Topical Steroid Withdrawal (TSW) occurs when topical steroids have been used in excess or for a prolonged period and are abruptly stopped. When you suddenly or incorrectly stop using the steroid, your skin can go through a huge adjustment period as it tries to recover from the effects of the medication.
AMPERNA® Probiotic Skincare is an advocate for topical steroid withdrawal awareness. Kiri (AMPERNA® founder) suffered from oral steroid withdrawals herself and her mission is to spread as much awareness and education on the real and serious condition as possible.
ITSAN – Support for a global community living with Eczema and TSWS is an incredible organisation AMPERNA® donates to, to help continue to raise this awareness and knowledge globally.
Kiri’s passion for sharing not only her own experience with steroid withdrawals but amplifying other sufferers’ stories via our social media as well.
You can watch the latest LIVE with Anthony Lexa here:
So, what happens to your skin when you are going through TSW?
How can AMPERNA® products help soothe your TSW skin?
What ingredients should you avoid if you are suffering from TSW?
Here is what your skin will go through at different stages of TSW
1. Disrupted Skin Barrier
When used over an extended period, topical steroids can weaken the skin's natural barrier. This causes the skin to become thinner and less able to retain moisture or protect against irritants, bacteria, and allergens.
When steroids are stopped, the skin struggles to regain its full barrier function, leading to dryness, flakiness, and increased vulnerability to irritants.
2. Inflammation and Redness
After stopping topical steroids, the skin can become inflamed, and blood vessels can dilate, which causes redness, swelling, and warmth. Inflammation is often a major symptom during TSW.
This can lead to intense itching, burning, and overall discomfort, which may resemble eczema or other inflammatory skin conditions.
3. Steroid-Induced Atrophy
Topical steroids can thin the skin over time (known as atrophy), which makes it more fragile and prone to tears, bruising, and irritation.
Once the steroids are stopped, the skin may appear more wrinkled or paper-thin and may take time to regenerate and strengthen.
4. Flare-Ups of Existing Conditions
Underlying condition may be exacerbated, such as eczema, rosacea, or psoriasis, which may have been suppressed by steroids.
This can lead to flare-ups of these conditions, with increased itching, scaling, or rashes that were initially under control while using the steroids.
5. Erythema and Oozing
Some people may experience intense redness (erythema) and skin that oozes clear or yellowish fluid. This occurs due to inflammation and weakened skin integrity, making it prone to infections or irritation.
Oozing, crusting, and open sores may appear as the skin struggles to heal, which can be quite distressing.
6. "Red Skin Syndrome"
This term is often used in connection with TSW to describe the intense, widespread redness and inflammation that can occur when stopping steroids. It is a reaction of the skin to the steroid withdrawal, where the skin becomes extremely red, hot, and painful.
The skin can feel extremely sensitive, and any touch or friction can cause further irritation or pain.
7. Peeling and Shedding of Skin
As the skin heals and regenerates, it may shed or peel excessively, especially during the early phases of TSW.
This can lead to dry, flaky patches and may create a "crusty" appearance as the skin works to renew itself.
8. Itching and Burning Sensations
Itching is a hallmark symptom during TSW. This is due to the inflammatory process and the skin’s heightened sensitivity as it adjusts to the absence of the steroid medication.
The intense itching can lead to scratching, which may damage the skin further and cause secondary infections.
9. Increased Sensitivity
Without the protective effects of topical steroids, your skin can become much more sensitive to environmental factors such as heat, cold, humidity, and skincare products.
Even mild irritation from things like fabrics or products with alcohol or fragrances can feel uncomfortable, and the skin may react more strongly than usual.
10. Healing and Regeneration
Over time, the skin begins to regenerate and repair itself. The process involves rebuilding the skin’s barrier, restoring moisture levels, and calming inflammation.
It can take months to fully recover, and skin may look better in some areas while other parts continue to peel or remain irritated. The skin might go through several phases of improvement and setbacks as healing progresses.
How Long Does TSW Last?
The duration of TSW can vary from person to person. While some may experience symptoms for a few weeks, for others, it can last several months to years. Healing is a gradual process, and managing it with gentle skincare, moisturising, and avoiding irritants is crucial.
AMPERNA® products that can help soothe your TSW skin
If you are going through TSW, it is essential to be patient and take good care of your skin with the right products, focusing on soothing and hydrating ingredients that reduce inflammation, support skin healing and provide nourishing hydration.
That is where AMPERNA® has help hundreds of TSW sufferers on their skin healing journey.
Navigating Topical Steroid Withdrawal can feel overwhelming, but you are not alone. At AMPERNA®, we have created products that are gentle, effective, and designed to support your skin as it heals and strengthens.
Here are the AMPERNA® products we recommend using if you are suffering from TSW:
1. Soothing Duo
How does it work to help soothe TSW?
AMPERNA®'s number 1 best-selling product, the DS Soothing Serum, is renowned as our non-steroid alternative for inflammatory skin conditions. The combination of copper and zinc gluconates help limit the spread of harmful bacteria as well as nourish the skins barrier.
Copper plays a key role in the synthesis and stabilisation of the skins proteins.
Zinc gluconates is essential for cellular repair and wound healing.
Ceramides help restore the skins protective barrier function and Vitamin B5 provides anti-inflammatory properties, helping soothe irritated skin.
Paired with our Lightweight Soothing Emulsion, our cationic moisturiser which is packed with ceramides, hyaluronic acid, and emollients to help protect the skin from free radical damage.
The hero ingredient within the Soothing Duo is where the AMPERNA® magic happens. Our probiotic complex Lactococcus ferment lysate is infused in the DS Soothing Serum and Lightweight Emulsion to support and strengthen the skin barrier whilst delivering healthy bacteria to the skin.
2. Wash + Lotion Duo
Do not neglect the rest of your skin, the Wash + Lotion Duo cleanses and hydrates your body while keeping irritation at bay—a must-have for calming full-body flare-ups. These products are designed to help calm inflammation, restore balance, and support your skin’s natural healing process.
Ceramides are lipids (fats) naturally found in the skin that help restore and maintain the skin barrier. Using products with ceramides can help protect the skin and reduce water loss, which is vital during TSW when the skin barrier is compromised.
The Hydrating Gentle Wash with Ceramides is a light fragrance – free body cleanser that gently cleans without stripping the skins natural ph. levels. It contains silverion which has antibacterial properties and colloidal oatmeal which hydrates and soothes the skin.
The Hydrating Gentle Lotion with Ceramides contains pentavitin which offers the skin 72 hours of deep hydration. It helps calm irritation and inflammation and offers damaged dry skin soothing comfort.
3. Probiotic+ SOS Daily Facial Spray
This cooling probiotic infused spray is a must have for TSW sufferers. It contains niacinamide which is known for its anti-inflammatory properties. Niacinamide helps calm irritated skin, boost the skin barrier, and reduce redness. It also helps with the healing process and reduces sensitivity.
Aloe Barbadensis Leaf Juice has cooling, soothing, and anti-inflammatory properties. It can reduce discomfort, hydrate, and help with healing.
Provitamin B5 also helps the skin retain moisture and promote healing.
The Probiotic+ SOS Daily Facial Spray is excellent stored in the fridge for added cooling to the skin.
TIP: With any new skincare products, we always suggest patch testing first to ensure no adverse reactions or irritations. Especially for skin suffering from TSW.
@ampernaskin Part 2: Why i created the AMPERNA probiotic line #skincare #bestskincare #skincaretips #acne #trendingskincare ♬ original sound - Amperna® Skincare
Ingredients to Avoid if Suffering from TSW
During Topical Steroid Withdrawal, your skin is extremely sensitive and compromised, so it is important to avoid ingredients that could further irritate, dry out, or damage the skin barrier. Here is a list of ingredients to be cautious with or avoid completely.
1. Fragrance (Synthetic or Natural)
Fragrances, even natural ones like essential oils, can be irritating to sensitive skin and may worsen redness, itching, and inflammation during TSW.
While essential oils are often seen as natural alternatives, they can be potent and cause irritation, especially in higher concentrations. Common ones like tea tree oil, lavender, and eucalyptus can exacerbate sensitivity during TSW if not used carefully.
2. Alcohol (especially Denatured Alcohol or Isopropyl Alcohol)
Alcohol can dry out the skin and strip it of its natural oils, worsening dryness, irritation, and inflammation.
3. Sodium Lauryl Sulphate (SLS)
SLS is a harsh surfactant found in many cleansers and shampoos. It can irritate and dry out the skin by stripping away the natural oils, leading to further sensitivity during TSW.
4. Retinoids (Retinol, Retinoic Acid, Tretinoin)
Retinoids are powerful exfoliants that can increase skin irritation and sensitivity, especially during TSW when the skin is already inflamed and vulnerable.
5. Alpha Hydroxy Acids (AHAs) & Beta Hydroxy Acids (BHAs)
Ingredients like glycolic acid, lactic acid (AHAs), and salicylic acid (BHA) are exfoliants that can cause stinging, peeling, or excessive dryness when your skin is already compromised.
6. Benzoyl Peroxide
Often found in acne treatments, benzoyl peroxide can be very drying and irritating to sensitive skin, making it unsuitable during TSW.
7. Synthetic Dyes & Colorants
Artificial dyes and colorants found in some skincare products can be irritating to already sensitive skin and may increase the risk of flare-ups or allergic reactions.
8. Citrus Extracts or Lemon
Citrus extracts can cause stinging, irritation, and increase sun sensitivity, which may worsen TSW flare-ups.
9. Harsh Exfoliants
Physical exfoliants with rough granules or harsh exfoliating tools can damage the skin and worsen irritation.
10. Elevated levels of Vitamin C (Ascorbic Acid)
While Vitamin C is a potent antioxidant, high concentrations (especially ascorbic acid) can be irritating to already sensitive skin and may cause a stinging or burning sensation during TSW.
11. Petroleum-based Products (like Mineral Oil)
Petroleum products can create a barrier that traps heat, sweat, or bacteria, which might increase irritation and lead to clogged pores.
12. Astringents like Witch Hazel
While witch hazel has anti-inflammatory properties, it can be very drying and irritating when used in high concentrations, particularly for skin during TSW.
During TSW, the goal is to reduce irritation, rebuild the skin barrier, and avoid anything that could exacerbate sensitivity. Keeping your skincare routine gentle, simple, and hydrating will help your skin heal more effectively.
