Topical steroid withdrawal: How to reduce rebound (flares) while eliminating topical steroids
If topical steroids have been used on children or adults for any length of time, damage to the skin's steroid-resistance is almost guaranteed. In fact, any remaining or recurring rash is most likely no longer due to eczema, but to the steroids' destructive effects on the skin and the person's immune system being unable to control the reaction.
How can wheatgrass help?
Wheatgrass works against the destructive effect of steroids. Whereas steroids suppress the immune response, wheatgrass appears to modulate the skin’s natural immunity in a way that facilitates the skin's ability to heal itself. We see this particularly in wound healing where the recovery of skin wounds can be quite rapid compared with "natural" healing. Also, there is laboratory and clinical evidence that wheatgrass assists the whole body's immune system in the general healing process and as a natural anti-inflammatory.
Essentially, we need to boost whole body immunity and the immune status of the skin itself. This can be achieved by applying wheatgrass extract or wheatgrass juice although because it is a concentrate, the former is more potent. Oral wheatgrass can also assist by modulating and strengthening one's immune system. It is also important to understand there is no magical overnight cure of steroid withdrawal, but wheatgrass can and does in the great majority of the thousands of cases I have treated, reduce the time taken to overcome rebound or the "Red Skin Syndrome". Bear in mind that the process may take some time, and that although most patients do fare well if they are prepared to persevere for 6 to 12 months, occasionally some do not.
What we frequently see after applying wheatgrass to eczema is reduction of redness (inflammation), scaling, cracking, itching and pain. Most importantly, if topical steroids have been used for an extended time, the rebound that frequently occurs on their cessation can be reduced or even eliminated providing they are reduced gradually.
The method is quite simple, but you need to be patient and persevere. Also, clinical experience in helping thousands of eczema patients dispense with steroids, leaves me with no doubt that daily ingestion of wheatgrass can hasten the healing process.
First, aim to reduce topical steroids gradually over a period of time - say two to three weeks or, if they have been used regularly for a long period, a month or two.
For the first week, start to boost the skin's immunity by applying wheatgrass two to three times daily, but in combination with the topical steroid. Wheatgrass first, steroid on top. Use either the wheatgrass extract in a cream base or as a lotion. Because the Dr Wheatgrass Skin Recovery Spray contains fewer ingredients than the other topicals, it is my preferred treatment for eczema in infants and children.
In the second week, try to reduce the steroid by 50 percent either on a daily basis, or every second day.
By week 3 it may be safe to reduce the steroid to twice weekly, then once weekly, then cease. In this way, you will build up the skin's immunity quite significantly so that the steroid may no longer be required provided wheatgrass continues to be applied once or twice daily.
In the event of flares, which often happen in the first few months but are usually milder than before, repeat the steroid/wheatgrass cycle. Often this period will be significantly shorter than the first 'cycle'.
I have helped numerous patients, adults and children, towards far better quality skin this way, most of whom have eventually been able to dispense with their steroids. Others only need to use the steroids to help them over a flare from time to time, but only for days rather than weeks or months.
In more severe cases, I use daily wheatgrass application in combination with oral steroids i.e. prednisolone, usually 20mg. daily to begin with, to get control over the eczema by reducing inflammation and itch. I then reduce the prednisolone by small increments of 2.5mg every three or four days as this helps significantly in reducing rebound. The aim is to cease oral steroids as soon as possible, but continue applying wheatgrass. If rebound occurs, I repeat the steroid cycle starting at 15mg. and repeat the gradual dosage reduction.
This process may take three to six months, but the outcome is often successful. Some patients may need to continue using wheatgrass indefinitely.
You can view some examples of wheatgrass skin recovery at these links:
- How wheatgrass can significantly improve quality of life in severe steroid-dependent eczema
- Steroid-dependent skin recovery
- Steroid-dependent nail recovery
- Eczema case history
- Eczema testimonials
- Severe steroid-dependent eczema - major flare (Graphic content)
- Fruit acid peel facial skin reaction
- Red Skin Syndrome healed with wheatgrass
Eczema Flare and Dry Skin Prevention
No eczema treatment, including wheatgrass and topical (or oral) steroids, is likely to work unless simple, 'damage control' measures are also taken. Reduce or eliminate exposure to adverse factors such as soap, hot water and frequent shampooing which dries the skin, aggravates the condition and slows recovery. My rules:
AVOID SOAP - of any kind. This includes soap-containing shampoos, dishwashing detergents etc. Try to find a colloidal oatmeal containing soap-free wash and shampoo. Oatmeal appears to have a similar immune-boosting action as wheatgrass and the two work synergistically.
In Australia, a good colloidal oatmeal shampoo/conditioner is the 'Dermaveen' brand. In the USA it is called 'Aveno'.
REDUCE EXPOSURE TO HOT WATER Take short (5 minutes maximum) showers and NO BATHS. Soap and hot water combine to remove sebum from the pores of the skin causing dryness and itchiness. (See figure)
APPLY Dr Wheatgrass Skin Recovery Spray or Cream or Superbalm twice a day – and persevere. For infants and young children, the Spray is preferable because it contains fewest ingredients therefore less likelihood of allergic reaction. However, reactions of any kind are rare. Use sparingly because a little wheatgrass goes a long way. Also, responses can vary a lot between individuals, so try to be patient and persevere. If a mild reaction does occur, stop the application for two or three days, then try again because in most cases the child's skin will settle down.
As well as strengthening the skin's immunity, biological actives from the wheatgrass are absorbed into the body and in time, the patient's immune status should strengthen. Boost this even further by taking Supershots, 5mls. daily. (1-2ml in infants and younger children). Many patients learn to control their eczema using only wheatgrass.