We often get asked about steroids creams and if our products can be used with or after using them. First off, I'd like to say that we are not general practitioners, so if you're at all concerned, talk to your GP for advice on your itchy skin condition.
However, what we can talk about and share is what other parents have told us they have observed, and share the process they followed to help manage their child's or their own itchy skin. For some, the goal has been to stop using a steroid cream, for others, they wanted to reduce the dependence on steroids and supplement it with a natural topical.
What other parents have told us
For a growing number of others, they have unwittingly been using a product they thought was natural, but it now turns out included steroid in the formula. We can understand how gutting that can be for parents who didn't want to go down that route and now find themselves with a child whose skin has become accustomed to the extra support a steroid cream provides. They've now effectively stopped the steroid cream 'cold turkey', without the chance to wean down - which is important - and their child's skin is itchier and angrier than ever. We're sorry if that's you. We hope the experiences of other parents can be of some help.
Eczema is a multi-factorial condition
We know eczema isn't an easy condition to tackle. As a bit of background, it's important to keep in mind that it's a multi-factorial condition meaning it's often related to a number of factors that vary from person to person. These can range from environmental triggers and internal gut health issues in some, to food triggers and temperature sensitivities in others - for example change in season, the heat of summer or the cold temperatures of winter. It's important to try to understand your child's triggers are or your own and to begin to address those.
Have you noticed your baby is fussier after dairy or gluten? Lately, I've heard of a few people for whom eczema is made worse by peas and lentils which was I hadn't heard of until recently. We can't stress how important gut health is when it comes to managing lots of conditions, but particularly skin conditions. You can read more about this in our blog written by Warren from BePure - Healing Eczema from the Inside.
The role of a good topical
Once you've identified your triggers and are working to minimise them, a good topical will help to soothe and protect skin and provide support for the skin barrier while the body gets to work on the healing process.
You can read more about food triggers and how to identify them at the end of this blog.
What is Topical Steroid Withdrawal or TSW
One thing we have read in research articles is that steroid dependency only occurs after long-term steroid use. Perhaps that is true of full-blown steroid withdrawal or TSW (topical steroid withdrawal) which leaves the skin angry, extremely dry, red, flakey, sometimes weepy and itchy.
Everyone is different but going through TSW can be a long process and the skin basically needs time to adjust to no longer having the support the steroid provided. So yes, it may be that TSW only occurs in those who have used these creams for a long time but a number of parents have told us that for some - not all - stopping a steroid, even if only used intermittently, was not an easy process for them. They noticed the skin was reluctant to settle with anything but the steroid and introducing new topicals, was sometimes met with a reaction, especially if they were introduced too quickly and too often.
Some parents noticed the skin needed time to 'acclimatise' to no longer having the steroidal support. For some, that can start a cycle of needing to use the steroid more often. All good if that's what you want to do, but for those who don't, it can take a while to get through that tough phase when the skin craves the steroid.
So what can you do?
Some parents have told us they were able to stop the steroid cream and start something new, without a problem. If that's your child, fantastic.
Others told us they tried to stop a steroid cream cold turkey, but it backfired with the skin becoming red, itchy and angry. Instead, they opted to introduce a new topical while still using the steroid cream which seemed to to help the skin become used to the new product.
One Mum told us she applied the Kawakawa Repair Balm 1x a day while still using the steroid cream. She gave this several days at this level and only increased to 2x a day if the skin tolerated the progression, then to 3x a day while still using the steroid. Several customers have told us they were able to very gradually wean down the amount of steroid used. Sometimes they could do this over a week or two, for others over 1-2 months.
Remember, if you're at all concerned, check with your GP or medical professional.
How to start using Kawakawa Repair after stopping steroid creams
If you want to start the Kawakawa Repair after stopping a steroid, the following approach is based on what other parents have told us:
1. Patch test first for 24hrs.
2. If the patch test is fine, choose an area of skin and apply the balm 1x a day. Monitor progress. Stick with this for at least a few days to a week.
3. Next, if all ok, apply the balm 2x a day for a least a few days to a week.
4. If all is ok, apply the balm 3x a day. Monitor progress and expand the area of application.
You will need to progress very gradually and build up use over time. The skin will need time to acclimatise to using something new which has actives of its own, even if they're natural, like Kawakawa Repair. This seems quite important, especially if you haven't had a chance to wean down gradually from using the steroid and had to stop suddenly.
Additional support
For those who find oat baths soothing, these can also be taken once a day as long as the bath isn't too long (10 minutes max as longer can further dry out the skin) or too hot (which can irritate the skin) to provide gentle relief and support to the skin.
You can also supplement an intensive topical or heavy balm like Kawakawa Repair with a fragrance free mosituriser for the rest of the body - Frankie's Kawakawa Body Oil is a nourishing blend that is gentle for sensitive and eczema-prone skin.
Remember, everybody's skin is different, will progress at different rates and every person's combination of triggers is unique to the individual. Keep this in mind as you work out the programme and timing that works best for you and keep in touch with your medical professional.
If you have any questions, please email info@frankieapothecary.co.nz
We wish you all the very best as you navigate your own or your child's sensitive skin issues.
