The subject of the post was moisturiser addiction. At the time, I had considered a lot of evidence to show that the skin can get dependent on moisturisers and decided to stop using them. I only lasted a couple of days. The tightness and cracking kicked in and was unbearable. I applied moisturiser and got sweet relief.
However, I read a really interesting report over on Tommy's Skin of Rose Blog, which I think everyone should read. The post was about a conference in Japan all about TSA. In Japan, they are a lot more advanced than the West when it comes to steroid addiction. Two doctors, the Doctors Sato, are pioneers in the field and have helped cure many people.
When I read the post, one particular quote jumped off the page at me:
"I personally have an impression that moisturiser withdrawal is still seen as an unfamiliar idea even among TSW patients. However, the doctors on the event all agreed that moisturiser withdrawal was 'usually essential' rather than 'encouraged'. I knew it was a good thing to do, but thought it was optional at the time I wrote the post. They explained that only about 10% of TSW patients healed without moisturiser withdrawal, and they were all mild case patients. TSW patients who recover well are usually doing moisturiser withdrawal strictly, according to the doctors. Even children can be addicted to moisturisers. Dr. Sato said that wiping off oozing or picking up scabs could be 'moisturisers' to your skin. "
OK. This sounds quite worrying. Only 10% healed without moisturiser withdrawal? Eek.
As you may guess, the itsan forum has been positively buzzing with debate on this issue.
I am not a doctor and certainly not in any position to offer medical advice on this subject. People have to decide what is best for them. However. I though I would write a list of Pros and Cons on the subject to help get things into perspective.
- The idea of moisturiser addiction makes sense. Think about it. If you apply moisturisers to the skin, the body will feedback that it is getting enough moisture. The skin will then stop producing as much natural oil because it falsely detects that it is getting enough. As the skin's natural moisture levels decrease, the patient has to apply more moisture to the skin, thus creating a cycle of moisture replenishment.
- The doctors Sato have a lot of experience treating TSW in Japan. Their findings are a result of many years studying those going through TSW.
- Moisturisers are full of nasties. Preservatives, fragrances and other ingredients can irritate the skin. One can be applying a moisturiser without realising that they are allergic to one or more of the ingredients. Ingredients in moisturisers can be highly irritant or even carcinogenic. I read an interesting study in the New Scientist, showing that when researchers applied certain creams to hairless mice and exposed them to UV light, they developed cancers. Of course, they argue that mice and humans are very different, but would you want to take that risk?
- Its all very well saying stop moisturising, but the fact remains that it is very difficult to do. I tried it. My skin was tight and flaky. I gave in! In the case of full-body TSW flares, movement may be severely restricted without moisturisers.
- We can't all hole ourselves away in the house. I have to take my kids to school, go shopping and generally interact with people. I wouldn't feel comfortable doing that with a cracked face.
- Letting skin dry out will damage the natural skin barrier. The skin will crack and may even bleed, leaving the skin at risk of secondary infection.
- Dr Rapaport and Dr Fukaya are also leading doctors in the field of TSW and have treated thousands of patients with the condition. Nowhere in their medical reports have they mentioned moisturiser withdrawal. *It has however, been brought to my attention that Dr Fukaya has since mentioned moisturiser addiction in his personal blog. The overall thought conveyed by his blogpost is that moisturisers are probably best avoided, although should be applied sparingly if necessary to comfort.
- I also personally know of quite a few fellow bloggers and Itsan members who have healed whilst using moisturisers. Jake, Rochelle, Tracy, Juliana, Karen and Keira to name but a few, now have clear skin but did not have to resort to moisturiser withdrawal.
I am on the fence really! I do not think MW is essential to healing, but it may certainly speed it up. Those who have managed to break through the pain barrier and tough it out seem to have had good results.
I think the body sorts itself out when left to do its own thing. During the course of TSW I have found that my skin oils have returned by themselves and now I do not have to moisturise my body at all. The skin on my face is still tight though and I do apply a very thin layer of cream once a day to my chin and cheeks, purely for comfort and movement.
Again, I want to mention that Dr Rapaport claims to have successfully healed over 2000 people from TSW without having to resort to moisturiser withdrawal.
As far as I know, there are not any published medical studies on this subject (unless there are any in Japanese). I hope that this will change into the future and that studies will shed further light on the matter.
My opinion of the issue echoes that of Dr Fukaya, who seems very balanced in his approach. He states:
"...They recommend not use any moisturizer though they know the method is really a hard-landing......So if utilizing any moisturizer is comfortable for your skin, it is not necesarily wrong to apply it. However, it is not a right idea if you think moisturizing is absolutely useful or necessary for the damaged skin. "
I would love to know your opinion on this subject and please feel free to comment below with your experiences of moisturiser withdrawal.