How Moisturiser Withdrawal help Topical Steroids/Protopic Withdrawal

Moisturiser Withdrawal means withdrawing from the act of moisturising.

Moisturiser Withdrawal (MW) mean more than just quitting Vaseline. MW means withdrawing from the act of moisturising. The list of MW don'ts also includes: no makeup, no sunscreen, no Tubifast, no long bathing and even limitation of drinking water (max. 1000 - 1500ml/day). Depending on your condition, you can fine-tune the MW method : zinc ointment can be good, rough gauze can be used to protect skin

"MW is usually mandatory in the healing process of TSW/PW", say some TSW doctors. They aren't being paranoid about the chemical components in skincare products. They are just convinced that moisturising delays healing during TSW/PW.

Their confidence in the indispensability of MW appears to come from their day-to-day experience rather than clinical hypothesis. For example, Dr. Kenji Sato, a strong advocate of MW, reminisces of the time when he discovered the positive effects of MW while treating his TSW patient and how he thought MW "completes" TSW
. Other doctors agree that MW works.

"No or less moisturizer if you want to advance recovery of the skin barrier."

It wasn't until I read Dr. Fukaya's article Is moisturizing really a help to cure? that I saw scientific evidence in MW. In the article, he introduces data and recommends "no or less moisturizer if you want to advance recovery of the skin barrier." He also explains why moderate water fasting can help healing during TSW/PW: moderate water fasting can increase aldosterone in blood, which can work for anti-inflammation. 

During my full-on TSW/PW, MW helped me heal better than any moisturisers did. This realisation came at the relatively later stage of my TSW/PW, and that was the stage of constant flaking. (my experience here). It was hard, of course, to bid farewell to the moment of peace during TSW/PW. But then, I must admit that after the brief moment of comfort, there always came extreme discomfort of tightness. MW eventually helped me alleviate the tightness. I eliminated everything that can moisturise my skin. Especially no bathing was great. 

After my skin calmed down, I've switched to semi-MW. Most days I still follow the list of MW don'ts - except that I use Dr. Fukaya's skin repair lotion. Some MW doctors may shake their head at it, but Dr. Fukaya claims "it never is a moisturizer." So I chose to believe that it doesn't affect my MW in any major way. 

"There is no need for patients to have anti-moisturiser attitude."

MW-supporting doctors acknowledge the hardness of MW. It can cause strong withdrawal symptoms, although it's usually not as bad as TSW. For this reason, they recommend starting MW with gradual reduction of moisturisers (area and amount). Dr. Kenji Sato adds, "There is no need for patients to have anti-moisturiser attitude (same for topical steroids withdrawal) or to think that you cannot go back to moisturising." 

It's okay to go back to moisturising - if you find MW too hard. Maybe reduce the amount or the area of application if you would like to. You can try MW again when your body is more ready. The same goes for TSW. On the same breath, Dr. Sato does recommend moisturising for atopic dermatitis. And I like that he doesn't dismiss medication. Ultimately the goal isn't mastery of anti-TS (or anti-moisturising) sentiment, nor elimination of TS from the earth, but healing of our skin.

*¹ Sato, K. (2015) Atopic Dermatitis - Treatment of Atopic Dermatitis in Adulthood Learned from Patients [New edition]
*² The following doctors incorporate MW to the TSW treatment: Dr. Kenji Sato, Dr. Mitsuko Sato, Dr. Hajime Kimata, Dr. Satoko Minaguchi, Dr. Jun Yoshizawa, Dr. Shigeki Fujisawa. 

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