdrawal is still a relatively new area, much more research is still underway. [6] For individuals undergoing topical steroid withdrawal, it can be unbearably exhausting on many levels – physical, emotional, social and financial. Instances such as having to be homebound and in isolation be it for months or years are very real struggles. It is not an easy journey. With social support and the right treatments to rebuild the body’s system, individuals undergoing topical steroid withdrawal can definitely be better supported in their journey of recovery. Besides Topical Steroid Withdrawal (TSW), Topical Steroid Addiction (TSA) and Red Skin Syndrome (RSS) are also two other syndromes that patients experience. While these terms are sometimes used exchangeably, there are differences between them. TSA refers to the origin of TSW, by which the body develops tolerance to topical corticosteroids, and as such, requires a higher dosage of the drug in order for one’s eczema condition to achieve the same effect that is initially achieved by a lower dosage. For TSA, periods of withdrawal from topical corticosteroids will cause a rebound of eczema symptoms. Other symptoms of TSA include redness in areas where the drug is not being applied as well as intense itching, burning and stinging [7] [8]. RSS on the other hand is a symptom of TSW and specifically refers to capillaries on the skin widening up after being artificially constricted by topical steroids. It can be accompanied by body redness or flushing, as well as painful burning and stinging sensations The root cause of eczema in Traditional Chinese Medicine According to the Traditional Chinese Medicine (TCM) view, eczema is commonly caused by deficiencies in the organs of Liver, Spleen and Kidney combined with pathogenic factors of wind (风邪), heat (暑邪) and dampness (湿邪). 1) Pathogenic Factor – Wind (风邪) In TCM, it is explained that illnesses that stem from pathogenic factors will reflect similar characteristics. We can all agree that wind