There is a not so obvious, but very serious lack of knowledge and understanding amongst the topical steroid poisoned (commonly referred as "topical steroid withdrawal") community on how to effectively treat the various symptoms that TS use has caused them after stopping their usage. And, how to effectively recover in the most comfortable and quickest possible way, which is after all, what we all want to do. The information is readily available but not being disseminated to those who need it.
Frankly, I am appalled at the lack of good information made available for people going through topical steroid poisoning and recovery. Or, should I say "topical steroid addiction and withdrawal" as most call it. The word "addiction" doesn't seem to be a very appropriate word to use if we truly want to raise awareness of this disease. The word "addiction" has negative connotations, and also has a negative stigma attached to it. The word "addiction" also is an extremely broad term and is very subjective. The word "poisoning" seems much more appropriate as it is not vague, and better describes the true nature and effects of TS use. I suppose it can be considered an addiction but still don't understand why we in the US don't call it poisoning. As Dr. Fukaya showed in a recent experiment titled How Topical Steroid actually affects your skin - Tested by Dr. Fukaya! we can see the effects of TS on skin and just how are poisonous they really are.
Let's look at the benefits of Dead Sea salt baths, followed by quotes and links to controlled studies.
From the Department of Dermatology, University of Kiel, Germany.
Proksch E, Nissen HP, Bremgartner M, Urquhart C
Abstract Magnesium salts, the prevalent minerals in Dead Sea water, are known to exhibit favorable effects in inflammatory diseases. We examined the efficacy of bathing atopic subjects in a salt rich in magnesium chloride from deep layers of the Dead Sea. Volunteers with atopic dry skin submerged one forearm for 15 min in a bath solution containing 5% Dead Sea salt. The second arm was submerged in tap water as a control. Before the study and at weeks 1-6, trans-epidermal water loss (TEWL), skin hydration, skin roughness, and skin redness were determined. We found one subgroup with a normal and one subgroup with an elevated TEWL before the study. Bathing in the Dead Sea salt solution significantly improved skin barrier function compared with the tap water-treated control forearm in the subgroup with elevated basal TEWL. Skin hydration was enhanced on the forearm treated with the Dead Sea salt in each group, which means the treatment moisturized the skin. Skin roughness and redness of the skin as a marker for inflammation were significantly reduced after bathing in the salt solution. This demonstrates that bathing in the salt solution was well tolerated, improved skin barrier function, enhanced stratum corneum hydration, and reduced skin roughness and inflammation. We suggest that the favorable effects of bathing in the Dead Sea salt solution are most likely related to the high magnesium content. Magnesium salts are known to bind water, influence epidermal proliferation and differentiation, and enhance permeability barrier repair.
The following list details some healing properties of the minerals found in Dead Sea Salt:
Magnesium: Aids sleep and relaxation, promotes quick healing of skin tissue and provides the skin’s surface with anti-allergic elements, essential for cell metabolism.
Bromide: Soothes skin, relaxes body muscles, and calms nerves.
Iodine: Important for the correct functioning of the thyroid gland and aids in the body's metabolic exchanges.
Sulfur: A natural disinfectant (constituent of certain vitamins). Known as a powerful detoxifying agent, as it works closely with the liver to rid the body of toxins.
Potassium: Helps balance moisture in the skin and body, aiding in the reduction of water retention and in the nourishment of cells. Potassium also regulates the nervous system.
Calcium: An essential mineral, known to strengthen bones and teeth. Also strengthens cell membranes and cleanses pores.
Sodium: Relieves stiffness and muscle cramps. Sodium is also a powerful detoxifying agent, helping cells retain nourishment and expel waste.
Zinc: When applied topically zinc is known to boost the immune system. Internally, it is a key factor in enzymatic regulation of cell proliferation.
International Journal of Dermatology
A 1999 study published in the International Journal of Dermatology tested one hundred patients with psoriasis who sought treatment in the Dead Sea. 75% of these patients were clear of their condition after four weeks of on-site treatment. Of this group, 68% remained clear (in remission) through 4 months, and 43% were clear after six months.
Journal of the American Academy of Dermatology
In a 2003 study published in the Journal of the American Academy of Dermatology, twenty seven patients traveled to the Dead Sea for treatment of plaque psoriasis. The treatment consisted of daily bathing in the Dead Sea and controlled sunlight exposure. 48 percent of the twenty-seven patients were cleared of psoriasis completely and stayed in remission. The other 41 percent demonstrated a positive response to the treatment.
Israel: Dr. Zvi Even Paz
In 1989, Israeli dermatologist Dr. Zvi Even Paz conducted a study to evaluate the effects of Dead Sea Salts on 50 psoriasis patients. It had already been established that bathing in the Dead Sea itself brought relief, but it was not known if the Dead Sea salts would have the same effect when used in different environments (such as a bathtub).
47 of the 50 patients experienced significant relief after soaking in a bath containing Dead Sea salts. The best results came to those who soaked in two pounds of salts (divided into 3 baths) three times a week for six weeks.
Germany: Dr. J. Arndt
Dr. J. Arndt conducted a controlled study involving 50 psoriasis patients, between 14 and 77 years of age. All patients were treated using Dead Sea salts in partial or full baths and were treated with the salts in a controlled way. In a full bath, 2 kgs of the salts were dissolved in a bath at a temperature of 27 C. The partial baths were made with a concentration of about 10%. The baths lasted for 20 minutes and followed by a rinse. The patient remains in a warm, packed condition after the bath to enhance the effect of the salts.
The treatment lasted for 3-4 weeks, with 3-4 baths per week. Within only one week of treatment, symptoms diminished, including itching and scaling joints. Other symptoms such as spread, redness and infiltration continued to decrease. Improvement was steady- after four weeks, patients were clear of all symptoms.
The symptom patients were most concerned about was itching, and they were thrilled to be relieved in less than one week. Sleeping disturbances go hand in hand with the itching and are widespread in psoriasis patients – and sleep also improved in Dr. Arndt’s study.
Both patients and physicians in the study interpreted the drastic decrease in discomfort and scaling within one week.
Healing was complete in 27 patients (54%), and in the other 22 cases, there was vast improvement in their condition. Tolerance to the treatment was excellent in all patients involved in the study, and none of the participants experienced any side effects whatsoever, dermatological or otherwise.
There are 21 minerals in Dead Sea salts that are thought to have anti-aging properties. The salts are very unique, because 12 of the minerals found in the Dead Sea cannot be found anywhere else. It is said that Cleopatra often bathed in the Dead Sea which is perhaps what kept her so famously beautiful? Magnesium chloride, potassium chloride, sodium chloride, calcium chloride, bromide, sulphates, and water of crystal are all found here, although the sodium in Dead Sea salts is much lower than the salts of any other ocean on earth.
Benefits of Dead Sea Salt
There are many minerals in the Dead Sea and it’s salt that are excellent for your skin. These minerals include magnesium, bitumen, sodium, potassium, iodine, zinc, calcium and many more. Each of these minerals has their own special properties.
The Magnesium levels in Dead Sea salt are 15 times higher than that found in the Mediterranean Sea. Magnesium has been shown to have beneficial effects for those with psoriasis, in particular providing relief from itching. Magnesium is also essential for cell metabolism and promotes quick healing of skin tissue and provides the skin’s surface with anti-allergic elements.
Sodium is great for dry skin because it helps to allow moisture to be absorbed more easily and Bitumen is an anti-inflammatory agent that is also found in Dead Sea salt.
Potassium is great for people who have asthma because it improves the oxidation of the muscles and the nervous system and Iodine is a necessary component in the development of the hormone thyroxin.
Zinc is helpful because it contains antioxidant properties which help to reduce the early signs of aging and help to speed up the healing process.
There are many different ailments that Dead Sea salt can be beneficial for. It can be helpful for people who have dry skin, cellulite, psoriasis (as mentioned above) and a whole host of other skin conditions. Soaking in salt water is great for people with these conditions, but because of the high concentration and the particular properties of Dead Sea salt it is so much more effective than regular salt water alone.
My experience in using Dead Sea salt baths
Below is a short summary of my own personal experience which should be quite helpful, especially for those with severe tsw symptoms. I had severe topical steroid withdrawal/steroid induced eczema symptoms on my hands, and much less severe symptoms on my arms, legs, feet, and other areas. Please bear in mind when reading this that although using dss baths were key for me, as was sun exposure, one can benefit just as much from using dss baths if your symptoms are not as bad. Frankly, even more so. The dss baths are very effective at clearing small spots over your entire body anywhere you used TS in lessor amounts. Larger symptom areas are a little harder to clear but the baths help with those as well. Not moisturizing is a must though. This information is for those who want to find comfort during their tsw. If you moisturize, dss will be of little benefit to you as will anything else you do.
Dead Sea salt baths are an important aid in helping one succeed with not moisturizing and in making your skin heal and feel better. You will have very dry skin when you stop moisturizing it. That is the object so don't let it alarm you. Dead Sea salt baths have a further drying effect on the skin and should be used according to your symptoms at any given time. Some people may start out their tsw with severe symptoms and may experience something similar to what I did. Others with less severe symptoms will want to use the baths less frequently. The goal is to be comfortable as possible while going through tsw. One must stop keeping the skin moist and allow it to heal if one wishes to achieve this goal. Dead Sea salt baths aid in that effort in a huge way.
You will find that you will be much more comfortable once you stop moisturizing, and doing dss baths are an effective means in aiding you in that effort. Comfort doesn't happen overnight. It usually takes a couple weeks to a month, depending on various factors. But once you make the transition, you will find that you are much more comfortable, and you will also find that your skin will show noticeable improvements. When people stop moisturizing they experience very dry skin at first and have a difficult time adjusting to it. The skin tightens up, can often crack, and feels extremely dry compared to what they are used to. Doing Dead Sea salt baths can be extremely useful in bringing relief from this effect even though they have a drying effect themselves. After a couple weeks the skin adjusts and the itching is noticeably reduced. Most skin splits and open sores are closed. All of a sudden you are comfortable and feel better than you did before starting tsw. It isn't that difficult and the payoff is huge.
I haven't moisturized in many months now and it makes me shutter to even think about the effects it had on my skin. And trust me when I say, we are not "different" in the sense of how moisturizing affects our skin. There are people that try MW in a unsuccessful way and are quick to exclaim that "MW didn't work for them", or "it was too uncomfortable". And "some people may benefit while others may not". "It's not for everybody". "We're all different". "Do what's comfortable for you". That's all hogwash! Don't believe any of that BS for one moment. People that say these things never did their research and never did MW correctly. Some try it and go back to moisturizing for a day and try it again, etc. Many try it by moisturizing less than usual. Others will give it a go but don't give it enough time. And, one of the biggest mistakes people make is they try it without the aid of dss baths. Therefore the reason for this post in the first place.
Also, ranking right up there at the top is most people who try MW don't look to those who have done it successfully for guidance or help, they try and reinvent the wheel and do it "their" way. Personally, I always copied success in life and it always gave me an edge in business by doing that. If you want to succeed at MW look at the ones who have succeeded for how they did it and copy what they did. Reinventing the wheel is great but no use in repeating mistakes made in the past by others before you. Don't be afraid to ask questions.
I recommend using water diluted pure tea tree oil as another aid when doing MW for closing any small persistent skin splits that don't heal after a couple weeks of doing the baths. These tiny buggers will still come and go since the skin is still very thin in different areas where ts were heavily applied. But they will decrease in time, because once you stop moisturizing the skin, it begins to toughen up pretty quickly. Another plus is when you do scratch in your sleep it doesn't cause near the damage due to the skin being so much stronger.
Before I did MW my hands were like hamburger meat for three months. One month before stopping ts, and two months after while I rebounded and moisturized. I could see that moisturizing my hands was only making them stay in the same condition with no improvement. The areas I never moisturized on my arms and legs were already getting better but my hands were staying a total mess. They were really bad and I was at my wits end after enduring so much pain and intense itching 24 hours a day. I had already researched endless hours and one night I was just sitting on my couch fiddling with my hands, contemplating everything I had learned, and out of the blue comes this eureka moment! It hit me at once. I knew right then that all I needed to do was to stop moisturizing and allow the skin to dry and scab over like any wound you want to heal. I knew that occlusive dressings wouldn't work since I had tried them. But this new idea made so much more sense to me. I couldn't take another month of huge gaping fissures in my palms and in the joints of my fingers. They were spreading to the tops of my hands from between my fingers. I was nearly 100% disabled. I had to do something and it dawned on me exactly what I had to do and how to do it. Stop moisturizing, do dss baths, and get sun exposure.
In week 8 of my topical steroid withdrawal I quit moisturizing, exposed my skin to the sun as much as possible without risking sunburn, did daily Dead Sea salt baths, and my skin splits, cracks, and fissures healed over quickly for the first time in months. In the beginning, the skin on my hands dried out so much I couldn't bend some of the fingers without breaking my skin open. But I was determined to make the skin breaks dry and scab over so I stuck it out. For about 3 days the pain was extremely intense. I had to take a strong painkiller on either my second or third day (don't remember which). I split it in two and took 1/2 in the early part of the day and the other half later. It helped some. By the 4th day my situation became more bearable, and by about day 7 or 8 my skin breaks had all scabbed over nicely and the old skin started to peel off on it's own, day after day, revealing new skin underneath.
It took a couple weeks from start to finish and it was brutally painful. My fingers and palms were red and swollen, and my skin felt hot like I had an infection. Keep in mind that my symptoms were quite severe to begin with and I was already experiencing a great deal of pain so the added extra pain did not really make much of a difference to me. NOTE: For those with less severe cases, this process should not be nearly as difficult as it was for me. I also had no information about how to do this since none existed in the U.S. at the time. That made it all the more difficult not knowing exactly what to expect other than what I had anticipated from a lot of thought and research on how the skin functions. Dr. Fukaya's researech on mice certainly contributed heavily to my theory that it would work.
I also had a script of antibiotics available at a moments notice if I were to decide to take them. I did make the decision to take them on about the 3rd or 4th day due to concerns over swelling, deep open cracks, redness and hotness of the skin. I didn't have a fever but that was the only missing infection symptom and I wasn't about to take the risk of having to stop in the middle of my attempt at doing this so I felt the antibiotics might protect me while I put my skin through the ordeal.. Looking back, I don't really know if I needed to take them or not.
As I was saying, in the first couple days the intense burning, itching and nerve pain along with tightness of the skin was nearly unbearable. I had one finger dry halfway closed and couldn't fit a glove over my right hand in the second or third day, so I soaked in a dss bath to soften the skin and was able to straighten my finger out without breaking the skin open. After doing the bath I went out into the sun and held it extended so it would dry that way and I could get a glove back on it. But, after a couple more days of self induced torture my skin finished scabbing over and began to slowly fall of on it's own, revealing new skin in it's place. The relief was unbelievable. All of my deep fissures and skin cracks were finally closed up. And there were many. Probably 20-30 total on my palms and fingers. After several more days of doing dss baths and exposing my hands to the sun I was able to get a few areas of raw oozing skin between my fingers to final heal over and stop wearing gloves. What a relief! I didn't have to wear gloves to guard against infection any longer!
Again, the skin barrier on my palms was completely destroyed from my prior prolonged and increased topical steroid use, so moisturizer withdrawal will not be as painful for everybody as it was for me. For many it should be a much easier experience than what I had. Again, depending on the severity of your symptoms and how badly the skin barrier is damaged, and other factors. For me, it was well worth the extra pain for a few days to be much more comfortable for the rest of my multi-month tsw journey. I am currently at month 8 and have been very comfortable ever since stopping moisturizing despite occasional flares and setbacks that are common with tsw. The main purpose of moisturizer withdrawal is for the comfort it brings. If it speeds up tsw recovery (which I believe it does), then that's just a plus. The difference between going through tsw moisturizing and going through tsw not moisturizing is like the difference between night and day. But one needs to do MW correctly if they are to succeed. Using dss baths and tea tree oil helps tremendously in accomplishing this.
After my first two days of nearly 90% healed skin I applied a moisturizer again (don't ask me why I don't know) and immediately went back into a flare within hours. It took another 2-3 weeks to heal my skin again by immediately stopping moisturizing and repeating the method I used the first time. The second time around was almost as painful as the first, but not quite as bad since my hands were in better shape that time around.
After I had healed my open wounds I began to cut back from doing dss baths every day to every second day. And, then later to every third day, and then I started going as long as possible without any baths or showers. I usually ended up feeling like I needed to do a dss bath about every 4-5 days for a period of a couple months. About a month ago I expereinced a huge flare and had to go back to every other day but now I'm much improved again and have cut back to every third day a couple weeks ago. I'm still on that maintenance schedule for now but almost ready to go back to once every 4-5 days asap.
There are different ways to do MW but this way is practically fail safe. Whether you are just beginning tsw or have been in it for a year, it can be done at anytime you are ready to make the effort. If your skin feels comfortable via moisturizing, and you are pleased with your progress, then I suggest you keep doing what you're doing. However, I have seen very few people that are comfortable and feel like they are progressing. Yet many of them say they are comfortable. It is quite perplexing to me. Either you are comfortable or you are not. If you are truly not, and feel you are healing too slow, then give MW a good 4 week try and see for yourself. You can always go back to moisturizing at any moment you like so you have nothing to lose and everything to gain. Look over the studies I have posted on my blog on how continuous moisturizing damages the skin barrier and ask yourself, "do I really want to keep moisturizing"?