Chinese Herbal Medicine for Topical Steroid Withdrawal

A Personalized Approach to Topical Steroid Withdrawal (TSW)

​If you are experiencing topical steroid withdrawal (TSW) you might be exhausted, in despair, and struggling to find relief. Your skin burns, itches, peels, or feels painfully sensitive. Sleep becomes difficult. Everyday activities feel overwhelming and you may have had to take time off from work or school. You might have tried numerous approaches to calm your skin, only to find little improvement, temporary relief, or progress that has stalled.

​

Many of the people who come to see me for TSW are in significant distress. Some have spent months or years searching for answers. Others have consulted multiple healthcare providers, tried numerous products and therapies, and still struggle to find care that addresses their needs. Some tell me their concerns were dismissed or were told by their dermatologist that TSW was not a real condition.

​

Topical steroid withdrawal has been the subject of growing medical attention, although questions about its diagnosis, and management remain. In February 2024, the British Association of Dermatologists, the British Dermatological Nursing Group, and the National Eczema Society published a joint statement acknowledging the severe symptoms people report and the need for better research and clinical support. The UK's medicines regulator also recognizes topical steroid withdrawal reactions as a potential adverse effect of topical corticosteroids. 

​

There are no consensus statements between major dermatological associations in the USA. However, the National Eczema Association does recognize TSW as a “potential consequence of extended topical steroids use.”  And they recommended Traditional Chinese medicine for management and treatment of topical steroid withdrawal and for eczema. 

​

People experiencing these symptoms deserve to be heard, assessed carefully, and supported.

I take your experience seriously.

​

As a licensed acupuncturist and board-certified Chinese medicine practitioner with more than 20 years of clinical experience, I specialize in Chinese herbal medicine and complex dermatological concerns. I offer individualized herbal online, telehealth consultations for people in the United States experiencing TSW.

​

Note: I do not use the term Red Skin Syndrome (RSS) for TSW because topical steroid withdrawal does not always appear red on more melanated skin tones. It may look purplish or a darker, more hyperpigmented color than your normal skin tone. Eczema can also look different on skin of color than on lighter skin tones and it is important to work with a practitioner who has specialized training in identifying skin disease on more melanated skin tones. Not only do I have this training, I also teach a course for other Chinese medicine practitioners about this topic as it pertains to atopic eczema.

​

How Chinese Herbal Medicine Can Help For Topical Steroid Withdrawal

​

Chinese herbal medicine offers an individualized approach to managing complex skin concerns. Rather than selecting herbs based on a diagnosis alone, I consider your specific skin symptoms, health history, digestion, sleep, energy, and other aspects of your health.

​

Traditional Chinese medicine uses diagnostic patterns to guide herbal selection. Two people with similar skin symptoms or diagnosis might receive different formulas because their overall presentations differ.

I combine this traditional assessment with my clinical experience and specialized training in Chinese herbal dermatology and consideration of emerging scientific research into medicinal herbs.

​

Living with persistent skin symptoms affects much more than your skin. Ongoing discomfort might interfere with sleep, concentration, work, relationships, and emotional well-being.

During your consultation, we discuss these concerns alongside your skin symptoms. You do not need to minimize the impact TSW has had on your life. I want to understand what you are experiencing and what you hope to improve so that we can create an action plan together and clarify expectations. 

​

Calming Inflammation and Skin Irritation of TSW

Burning, swelling, tenderness, skin peeling or flaking, and skin discoloration are among the symptoms people with topical steroid withdrawal often describe. These symptoms can cause intense discomfort and make even gentle skin care difficult. In my clinical practice I have helped most of my clients move past dermatological symptoms resulting in calm clear skin. View the before and after gallery of photos here.

​

Laboratory and animal studies suggest certain Chinese herbs contain compounds with anti-inflammatory activity. Researchers have examined how some of these compounds influence inflammatory signaling and immune responses involved in skin conditions. 

​

In my practice, I consider your specific symptoms and overall presentation when selecting herbs. The approach for skin with pronounced warmth and swelling might differ from the approach for skin dominated by dryness, peeling, and persistent itching.

The aim is to develop an herbal formula suited to your individual needs.

Easing Itching, Burning, and Discomfort of TSW

Persistent itching often leads to scratching, further irritation, and disrupted sleep. Burning and stinging might make washing, dressing, or applying moisturizer uncomfortable or even impossible.

I carefully consider the nature of your discomfort when selecting herbs for your formula. I also want to understand how your symptoms affect your sleep, energy, and daily life.

​

My goal is to provide compassionate, individualized care that responds to your concerns and adapts as your symptoms change.

​

Supporting Skin Barrier Health

Your skin barrier helps retain moisture and protect against irritants, allergens, and microorganisms. When the barrier is impaired, your skin often becomes dry, fragile, and more sensitive to products and environmental triggers.

​

I consider your skin's current condition when developing your herbal plan. Gentle skin care, appropriate moisturizers, and medical guidance also play important roles in caring for sensitive or damaged skin. Learn more about this by downloading my free e-Book and checking out my blog posts.

​

What to Expect from a Consultation With Juliette Aiyana, MTCM

​

A Thorough, Individualized Assessment

We begin by reviewing your skin concerns, symptom history, previous treatments, current medications and supplements, and overall health. You will be directed to fill out a health history form and instructed on how to take photos of your skin and how to submit them to me before our online, telehealth consultation. I ask about the location and character of your symptoms, what aggravates them, and how they affect your daily life.

​

Topical steroid withdrawal can resemble an eczema flare, allergic contact dermatitis, skin infection, and other conditions. A medical assessment is important when the diagnosis is uncertain or symptoms are severe. I encourage coordination with your dermatologist or other healthcare providers when appropriate.

​

Personalized Chinese Herbal Formulas

I tailor an individualized herbal formula based on your presentation and health history. I consider your current symptoms, medications, supplements, and relevant safety factors when selecting herbs and determining appropriate amounts. Herbs are shipped to you from the herbal dispensary.

​

I explain the rationale behind your formula and discuss relevant precautions. Some herbs have potential side effects, including allergic reactions, liver effects, and interactions with medications. Careful selection and professional oversight are essential.

​

Read my Chinese Herbal Medicine FAQ for more detailed information.

​

Regular Follow-Ups and Ongoing Adjustments

Your skin symptoms and needs will change over time. You will submit progress photos before each appointment. Follow-up consultations allow us to review your response to the herbs, reassess your presentation, and adjust your formula when appropriate.

​

Progress varies from person to person. Some people hope for less itching and burning, better sleep, or improved tolerance of skin care products. Others are working toward gradual improvements in skin texture and appearance. I have been able to help most of the people I have worked with.

​

Is Chinese Herbal Medicine Right for You?

I understand how discouraging it feels to live with persistent skin symptoms while searching for something that helps. I also understand why you might feel frustrated after trying multiple approaches without the improvement you hoped for.

​

A consultation might be appropriate if you:

• Experience persistent burning, itching, peeling, flare-ups or other skin symptoms after reducing or stopping topical steroids.

• Have tried several approaches without lasting relief or feel your progress has stalled.

• Want to explore individualized Chinese herbal care as part of your plan for skin health.

• Have complex skin concerns and want an assessment that considers your overall health.

• Seek care from a practitioner with specialized experience in Chinese herbal dermatology.

You deserve to have your concerns heard and your symptoms assessed with care. My role is to provide thoughtful, individualized Chinese herbal care, explain my recommendations, and work with you to determine whether this approach fits your needs. If you have questions for me, I invite you to schedule a Discovery Session.

​

Note: Please speak with your prescribing healthcare professional before stopping or changing topical corticosteroids. If you are experiencing rapidly worsening symptoms, severe pain, spreading warmth, pus, fever, or extensive skin inflammation, seek prompt medical attention.