tag:blogger.com,1999:blog-16325855072011688592024-03-12T15:58:05.108-07:00Skin of Rose - Topical Steroids & Protopic WithdrawalMy journey through Topical Steroids & Protopic withdrawal, for my own record purpose and hope to get connected with people with the similar conditions.Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.comBlogger47125tag:blogger.com,1999:blog-1632585507201168859.post-44624542000584110272020-01-14T14:41:00.001-08:002020-01-15T12:39:55.065-08:005 Ways Pregnancy Affected My Eczema<div class="separator" style="clear: both; text-align: center;">
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I married my husband 10 years ago. Unlike most of my friends who got married, we held off having a baby. It was because of my topical steroids withdrawal (TSW) and protopic withdrawal (PW), which affected my health so much that having a baby was impossible, at least it felt so. Two years ago, after many years of healing, my husband and I decided to give it a go and 3 months ago I gave birth to a beautiful boy.<br />
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I would like to share how my skin changed during my pregnancy and after giving birth.<br />
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<b>1. Pregnancy made my eczema worse from the second trimester</b></div>
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I cannot remember where I read this (it was a comment from one of the TSW doctors) - apparently, there are three ways eczema reacts to pregnancy: 1) improvement, 2) aggravation, and 3) no change. Each has a 1/3 chance. </div>
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When I discovered that I was pregnant, I had clear skin and great health. Soon, people started commenting on my so-called "pregnancy glow". Sadly, it didn't last. From the 2nd trimester of my pregnancy, I was badly hit by pollen allergy. My skin quickly flared up. It continued to get worse until I gave birth (red, flaky and wrinkly skin, although not as bad as TSW..!). Three different doctors advised me to use topical steroids. There is data indicating a relationship between low birth weight and the use of topical steroids during pregnancy, yet topical steroids are widely considered to be safe during pregnancy. In the end, I was prescribed non-steroidal creams (Eczaid, Vea Olio, Weleda, Sudocream), which I tried but noticed no difference. I look miserable in the pictures taken in the labor room. Yet, I'm happy to let you know that my skin started improving considerably since giving birth and as of now it is pretty back to normal.<br />
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<b>2. Allergy got worse</b></div>
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Many websites say that allergy symptoms can become more severe during pregnancy, which was true in my case. The problem I faced was that the medications I could take during pregnancy were limited. I used to take <i>Bilastin</i>, which kept my allergy under control, but it wasn't supposed to be suitable during pregnancy. My gynecologist prescribed me <i>Polaramin</i>. I also took over-the-counter <i>Loratadine</i>, which is recommended on <a href="https://www.nhs.uk/common-health-questions/pregnancy/can-i-take-hay-fever-medicine-during-pregnancy/" target="_blank">the NHS website</a>. They didn't work so well for me. Unfortunately, as far as I was told by several doctors and midwives, there isn't much help available to relieve the allergic symptoms during pregnancy. </div>
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<b>3. Eczema patches appeared where I never had them</b></div>
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Very itchy eczema patches appeared on my belly (*picture below), fingers and right thigh, where I never had eczema before. They look like typical eczema (not like TSW symptoms), and it gradually spread. It was stubborn, insanely itchy eczema. I'm glad to let you know that they all disappeared naturally after giving birth without using any medications.<br />
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<b>4. Pregnancy made me sweat like crazy</b></div>
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Before pregnancy, I barely sweat even during the height of summer and the hot weather used to improve my eczema. But, the whole summer during pregnancy I sweat like I never did before! It affected my eczema as well as my mood. During the nights I would wake up feeling suffocated, almost giving me panic attacks. This continued until a few weeks after giving birth, when it was already the autumn. Since then, I haven't had the same issue. I'll see how I react in the next summer -I doubt that it'll affect me the way it did. </div>
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<b>5. Relaxation was the best medication for eczema during pregnancy</b></div>
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Pregnancy can be stressful, and stress can trigger eczema. I started taking yoga classes and regularly had massages to alleviate stress. I noticed I didn't scratch when I'm in the yoga class or the massage room. I didn't feel itchy. I kept practicing yoga and taking massage until a month before I gave birth. I can confidently say that both helped me relaxed and heal my skin.<br />
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My family and I are surprised at how much my skin healed after giving birth without any medications. Even my midwife and doctor commented on how I looked better after pregnancy. I probably could've healed much faster if I slept better though - oh well, lack of sleep is a rite of passage for new parents and I feel immensely lucky to be able to experience it.</div>
Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com4tag:blogger.com,1999:blog-1632585507201168859.post-41206169408140389532019-08-22T06:41:00.001-07:002020-03-27T07:56:49.216-07:00Diary of Topical Steroids Withdrawal at Hannan Chuo Hospital 3<div class="separator" style="clear: both; text-align: center;">
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<span style="background-color: white; font-family: "roboto"; font-size: 16px;">This manga piece is created by Yoshimi Numajiri, who was a patient at Hannan Chuo Hospital due to her steroids addiction. The original piece in Japanese can be found on <a href="http://www.hannan-chuo-hsp.or.jp/shinryoka/hifuka/datsusute.html" target="_blank">the hospital website</a>. The comic is written in a Japanese manga style, so please read</span><b style="background-color: white; font-family: Roboto; font-size: 16px;"> from right to left.</b><br />
<span style="background-color: white; font-family: "roboto"; font-size: 16px;">You can click each image to enlarge. </span><br />
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<span style="background-color: white; font-family: roboto; font-size: 16px;">Read more of her comics on TSW:</span></div>
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<span style="background-color: white; font-family: roboto; font-size: 16px;"><a href="https://skinofrose.blogspot.com/2016/03/comic-by-yoshimi-numajiri-her-tsw.html" target="_blank">Diary of TSW at Hannan Chuo Hospital 1</a></span></div>
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<span style="background-color: white; font-family: roboto; font-size: 16px;"><a href="https://skinofrose.blogspot.com/2016/03/comic-by-yoshimi-numajiri-2-mocchis.html" target="_blank">Diary of TSW at Hannan Chuo Hospital 2</a></span></div>
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Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com0tag:blogger.com,1999:blog-1632585507201168859.post-9280349488265706912018-02-22T16:33:00.001-08:002018-02-27T20:34:19.250-08:00Translation of Dr. Sato's TSW method<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgslm7eEmOBnr2pAhxNCbB0hWbKZHej8aPD0CIyu5EQaa7Ri9H4LmfEV7QI254wysekmRytuaANau9-PNfUPREJ6CXpez6k2UhpCWBegnpTJzndmQbYBnVuQrH4ePTiamoyYBVTf48ReYR9/s1600/kenjisato_2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="193" data-original-width="640" height="193" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgslm7eEmOBnr2pAhxNCbB0hWbKZHej8aPD0CIyu5EQaa7Ri9H4LmfEV7QI254wysekmRytuaANau9-PNfUPREJ6CXpez6k2UhpCWBegnpTJzndmQbYBnVuQrH4ePTiamoyYBVTf48ReYR9/s640/kenjisato_2.jpg" width="640" /></a></div>
<br />
I was given the useful website, which summarises Dr. Sato's method of TSW in English.<br />
It's concise and covers the basics of Dr. Sato's TSW method.<br />
<br />
<a href="http://atopic-dermatitis-without-steroid.com/details/">http://atopic-dermatitis-without-steroid.com/details/</a><br />
<br />
x<br />
<br />
<br />
<br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com2tag:blogger.com,1999:blog-1632585507201168859.post-31695504147140435682017-04-02T06:53:00.000-07:002017-04-02T09:23:07.919-07:00How Moisturiser Withdrawal help Topical Steroids/Protopic Withdrawal<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7188AT7mnDCCbS_9zkPQyzl3C582thP3RJnS1vVcYTONDRRlIuNBlWRdGzWzRRqYYiaEmW-9yVwqq0vJ-c1apqy97rTVwC-VlGAgmZACLXXWbxCog8qDzfyKhFF6-H8XSH-EEBnC7GAox/s1600/mw.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7188AT7mnDCCbS_9zkPQyzl3C582thP3RJnS1vVcYTONDRRlIuNBlWRdGzWzRRqYYiaEmW-9yVwqq0vJ-c1apqy97rTVwC-VlGAgmZACLXXWbxCog8qDzfyKhFF6-H8XSH-EEBnC7GAox/s640/mw.jpg" width="640" /></a></div>
<h2>
<span style="background: white; color: #222222;">Moisturiser Withdrawal means withdrawing from
the act of moisturising.</span></h2>
<span style="color: #222222; mso-ansi-language: EN-GB;">
<span style="background: white;">Moisturiser Withdrawal (MW) mean more than just quitting Vaseline. </span></span><span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">MW</span></span><span style="background-color: white; color: #222222;"> means withdrawing from the act of moisturising. T</span><span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">he 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)</span></span><span style="background-color: white; color: #222222;">*¹</span><span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">. Depending on your condition, you can fine-tune the MW method : zinc ointment can be good, rough gauze can be used to protect skin</span></span><span style="background-color: white; color: #222222;">*¹</span><span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">. </span></span><br />
<span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;"><br /></span></span><span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">"MW</span></span><span style="background-color: white; color: #222222;"> is usually mandatory in the healing process of TSW/PW", say <a href="https://skinofrose.blogspot.com.es/2013/09/tsw-event-report-from-japan.html" target="_blank">some TSW doctors</a>. T</span><span style="background-color: white; color: #222222;">hey aren't being paranoid about the chemical
components in skincare products. They are just convinced that moisturising
delays healing during TSW/PW.</span><br />
<span style="color: #222222; mso-ansi-language: EN-GB;">
<br />
<span style="background: white;">Their confidence in the indispensability of MW
appears to come from their day-to-day experience rather than clinical hypothesis. For example,<a href="https://skinofrose.blogspot.com.es/2013/09/another-tsw-doctors-to-know.html" target="_blank"> Dr. Kenji Sato</a>, 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</span></span><span style="background-color: white; color: #222222;">*¹</span><span style="background-color: white; color: #222222;">. Other doctors agree that MW works</span><span style="background-color: white; color: #222222;">*²</span><span style="background-color: white; color: #222222;">.</span><br />
<h2>
<span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">"No or less moisturizer if you want to
advance recovery of the skin barrier."</span></span></h2>
<span style="color: #222222; mso-ansi-language: EN-GB;">
<span style="background: white;">It wasn't until I read Dr. Fukaya's article <i><a href="http://mototsugufukaya.blogspot.com.es/search/label/16%20Is%20moisturizing%20really%20a%20help%20to%20cure%3F" target="_blank">Is moisturizing really a help to cure?</a></i> 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 </span></span><span style="color: #222222;">aldosterone in blood, which can work for anti-inflammation. </span><br />
<br />
<div class="MsoNormal">
<span style="color: #222222; mso-ansi-language: EN-GB;">
<span style="background: white;">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 <a href="https://skinofrose.blogspot.com.es/2012/07/to-moisturise-or-not-to-moisturise.html" target="_blank">here</a>). It was hard, of course, t</span></span><span style="background-color: white; color: #222222;">o bid farewell to the moment of peace during TSW/PW. </span><span style="background-color: white; color: #222222;">But then, I must admit that after the brief moment of comfort, there always came extreme discomfort of tightness.</span><span style="background-color: white; color: #222222;"> MW </span><span style="background-color: white; color: #222222;">eventually </span><span style="background-color: white; color: #222222;">helped me alleviate the tightness. I eliminated everything that can moisturise my skin. </span><span style="background-color: white; color: #222222;">Especially no bathing was great. </span><br />
<br />
<span style="background-color: white; color: #222222;">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 <a href="http://drfukaya.ocnk.net/" target="_blank">Dr. Fukaya's skin repair lotion</a>. Some MW doctors may shake their head at it, but Dr. Fukaya claims "</span><a href="http://mototsugufukaya.blogspot.com.es/search/label/16%20Is%20moisturizing%20really%20a%20help%20to%20cure%3F" target="_blank">it never is a moisturizer.</a><span style="background-color: white; color: #222222;">" So I chose to believe that it doesn't affect my MW in any major way. </span><br />
<h2>
<span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background-color: white;">"There is no need for patients to have anti-moisturiser attitude."</span></span></h2>
<span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">MW-supporting doctors acknowledge the hardness of MW. It can cause strong withdrawal symptoms, although it's usually not as bad as TSW</span></span><span style="background-color: white; color: #222222;">*¹</span><span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">. For this reason, they recommend starting MW with gradual reduction of moisturisers (area and amount)</span></span><span style="background-color: white; color: #222222;">*¹</span><span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;">. 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."</span></span><span style="background-color: white; color: #222222;">*¹</span><span style="background-color: white; color: #222222;"> </span><br />
<span style="background-color: white; color: #222222;"><br /></span>
<span style="background-color: white; color: #222222;">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. O</span><span style="background-color: white; color: #222222;">n the same breath,</span><span style="background-color: white; color: #222222;"> Dr. Sato does recommend moisturising for atopic dermatitis</span><span style="background-color: white; color: #222222;">*¹</span><span style="background-color: white; color: #222222;">. 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.</span><br />
<span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white;"><br /></span></span>
<span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white; font-size: x-small;">*¹ Sato, K. (2015) <i>Atopic Dermatitis - Treatment of Atopic Dermatitis in Adulthood Learned from Patients </i>[New edition]</span></span><br />
<span style="color: #222222; mso-ansi-language: EN-GB;"><span style="background: white; font-size: x-small;">*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. </span></span></div>
Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com1tag:blogger.com,1999:blog-1632585507201168859.post-43147810271596874302017-03-23T12:00:00.001-07:002017-04-09T03:08:01.525-07:00Protopic Withdrawal<div style="background-color: white; margin: 0px;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6qXZzyL42JDkS9ZXTAp2LJm3RaTO1V-5tc8EPyVr104WNrOdwcTNIHXzWjppqW6APQZElqvVoPc1vIcJP3iid_vRNn_FzkREeBb8TYEQuNE98ALiE9WqFDCbm1PL5wr8g-LWCeiVK8pI7/s1600/23march.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6qXZzyL42JDkS9ZXTAp2LJm3RaTO1V-5tc8EPyVr104WNrOdwcTNIHXzWjppqW6APQZElqvVoPc1vIcJP3iid_vRNn_FzkREeBb8TYEQuNE98ALiE9WqFDCbm1PL5wr8g-LWCeiVK8pI7/s640/23march.jpg" width="640" /></a></div>
<br />
When I started my TSW/PW back in 2008, the first few years were a total roller-coaster in the darkness. In recent years, I'm still on that roller-coaster, but in the light - I can see where it's going more or less.</div>
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The pattern of my symptoms has changed over the last 9 years. From oozing crusts to dry patches. From "strange" flares to herpes infections. From the unexpected to the expected. Most notable change of all is that the side effects of tacrolimus, trade name of Protopic(PT), have become more evident than ever, after the TS adverse effects have seemingly gone away.</div>
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<br /></div>
<div style="background-color: white; margin: 0px;">
Protopic is a powerful immunosuppressant with unknown history of long-term effects. The molecular size of PT is bigger than TS. It's invented as an alternative medication for atopic dermatitis to avoid the side effects of TS. My dermatologist prescribed me PT saying, "Unlike steroids, Protopic doesn't have<i> any</i> side effects". Well, he should've elaborated the information more: PT doesn't have the side effects of atrophic skin or capillary dilatation which TS can cause, but comes with other side effects you need to be aware of, and honestly, there isn't much data.</div>
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<br /></div>
<div style="background-color: white; margin: 0px;">
One of the problems of PW is that there isn't much information about it at all. Apparently, there aren't many PW sufferers and even TSW doctors don't often talk about it. The discourse of Red Skin Syndrome is centred around TSW, and PW feels like just a spin-off. This is fair enough. Most people going through PW have used TS at one point in their life. I did too. However, I've always considered myself going through more of PW than TSW. This is because I used TS for only 6 months as it never worked for me, but PT for 2 + years as it worked magic.</div>
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<a href="http://skinofrose.blogspot.com.es/2013/09/another-tsw-doctors-to-know.html" target="_blank">Dr. Kenji Sato</a> says in his book that PW is often more complicated and takes longer to heal than TSW. His data shows that patients who used PT in addition to TS stay hospitalised 5 days longer than the ones with just TS. He also confirms that the PT affected skin is more oozy than TS-affected one.</div>
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<br /></div>
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My main PW symptoms include incessant herpes infections and nerve pain, severe conjunctivitis and fatigue. Basically the low immune system. The most annoying problems have been herpes and nerve pain. Pain is exhausting and often I have no energy. To battle off herpes virus, I have some advice from Dr. Sato and would like to share it in the next post.</div>
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Recent research shows the possible connections of the herpes virus to depression and fatigue (including <a data-saferedirecturl="https://www.google.com/url?hl=ja&q=http://www.med.or.jp/english/pdf/2006_01/027_033.pdf&source=gmail&ust=1490381857968000&usg=AFQjCNFMdfAyKgnlUcpKO92WqS3swY_YVw" href="http://www.med.or.jp/english/pdf/2006_01/027_033.pdf" target="_blank">chronic fatigue syndrome</a>, <a data-saferedirecturl="https://www.google.com/url?hl=ja&q=http://www.marketwired.com/press-release/protein-from-common-smoldering-virus-linked-chronic-fatigue-syndrome-depression-871800.htm&source=gmail&ust=1490381857968000&usg=AFQjCNGFJJZDK1LFCSdyUOywTsCEYQcK7Q" href="http://www.marketwired.com/press-release/protein-from-common-smoldering-virus-linked-chronic-fatigue-syndrome-depression-871800.htm" target="_blank">another article</a>). I always thought my extreme fatigue and depression during the winter was because of my laziness and weakness. But I've reached the point that it only makes sense to me if it's due to the viral infection. As one evidence, the anti-viral tablets seems to alleviate or completely get rid of my mood problems as well as my skin infection.</div>
<br />
<span style="background-color: white;">It is often believed that the side effects of TS cease with time. But, Protopic? I don't have the answer yet. Dr. Sato says that the adverse skin reaction to infections (such as herpes) become less as infections repeat. I hope this to be true, because my PW symptoms haven't improved since I quit.</span><br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com8tag:blogger.com,1999:blog-1632585507201168859.post-79906862775856401842017-02-27T12:07:00.002-08:002017-03-28T13:04:55.580-07:00My 9th anniversary<div class="separator" style="clear: both; text-align: center;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcyPveHJCdgyK0STy_v3q3_Z4MR_z9xfvhjFZ8vLy7vyOVmNCl-K6f-TeC2mFvSoU-ePJiVDt0dO3b9mQDS16Oa2GcyfRCVQHi2gzZrcJxkV-tHMkOq9AWghZr_gEtB-ImQkcyeTV_-TMK/s1600/27feb.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcyPveHJCdgyK0STy_v3q3_Z4MR_z9xfvhjFZ8vLy7vyOVmNCl-K6f-TeC2mFvSoU-ePJiVDt0dO3b9mQDS16Oa2GcyfRCVQHi2gzZrcJxkV-tHMkOq9AWghZr_gEtB-ImQkcyeTV_-TMK/s640/27feb.jpg" width="640" /></a></div>
<br />
My memory is blurry, but I think this month marks the 9th anniversary of TSW/PW. I've been off PT since 2008 and TS since 2011.<br />
<br />
Do I now have a flare-free healthy skin all year around? Unfortunately, no. For example today, I'm basically a red panda. Only during winters, I spend months with the troubles such as eczema, conjunctivitis and eczema herpeticum, though <b>it's nowhere near as bad as the peak of the withdrawal.</b><br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQfgXHbu7KyG7colAyrYTPvHnRFLPfwbNH7UrI3v7KICloH8XI4NLXYUKW5BpQh5QcYjP90wLKvC9YaRZGjS7GSN-gHnaSi-5pz-UTxtJ2g6UEkiJjFHkYmWvKg4fi8Ky0HjbqQhK_iFGO/s1600/27feb2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQfgXHbu7KyG7colAyrYTPvHnRFLPfwbNH7UrI3v7KICloH8XI4NLXYUKW5BpQh5QcYjP90wLKvC9YaRZGjS7GSN-gHnaSi-5pz-UTxtJ2g6UEkiJjFHkYmWvKg4fi8Ky0HjbqQhK_iFGO/s320/27feb2.jpg" width="220" /></a><br />
As far as I understand it, what I'm still struggling against is the condition caused by Protopic. I used TS for 6 months and PT for 2 years. My low immune system, triggering months-long skin malfunctions, has been the problem I get every winter.<br />
<br />
I try to sum up my experiences of the last 9 years, but it doesn't feel right to do it at the moment, because I'm still in the middle of the process, the experiments, the attempts to figure out the best balance between my life and skin. My current projects include taking vitamin D and seeing a psychotherapist, the latter I should've done 9 years ago.<br />
<br />
I don't regret the decision that I started, and continue, the withdrawal. No matter what my skin condition is today, I now understand why it is the way it is. It makes sense to me. I still sometimes feel defeated and hopeless, but I know one thing for sure: it will clear up.<br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com1tag:blogger.com,1999:blog-1632585507201168859.post-50976302995460758942016-08-01T10:11:00.001-07:002017-03-28T15:06:46.460-07:00Updated review on Dr. Fukaya's hyaluronic lotion This is a follow-up review on <a href="http://skinofrose.blogspot.com/2013/06/dr-fukayas-skin-repair-lotion-now.html" target="_blank">Dr. Fukaya's Skin Repair Lotion</a> (as requested by Liz). <br />
<br />
I've been using this lotion since April 2013, and have been very happy with the results.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhleFUhEziJqEQ0czh8pxxsjbRNkrWvYSfLt6ptcn9UsY-cAhvjeCxaz2lhe3wruW9ZPDcUn5Xf2KmAFcc9arzJBWHaGn1wWHeXgqhq37yiyiphXMNl1dCRBNv74MDlDtAKBA6AjCEV5qAN/s1600/photo(1).jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhleFUhEziJqEQ0czh8pxxsjbRNkrWvYSfLt6ptcn9UsY-cAhvjeCxaz2lhe3wruW9ZPDcUn5Xf2KmAFcc9arzJBWHaGn1wWHeXgqhq37yiyiphXMNl1dCRBNv74MDlDtAKBA6AjCEV5qAN/s640/photo(1).jpg" width="640" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtCd_RCSIG42Z2m4j_7ckUOG9J78-3Ey4xQw9D2TyevlSzsbf5n1dtE8vzejOQKfN4y1ryCVrcmKh0jg2RfYUHl7_KiRVy3H9dMAzS4W4amOQklzOJyHgyOKlHKw9FUm3ZFufqP9lCwdkv/s1600/recent.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="253" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtCd_RCSIG42Z2m4j_7ckUOG9J78-3Ey4xQw9D2TyevlSzsbf5n1dtE8vzejOQKfN4y1ryCVrcmKh0jg2RfYUHl7_KiRVy3H9dMAzS4W4amOQklzOJyHgyOKlHKw9FUm3ZFufqP9lCwdkv/s320/recent.jpg" width="320" /></a></div>
<br />
No filter, no makeup. <br />
My skin is a lot thicker, the skin tone is more consistent - generally healthier! <br />
Dr. Fukaya's lotion is the only skincare product I've been using for my skin - I use it twice a day, or sometimes just once. I buy a big bottle (150ml) as it works out cheaper, but also have a small one (30ml) ready for travel. <br />
<br />
What I'm also happy about is that it doesn't seem to interfere with my moisturiser withdrawal. I don't have any drying-up feeling after shower even when I skip the lotion. My skin seems pretty happy on its own. <br />
<br />
I have been having seb derm in recent years (you see a tiny patch under my right eye) but the lotion doesn't exacerbate or irritate it. I've been finding it nice and safe on my skin.<br />
<br />
If you are interested, you can find more about the lotion on the official Dr. Fukaya's online shop <a href="http://drfukaya.ocnk.net/">http://drfukaya.ocnk.net/</a><br />
<br />
That's all folks!Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com7tag:blogger.com,1999:blog-1632585507201168859.post-79618734165850542952016-07-06T07:00:00.002-07:002017-03-29T10:18:15.412-07:00Improvement rate of Atopic Dermatitis: Research results!<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4HRnbWQIWCE4tSiuemP6ERoZ5QPJrF72zqLA5GlGNg5e7Hselma49tTXKLCuCctG4D8TYFpdte_PsyoWTL6gjuTpGVDcJ9aNHlK9q25_tUaU9I1ZoPjurzcCraHdYTz4O_BYlWTpN4nPx/s1600/blog3.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4HRnbWQIWCE4tSiuemP6ERoZ5QPJrF72zqLA5GlGNg5e7Hselma49tTXKLCuCctG4D8TYFpdte_PsyoWTL6gjuTpGVDcJ9aNHlK9q25_tUaU9I1ZoPjurzcCraHdYTz4O_BYlWTpN4nPx/s640/blog3.jpg" width="640" /></a></div>
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<br />
Eight TSW doctors have released the new study paper on the progression and improvement rate of atopic dermatitis (AD) without steroids. It was conducted last year (<a href="http://skinofrose.blogspot.com.es/2015/02/tsw-docs-start-new-project-in-japan.html" target="_blank">here</a>) and the results are finally in! <br />
<br />
The improvement rate was shown in three age categories:
under 2 yrs old (infants), 2 - 11 yrs old (children) and 12 yrs old +
(adults). Each rate was compared to the study by Dr. Furue et al in 2003,
which shows the improvement rate of atopic dermatitis with steroids.<br />
<br />
It has to be taken into account the fact that two studies were conducted at a different time & place, by different raters. Yet, the data and what they indicate are very interesting. <br />
<br />
Read the full study paper <a href="https://www.dovepress.com/articles.php?article_id=27740" target="_blank">here</a>.<br />
<br />
If you just want to look at the numbers, Dr. Sato has shared us the power point document for that.<br />
<a href="https://www.dropbox.com/s/xd1dlzcdnlvkdyw/translated_comparison.pptx?dl=0" target="_blank">https://www.dropbox.com/s/xd1dlzcdnlvkdyw/translated_comparison.pptx?dl=0 </a><br />
<br />
In a nutshell, the results look like this: <br />
<iframe allowfullscreen="" frameborder="0" height="360" mozallowfullscreen="" src="https://player.vimeo.com/video/172575812?title=0&byline=0&portrait=0" webkitallowfullscreen="" width="540"></iframe>
<br />
Just for your information, Dr. Furue (one of the authors of the study with steroids) is the main author of Japan's AD treatment guideline, which sets topical steroids as the first choice for AD treatments in the country. <br />
<br />
TSW doctors have been requesting for ages to change this guideline to give patients a choice of non-steroids treatments. Unfortunately, the recent revision of the guideline did not acknowledge this (more details <a href="http://skinofrose.blogspot.com.es/2016/03/new-atopic-dermatitis-treatment.html" target="_blank">here</a>) in spite of their clinical reasoning and 16,112 signatures from patients, doctors, parents and families, not to mention the growing TSW communities worldwide.<br />
<br />
The study paper ends by referring to negligence. A mother was rejected for a consultation by a dermatologist because she refused to use topical steroids on her baby, and accused of negligence. The authors believe that it is such dermatologist's attitude which is negligence. Sadly, from my own experience this type of dermatologists is common in Japan. "No steroids, no medical help", how unprofessional. <br />
<br />
I hope many people have a look at the study paper and learn that there
are a number of cases where topical steroids are unnecessary to treat
AD.<br />
<br />
Last but not least, I thank the doctors who contributed their fund, time and efforts for this insightful study! <br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com1tag:blogger.com,1999:blog-1632585507201168859.post-73063401367713677092016-03-26T09:52:00.001-07:002017-03-29T10:19:46.315-07:00Diary of Topical Steroids Withdrawal at Hannan Chuo Hospital 2<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTHQDPPf3aplfyMVvbdC6W-PsqH4ywiFl5qUJougsnNR6jq1NPXW5a83SKj06N0C_lgtPiQBZVCOxHu3xa3AkfnzWMibwmAlRFk7tv1nBN1GH06VCN_MRPw4gY4yOyj4H7QPc1qh3fE2VF/s1600/mocchi.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTHQDPPf3aplfyMVvbdC6W-PsqH4ywiFl5qUJougsnNR6jq1NPXW5a83SKj06N0C_lgtPiQBZVCOxHu3xa3AkfnzWMibwmAlRFk7tv1nBN1GH06VCN_MRPw4gY4yOyj4H7QPc1qh3fE2VF/s640/mocchi.jpg" width="640" /></a></div>
<br />
Here is the second episode of Ms. Numajiri's comics on TSW. This episode is based on the interview with a patient, 36 years old man who used topical steroids for 30(+?) years. He is one of the patients of Dr. Sato and now fully recovered. <br />
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The comic is written in a Japanese manga style, so please read<b> from right to left, top to bottom.</b><br />
You can click each image to enlarge. <br />
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Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com2tag:blogger.com,1999:blog-1632585507201168859.post-21193195727310877992016-03-20T15:59:00.001-07:002017-03-29T10:18:37.856-07:00New Atopic Dermatitis treatment guideline in Japan <div class="separator" style="clear: both; text-align: center;">
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The Japanese Dermatological Association(JDA) published <a href="https://www.dermatol.or.jp/uploads/uploads/files/guideline/atopicdermatitis_guideline.pdf" target="_blank">the latest guideline for atopic dermatitis (AD) treatment</a> last month. It's been 7 years since the last version was released in 2009, and in spite of the constant hard work of TSW doctors in Japan along with <a href="https://www.change.org/p/%E3%82%A2%E3%83%88%E3%83%94%E3%83%BC%E6%82%A3%E8%80%85%E3%81%AB%E6%B2%BB%E7%99%82%E6%B3%95%E9%81%B8%E6%8A%9E%E3%81%AE%E8%87%AA%E7%94%B1%E3%82%92-%E3%82%A2%E3%83%88%E3%83%94%E3%83%BC%E6%80%A7%E7%9A%AE%E8%86%9A%E7%82%8E%E8%A8%BA%E7%99%82%E3%82%AC%E3%82%A4%E3%83%89%E3%83%A9%E3%82%A4%E3%83%B3-%E6%94%B9%E8%A8%82%E3%82%92%E8%A6%81%E6%B1%82%E3%81%97%E3%81%BE%E3%81%99/u/8335984" target="_blank">the petition by ATOPIC</a>, <b>topical steroids addiction (TSA) was not acknowledged in the guideline.</b> It's a shame, not just because the guideline didn't raise the problem of TSA, but for many more reasons. <br />
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Firstly, the latest guideline continues to recommend topical steroids and tacrolimus ointment (topical calcineurin inhibitor, eg. protopic) to treat AD, as their "effectiveness and safety are scientifically well proven". It also encourages <i>the proactive treatment</i> for recurring rash - the regular application (twice a week) of topical steroids or tacrolimus onto clear skin to prevent the recurring inflammation. By this, the guideline is practically promoting to use larger amount of topical steroids/tacrolimus on, what I assume, the majority of the patients as AD is a chronic condition.<br />
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Secondly, in the section of <i>Handling fear of steroids</i>, the guideline says that the poor results are often due to "misunderstanding of topical steroids (commonly confusions with the side effects of oral steroids, and between the exacerbation of AD and the side effects of topical steroids)". This last part of the sentence means that JDA would likely to diagnose the topical steroids addiction as the exacerbated AD (which comes with more prescriptions of topical steroids and/or tacrolimus ointment).<br />
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Also, for tacrolimus ointments the guideline says that it is almost equal to the strong class topical steroids (0.1% tacrolimus for adults on body and extremities). It also advises to use the very strong class topical steroids to improve the rash before switching to tacrolimus. The guideline doesn't emphasise the safety of tacrolimus as much as they do for topical steroids as apparently they acknowledge the risk, yet it still holds a place of a good plan B treatment in case topical steroids don't work (and you still need to try the highest potency topical steroids to know this).<br />
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As a patient, when the guideline is like this, it's difficult for me to see a dermatologist for any issues, because I know that they'll see my skin and tell me to use topical steroids/tacrolimus and will be a problem when I say no. For example, this week I've had a wide area of herpes infection on my face. The following picture doesn't show the whole image but you can see what's going on. This is the side effect of tacrolimus ointment (Protopic), which I haven't used since 2008. Still now, I have the outburst of herpes infection (large area on face) at least once or twice every year, and cold sores almost every month. With the terrible headache and pain I've had this week, I thought of going to a dermatologist - then felt my inner struggle and distrust so strongly that I just couldn't go. And this is not good - what if I'm in circumstances where I actually need to see a doctor, and not seeing a doctor does more harm to me? <br />
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At the release of the guideline, <a href="http://steroid-withdrawal.weebly.com/2087712403352012639526360124342555220986123751241412377.html" target="_blank">Dr.
Fukaya has acted quickly and been preparing to submit the request to
JDA asking to refer to the important side effects of topical steroids</a> (English version at the bottom of his post).<br />
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Some of my readers wrote to me before that Japan is advanced when it comes to TSA/W, but the reality is not easy. We are just lucky to have some hard working TSW doctors. Still a long way to go. <br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com4tag:blogger.com,1999:blog-1632585507201168859.post-87459783223902574092016-03-16T16:02:00.002-07:002018-01-25T10:40:46.975-08:00Diary of Topical Steroids Withdrawal at Hannan Chuo Hospital<div class="separator" style="clear: both; text-align: center;">
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I would like to share a comic by Ms. Yoshimi Numajiri, who tells her experience at Hannan Chuo Hospital in 2012. She is a professional Japanese comic artist and spent 40 days in a hospital for topical steroids withdrawal. Hannan Chuo Hospital is one of the few (perhaps only) hospitals in Japan, where you can stay for TSW. I've written about <a href="http://skinofrose.blogspot.com.es/2014/10/consultations-with-dr-sato-at-hannan.html" target="_blank">the hospital</a> several times on my blog along with <a href="http://skinofrose.blogspot.com.es/2013/09/another-tsw-doctors-to-know.html" target="_blank">Dr. Kenji Sato</a>.<br />
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Sometimes I've wished that there was an actual TSW village, where you can spend your entire recovery time with fellow patients. I think Hannan Chuo Hospital is the closest to it. It's interesting to look at it through Ms. Numajiri's eyes, and certainly, there are many details which we can relate to.<br />
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The comic is written in a Japanese manga style, so please read<b> from right to left, top to bottom.</b><br />
You can click each image to enlarge. Hope you enjoy it! <b> </b><br />
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<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com6tag:blogger.com,1999:blog-1632585507201168859.post-22938476682606876142016-02-03T12:08:00.001-08:002017-04-01T13:52:49.469-07:00Dr. Fukaya's new article: cortisol production and topical steroids<div class="separator" style="clear: both; text-align: center;">
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Just a quick post to share Dr. Fukaya's article on the relationship between the production of cortisol and topical steroids. The article has some patients' pictures and shows how the different stages of TSW present distinctive formations of skin. It is a very interesting illustration of the TSA mechanism. <br />
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You can download for free from <a href="http://link.springer.com/article/10.1007%2Fs13555-016-0096-7" rel="noreferrer" target="_blank">http://link.springer.com/<wbr></wbr>article/10.1007%2Fs13555-016-<wbr></wbr>0096-7</a><br />
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<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com0tag:blogger.com,1999:blog-1632585507201168859.post-7135647815254504342015-06-19T08:36:00.001-07:002017-03-29T10:18:26.917-07:00Atopic Dermatitis = the decreased patchy cortisol production in epidermis?<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuFYwSNJvCH6x_BRjEcjn2y2ic0QGCxQoWWsm_KAqC1LJd3Z338DfPTpFafy9vQhrlGGO_gEmCqpcRIfAchPrjByMz8yL4W4b9WaX9Y3vxoK8NMoUrn1aK0kWc9wOfotEZl9pOpHVdfamf/s1600/fukaya1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuFYwSNJvCH6x_BRjEcjn2y2ic0QGCxQoWWsm_KAqC1LJd3Z338DfPTpFafy9vQhrlGGO_gEmCqpcRIfAchPrjByMz8yL4W4b9WaX9Y3vxoK8NMoUrn1aK0kWc9wOfotEZl9pOpHVdfamf/s640/fukaya1.jpg" width="640" /></a></div>
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<br />
Dr. Fukaya has posted a new article on his Japanese blog. <br />
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<b>Atopic eczema can be the decreased patchy cortisol production in epidermis</b><br />
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The below picture is a dyed adrenal gland - the brown areas show that there are cortisol, which are found plenty in the cortical cytoplasm.
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/8150647_orig.jpg" style="max-width: 100%; width: auto;" /><br />
The picture below is dyed skin. Epidermis is certainly dyed, and in this case especially hair follicles are strongly tinted.
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/2583588_orig.jpg" style="max-width: 100%; width: auto;" /><br />
This one below is my skin. The epidermal cells are evenly dyed.
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/7768792_orig.jpg" style="max-width: 100%; width: auto;" /><br />
If you test on people with atopic eczema, however, some areas are not dyed at all. There are the parts where still produce steroids, but only in patches. This picture below is from a patient, who has withdrawn from topical steroids for a long time.
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/1538551_orig.jpg" style="max-width: 100%; width: auto;" />This can explain the clinical condition of atopic dermatitis.<br />
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<b>Steroids help to make skin thin and differentiated. Therefore, when epidermis stops producing steroids, it becomes thickened. Steroids are also thought to adjust and lessen reactions to external stimulus and allergens. So, without steroids, skin inflammation increases. It results in more intense immune reaction and non-specific hypersensitive reaction. </b>
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This picture below is from a different patient, who has been using topical steroids everyday for a few years to suppress atopic dermatitis. It shows that the epidermis isn't thickened, and cortisol production isn't patchy. Topical steroids are helping to increase the cortisol level in epidermal cells. As a result, the cortisol is evenly produced, although I think that the cortisol production would be patchy without using topical steroids. This is possibly the benefit of topical steroids treatment.
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/8179569_orig.jpg" style="max-width: 100%; width: auto;" /><br />
But, a different part shows the deficiency in the cortisol production as in the picture below.
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/3317257_orig.jpg" style="max-width: 100%; width: auto;" /><br />
It is noteworthy that another patient showed the patchy cortisol levels when his skin was worse,
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/5249091_orig.jpg" style="max-width: 100%; width: auto;" /><br />
but the cortisol production becomes even when his skin was improved (supposedly natural healing, as he has not been using topical steroids).
<img alt="Picture" src="https://steroid-withdrawal.weebly.com/uploads/3/7/9/4/37940495/1316486_orig.jpg" style="max-width: 100%; width: auto;" />
This is only my hypothesis, but from all those cases, I think:
<b>Atopic eczema is the decreased patchy cortisol production in epidermis, therefore epidermis becomes thickened and cannot fully differentiated. Also, it cannot control external stimulus and allergens with self-produced cortisol, which results in skin inflammation. </b><br />
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Although topical steroids help to produce cortisol in epidermis and make skin seemingly normal, it could be the case that epidermis stops responding to topical steroids after a long term use. <br />
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When epidermis cells create more cortisol by application of topical steroids, nearby epidermis cells also respond to produce more cortisol. If epidermis stops corresponding to topical steroids, those nearby cells also function less and eczema would be worse. This can be interpreted as "rebound".<br />
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Also, <b>the mechanism of natural healing can be the evenly produced cortisol.</b> So-called "moisturiser withdrawal", which helps to increase the cortisol level in epidermis, may be working to make the cortisol production evenly. UVB radiation also helps to increase cortisol in epidermis, so it makes sense to use as a treatment for atopic eczema.<br />
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This hypothesis can explain various phenomana related to atopic eczema, but it is still a hypothesis. There are only a small number of cases yet and it requires further validation with testing on varied types of skin rash.
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Dr. Fukaya is now looking into his hypothesis further, by calling for volunteer participants to collect more test cases in Japan. I will update when more info comes. Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com4tag:blogger.com,1999:blog-1632585507201168859.post-71899548082323607332015-06-16T11:43:00.002-07:002017-03-23T15:31:56.234-07:00Eczema Herpeticum<div class="separator" style="clear: both; text-align: center;">
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Do you have eczema?<br />
Are you going through TSW or PW?<br />
Have you ever had a cold sore?<br />
<br />
If yes to these tree questions, this post is for you.<br />
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You may have never heard of Eczema Herpeticum (EH). <a href="http://www.bad.org.uk/site/1466/Default.aspx" target="_blank">The British Association of Dermatologists </a>defines EH as 'a widespread, potentially serious infection of the skin that can affect people with atopic eczema'. The cause of EH is herpes simplex, which is the same virus that causes cold sores. I understand EH as more severe version of cold sore.<br />
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We, eczema sufferers, need to be careful as we are more susceptible to EH. But dealing with the EH is actually a lot easier than TSW. I got EH in 2008 and was hospitalised for 2 weeks. And, I would like to share with you my experience and the treatment I was given. I made some mistakes in the initial treatment of EH. So, hopefully by reading my story, you won't make the same mistake. And, if you should ever get one, you know what to do.<br />
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Alright, here is my story.<br />
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At the second month into my first TSW/PW, I noticed a bunch of small blisters on my face. I thought it was just a normal withdrawal reaction, so ignored them at first. A few days later, I started thinking that there was something weird about those blisters. They were spreading too aggressively and too quickly. I had fever as well. I went to see a GP after waiting for a week to get my appointment (*my first mistake, shouldn't have waited so long). I was diagnosed with EH, and prescribed with antibacterial cream. I applied the cream, but the next morning it was spreading even more. I felt that my EH was too severe to treat with just the cream. So, I went back to the doctor. As soon as the GP saw me (a different GP from the day before), she started making arrangements for my hospital admission. <br />
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During my stay at the NHS hospital, I was given a private room to avoid any contacts with other patients because EH was highly contagious. I wasn't allowed to leave the room at all. I was injected with antiviral twice a day. Nurses put a thick layer of moisturiser on my face during the injection. I also took anti-histamine tablets and anti-allergy tablets. I was worried if they were going to make me use TS. This never happened, as TS had adverse effects to herpes virus.<br />
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After 2 weeks, my EH was all cleared without a scar. To my surprise, my eczema and withdrawal symptoms disappeared too at this point. That means my first TSW/PW only took me about 2 months to heal up. I still don't know why my eczema and withdrawal reaction went away with EH. I can only guess that the antivirals did something to it. I've got before/after photos : a day before I was hospitalised (April 2008) and one month later (June 2008). <br />
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Note: The before photo is pretty graphic:<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCeHionxSJX0Q6g5YnVFn5SsaKinLuXNIyw25BXeUw1ZIVR80F4ricbXrSrK9BMcjebCgkDUVOnTcvEQPsFJSJRuAMsH4ipgLdTvF3oFz_BRQuGWVvJ9drKkqDEGIZI5KZjYFefVMKuxTq/s1600/eh_pic.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="143" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCeHionxSJX0Q6g5YnVFn5SsaKinLuXNIyw25BXeUw1ZIVR80F4ricbXrSrK9BMcjebCgkDUVOnTcvEQPsFJSJRuAMsH4ipgLdTvF3oFz_BRQuGWVvJ9drKkqDEGIZI5KZjYFefVMKuxTq/s200/eh_pic.jpg" width="200" /></a></div>
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You may think that taking only 2 months to recover from TSW was very lucky. Not really. After my first TSW/PW and EH, I was traumatised. Here comes the next problem - I became addicted to the antiviral tablets (*my second mistake). When I left the hospital, I was given several boxes of Aciclovir 400mg. I took two tablets daily. When I was about to run out the Aciclovir, I went panic. I managed to get more Aciclovir from my GP and kept taking them for 6 months. After I finally stopped, I got all flared up which was my second rebound. <br />
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So, here are somethings I learnt from dealing with my EH: <br />
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1. If you think you got EH, go to your doctor (or A&E if severe) immediately. They know what to do and won't use TS on you.<br />
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2. When treated correctly, EH will simply go away. I found EH a lot easier to deal with compared to TSW.<br />
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3. If you have a minor cold sore, you don't generally need to see a doctor. Just use behind-the-counter drugs like Zovirax and it usually goes away within 2 weeks.<br />
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4. If you have EH or cold sore and worried about scars, don't worry. Strangely, they never leave any scars afterwards no matter how severe they are.<br />
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5. If you are an adult and get cold sore for the first time, the symptoms may become severe including fever etc.<br />
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That is it for today! x<br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com4tag:blogger.com,1999:blog-1632585507201168859.post-19829776768019540702015-02-03T07:11:00.002-08:002018-01-21T03:12:06.655-08:00TSW docs start a new project in Japan<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTrUyiqLZOXj-zE0tPzlKuzwloVY7M4sksX_2KcVFkz_hlx2QLIChUYH8I6BUytflLPbcpwneKWw_PouZ3Xxf-khBgauzGWybKpfN31ALRcgC2vDV3AM7NFZN2ccsfHve6K4aI_fz6YOeU/s1600/tswdocs.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTrUyiqLZOXj-zE0tPzlKuzwloVY7M4sksX_2KcVFkz_hlx2QLIChUYH8I6BUytflLPbcpwneKWw_PouZ3Xxf-khBgauzGWybKpfN31ALRcgC2vDV3AM7NFZN2ccsfHve6K4aI_fz6YOeU/s640/tswdocs.jpg" width="640" /></a></div>
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While catching up with Dr. Fukaya's blog posts, I found about the new project TSW docs started this year in Japan. It's good news and I thought that I'd share!<br />
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On 1st January 2015, six TSW docs initiated the project to clinically observe and evaluate the progress of TSW over 6 months. So far, there are 8 clinical institutions participating across Japan. They are going to check how your eczema changes over 6 months during TSW as well as redness and skin atrophy.<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6i6ojovIKCO8tPGXZODmSSaRfFBaCWNPZoZ7ybIsBcl63SkWn6aArXPo1CoFJNB-9O_M7ehmN-sqgq8Rta5MkWOWv4Qk4vdBTe_bUIDbpwztRb8T2PhTlw1qXHBXTBVQM8jW1ltq2-vOy/s1600/4264742.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6i6ojovIKCO8tPGXZODmSSaRfFBaCWNPZoZ7ybIsBcl63SkWn6aArXPo1CoFJNB-9O_M7ehmN-sqgq8Rta5MkWOWv4Qk4vdBTe_bUIDbpwztRb8T2PhTlw1qXHBXTBVQM8jW1ltq2-vOy/s1600/4264742.jpg" width="231" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">a leaflet for the clinical assessment</td></tr>
</tbody></table>
<a href="http://steroid-withdrawal.weebly.com/1247312486125251245212489124342035129992123751239412356124501248812500125402461530382331782881412398320763694235519266191239512372213322114712367123841237312356.html" target="_blank"><br />Dr. Fukaya says</a> that they are hoping to see 200 patients over a year and get more docs and clinical institutions involved in the assessment. The results will be published in journal. The assessment is registered with Clinical Trials Registry and funded by the docs themselves (no commercial, third-party funds involved).<br />
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Here is the list of the participating docs and clinics/hospitals, in case you're wondering:<br />
<br />
Dr. Mototsugu Fukaya (Tsurumai Koen Clinic - City: Nagoya)<br />
Dr. Mitsuko Sato (Sato Shonika - City: Osaka)<br />
Dr. Kenji Sato & Dr. Takahiro Yamada (Hannan Chuo Hospital - City: Osaka)<br />
Dr. Hajime Kimata (Kimata Hajime Clinic - City: Osaka)<br />
Dr. Shigeki Fujisawa (Fujisawa Hifuka - City: Tokyo)<br />
Dr. Haruhiko Dozono (Dozono Medical House - City: Kagoshima)<br />
Dr. Jun Yoshizawa (Yoshizaka Hifuka - City: Kanagawa) <br />
Dr. Satoko Minaguchi (Ageo Futatsumiya Clinic - City: Saitama)<br />
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I admire their efforts and dedication to start this project, and it's wonderful to see the TSW docs are all united to work towards the same direction.<br />
(You can also see a lovely picture of the six TSW docs on Dr. Fukaya's blog: <a href="http://steroid-withdrawal.weebly.com/33073124731248612398208082998312383123851236421517214762362712395385981241412426124141237512383.html" target="_blank">here</a>)<br />
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I personally think that one of the hardest things you face during TSW is the feeling of not knowing what you're doing is right - which comes from the lack of the clinical evidences that shows that TSW is a valid, working method. I cannot wait to see the results!<br />
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Wishing everyone happy healing.<br />
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x<br />
<br />
<span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"></span></span></span></span></span></span></span></span></span><br />
<span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"><span style="color: #415161; font-style: normal; font-weight: 400; text-decoration: none;"></span></span></span></span></span></span></span></span></span></span>Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com4tag:blogger.com,1999:blog-1632585507201168859.post-86162595425316908122015-01-19T08:21:00.000-08:002017-03-25T15:59:40.837-07:00Quick update<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjehE_p2nOsbzJeXgEVD9BIJrylht_RFaUcWs4SdQ9uYRa0oPF46PLUXsEWTSlClteQntgdnYEG3k20ri6XYGxXO_57hGQ_EVP7Z1UbJsZtcr8W2dPPgHsaZVtuOXMOmzI44mWLkJViaO55/s1600/1901.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjehE_p2nOsbzJeXgEVD9BIJrylht_RFaUcWs4SdQ9uYRa0oPF46PLUXsEWTSlClteQntgdnYEG3k20ri6XYGxXO_57hGQ_EVP7Z1UbJsZtcr8W2dPPgHsaZVtuOXMOmzI44mWLkJViaO55/s640/1901.jpg" width="640" /></a></div>
<br />
<br />
Just a quick update for myself.<br />
<br />
My skin has been okay. The only thing is that over the last few weeks I've been itching my face and can actually see some red patches. I suspect that it is no longer the withdrawal reaction, but Seb Derm.<br />
<br />
Compared to the same time last year, the general condition of my skin is better. But, as the last few years confirmed, my skin gets worse during winter and better in spring/summer. The same thing seems happening this year too.<br />
It's hard to generalise my current skin condition, as it changes everyday (sometimes every hour!). <br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9zAq_j2Szen68Mtu_yZjgG4mjsC1gYxZM5w5YMRMkQpKh9T0sEnHVkuekoTSewAHcllbgCmLQBa8j5I8KpYU_DyidqTqKrrVgeVbwatqErRVfYkksFUvRp_tRbzP6NNwM95mCoXO6Zh1d/s1600/pic1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9zAq_j2Szen68Mtu_yZjgG4mjsC1gYxZM5w5YMRMkQpKh9T0sEnHVkuekoTSewAHcllbgCmLQBa8j5I8KpYU_DyidqTqKrrVgeVbwatqErRVfYkksFUvRp_tRbzP6NNwM95mCoXO6Zh1d/s1600/pic1.jpg" width="200" /></a></div>
19/01/2015 (today)<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOC92WyeE5CK04C_h8gJgTaTMz7inVHAPFPqKZgdihQ8y88wan8w3jfVvAC0cMuoWz8vhTnUuFABI0eazi7z8TE5-yzWORKO7QJwaKO1aVC7yqg5sH3WXhlOPV_DzvSy6ZkQAka5eSIh9t/s1600/pic2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOC92WyeE5CK04C_h8gJgTaTMz7inVHAPFPqKZgdihQ8y88wan8w3jfVvAC0cMuoWz8vhTnUuFABI0eazi7z8TE5-yzWORKO7QJwaKO1aVC7yqg5sH3WXhlOPV_DzvSy6ZkQAka5eSIh9t/s1600/pic2.jpg" width="155" /></a></div>
20/01/2014 (last year)<br />
<br />
<br />
I've been feeling that I should probably re-think my skin tactics as now I've got a different problem, Seb Derm. Not sure how to tackle this yet, but hopefully I'll find out...<br />
<br />
Hope 2015 will be a better year for everyone.<br />
<br />
xTommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com0tag:blogger.com,1999:blog-1632585507201168859.post-87967358836889267302014-10-31T11:30:00.001-07:002017-03-24T15:15:36.966-07:00Consultations with Dr. Kenji Sato<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9RIi3pU2NrnY7wze8H-g9xhYQFz3ZJNLXW-lV6h68hABpS0H8taiMnPSaLt5By3RH_FXcC6tqJV1iEgou84dx2ePRyx6ec-0Gt4xlZaAua8f2KLn-6sc90MBVJwUXN3EuSw3TML_8Fp0n/s1600/kenjisato.jpg" imageanchor="1" style="clear: left; display: inline !important; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9RIi3pU2NrnY7wze8H-g9xhYQFz3ZJNLXW-lV6h68hABpS0H8taiMnPSaLt5By3RH_FXcC6tqJV1iEgou84dx2ePRyx6ec-0Gt4xlZaAua8f2KLn-6sc90MBVJwUXN3EuSw3TML_8Fp0n/s640/kenjisato.jpg" width="640" /></a></div>
<br />
I've been receiving some questions regarding visiting Dr. Kenji Sato.<br />
I forwarded the questions to him and he kindly gave me a response.<br />
<br />
<i>"Currently, because of time constraints and my English ability, it is difficult to consult with patients from overseas via emails or telephone. I think, however, consultations in person would be possible.</i><br />
<i><br /></i>
<i>I would only be able to see one patient each month on Wednesday for an hour (at Hannan Chuo Hospital in Osaka). I would like to have the summary of a patient's skin history and any questions they may have in advance, so that we can spend the time efficiently. If a patient can provide me with some pictures of their skin, that would be helpful too."</i><br />
<br />
Dr. Sato added that he has little experience examining patients from overseas, so he may need some time to get used to it. <br />
<br />
<b>The address of Hannan Chuo Hospital</b><br />
3-3-28 Minami Shin Machi, Matsubara, Osaka 580-0023 Japan<br />
(The closest station is Nunose Station on Kintetsu Minami Osaka Line)<br />
<br />
<b>Website</b><br />
http://www.hannan-chuo-hsp.or.jp/<br />
<br />
<b>Email</b><br />
<span style="font-family: "ms ui gothic"; font-size: x-small;"><a href="mailto:jimukyoku@hannan-chuo-hsp.or.jp" style="background-color: white; color: #1155cc; font: 14px arial,sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;" target="_blank">jimukyoku@hannan-chuo-hsp.or.j<wbr></wbr>p</a></span> <br />
<br />
<b>Telephone</b><br />
<table class="ts intrlu" style="width: 100%px;"><tbody>
<tr><td valign="top"><nobr>+81 72-333-2100</nobr></td></tr>
</tbody></table>
<br />
<iframe frameborder="0" height="300" src="https://www.google.com/maps/embed?pb=!1m14!1m8!1m3!1d1642.5855868128308!2d135.5364317!3d34.57453510000003!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x6000d9684871bf57%3A0xa7182755f57cfaea!2z5pel5pysLCDlpKfpmKrlupzmnb7ljp_luILljZfmlrDnlLrvvJPkuIHnm67vvJPiiJLvvJLvvJg!5e0!3m2!1sja!2suk!4v1414158246504" style="border: 0;" width="400"></iframe>
<br />
<br />
Hope this helps.<br />
<br />
xTommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com6tag:blogger.com,1999:blog-1632585507201168859.post-70665366663126326162014-10-17T15:23:00.000-07:002017-03-29T10:20:03.719-07:00Month 36 <div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsINHFroq2cprllun5K6Awmhi7LKn3iHtl8dGXHv7yxZ27hpB1-EjucRbgVWw7Gs2d17tnGui_4wS_4soIqnRWjxI748llA9Iv2DFJAdzdsqJCgNSKLv65JfY27h0_J8lZHU5d_L45LmT8/s1600/2914.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsINHFroq2cprllun5K6Awmhi7LKn3iHtl8dGXHv7yxZ27hpB1-EjucRbgVWw7Gs2d17tnGui_4wS_4soIqnRWjxI748llA9Iv2DFJAdzdsqJCgNSKLv65JfY27h0_J8lZHU5d_L45LmT8/s640/2914.jpg" width="640" /></a></div>
<br />
It's been 3 months since my last post. I'm nearly 36 months into my last TSW.<br />
The past 3 months have flown away so quickly, I only now noticed that I got some comments and questions from my dear readers (I will reply very soon!).<br />
<br />
Some of the comments were about how I'm doing now.<br />
Well, I've been doing well! I still have dry patches on my face, but it's not red anymore.<br />
And, I think that it doesn't stand out. My life is all back to normal! <br />
I took a quick pic on my iPhone to give you some ideas on how my skin looks like at the moment.<br />
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbPwDUZ9vVAL6tiDW97dyYvKS7cSxgbSPgaOpFLzdvSUIPJb9EEXbNokCareX1O88JB382mjsmHGPHL4Hh2AMeMCd3Xt97Qn2LwaFZSGpl6HBKcN1ORpoJHFI4ghII3aMxrMkYc5i8kPHK/s1600/photo.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbPwDUZ9vVAL6tiDW97dyYvKS7cSxgbSPgaOpFLzdvSUIPJb9EEXbNokCareX1O88JB382mjsmHGPHL4Hh2AMeMCd3Xt97Qn2LwaFZSGpl6HBKcN1ORpoJHFI4ghII3aMxrMkYc5i8kPHK/s1600/photo.jpg" width="150" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">I'm not good at taking a selfie...</td></tr>
</tbody></table>
Another good news is that the article by the all-star TSW docs from Japan is now published and is free to download. I would recommend to take a look, as they explain the very basic of TSA in an easy to understand way.<br />
<br />
<a href="http://www.dovepress.com/articles.php?article_id=18757" target="_blank">http://www.dovepress.com/artic<wbr></wbr>les.php?article_id=18757</a><br />
<br />
It's written by Dr. Mototsugu Fukaya,<sup> </sup>Dr. Kenji Sato, Dr. Mitsuko Sato, Dr. Hajime Kimata,<sup> </sup>Dr. Shigeki Fujisawa, Dr. Haruhiko Dozono, Dr. Jun Yoshizawa,<sup> </sup>and Dr. Satoko Minaguchi.<br />
I'm thankful to those doctors raising awareness of Topical Steroid Addiction.<br />
<br />
It's getting a bit chilly in the UK these days and I hope this winter isn't going to be too hard on us!<br />
<br />
Wishing everyone a steady healing. <br />
<br />
xxxTommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com4tag:blogger.com,1999:blog-1632585507201168859.post-61763475077982267962014-07-27T20:11:00.001-07:002017-03-25T15:59:40.830-07:00Month 33<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGILbBmDEXZTfxfcfEiLVs54g6C8uqgAb7IexZ-e0bXrM3mwosln_129wK_2q6tqu3McdJZ260FNVtYlT_j8bitvBnYsyMOli60-FFd0HWv_521rv8dSN-tVD3HUexwv6hvPocNOHLfh1w/s1600/blog27.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGILbBmDEXZTfxfcfEiLVs54g6C8uqgAb7IexZ-e0bXrM3mwosln_129wK_2q6tqu3McdJZ260FNVtYlT_j8bitvBnYsyMOli60-FFd0HWv_521rv8dSN-tVD3HUexwv6hvPocNOHLfh1w/s640/blog27.jpg" width="640" /></a></div>
<br />
Just a quick update on my progress of TSW, PW and MW.<br />
<br />
It has been pretty good. I am happy with how I am.<br />
My skin can still be unstable sometimes, but it no longer hinders my life.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6p_UztmoBmbQk5Qac-ZiLAG1LUt3j5iJDad-M_CSVqlhh7e6aIo9PxGaxNJ6xjIQdFUzvhuQtBwNCesn9cI1WB4Tnt2U1BVFsDwDo0-6Sd9aLzWDSKBUYhfpuWZpZlt00-VuiezS0b5LY/s1600/face.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6p_UztmoBmbQk5Qac-ZiLAG1LUt3j5iJDad-M_CSVqlhh7e6aIo9PxGaxNJ6xjIQdFUzvhuQtBwNCesn9cI1WB4Tnt2U1BVFsDwDo0-6Sd9aLzWDSKBUYhfpuWZpZlt00-VuiezS0b5LY/s1600/face.jpg" width="135" /></a></div>
June 2014<br />
(wearing minimum makeups on eye brows, lips and cheeks)<br />
<br />
Apparently, on the way to healing, some strange things happen to your skin.<br />
For me, they are seborrheic dermatitis and heat-induced hives. Seborrheic dermatitis started coming up since early this year, and hives since a couple of months ago. But both are not severe, so I let them be. After the horrible stage of TSW & PW, it should be easy to handle these, right? Besides, I take them as positive signs rather than negative ones. <br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5ubql1chFE1s83PlcMgu6QAHiu9SXVwHWjulpjT_LkHPM4uXMUKB6K0fcaYxTp9sAXb-WHBrsZJ7YLvur-YwFXx30XvymYnd8UDTQZBd3G0aK5mE94Rd_kPlJeF4MRczit-4fiGfHBiKU/s1600/flare.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5ubql1chFE1s83PlcMgu6QAHiu9SXVwHWjulpjT_LkHPM4uXMUKB6K0fcaYxTp9sAXb-WHBrsZJ7YLvur-YwFXx30XvymYnd8UDTQZBd3G0aK5mE94Rd_kPlJeF4MRczit-4fiGfHBiKU/s1600/flare.jpg" width="180" /></a></div>
You can see seborrheic dermatitis on the side of my nose and hives around my cheek.<br />
(Pic - July 2014) <br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOXCxOvV-5ZxXj0J127tenMWTUTOkz7NG3MATtLy4e5Ji7k3pTjFwppREFbbPIBuH7W5uNFH3ODuW240qbykWM4iLvj37vNaA5fRzIA9CxTIiqvIVqaVf6DSR7gQp7H9wx3JXoL5YahYyM/s1600/hives.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOXCxOvV-5ZxXj0J127tenMWTUTOkz7NG3MATtLy4e5Ji7k3pTjFwppREFbbPIBuH7W5uNFH3ODuW240qbykWM4iLvj37vNaA5fRzIA9CxTIiqvIVqaVf6DSR7gQp7H9wx3JXoL5YahYyM/s1600/hives.jpg" width="138" /></a></div>
Heat-induced hives around my eye.<br />
They usually disappear after a couple of hours.<br />
(Pic - July 2014)<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHI8uDnUqQRF9s7FHcOPvREBzFtNTsNw9olm-yUBldWMV-9ajNWPe2rCZ4AIOfCxBbbnm_mLFJLgruRei9ksEJJuzQL41U6dE4vdtPGBZQ4I-gf6X4ZIEkrYh3_RuwTZs51U74nekndIB6/s1600/%E5%86%99%E7%9C%9F(1).jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHI8uDnUqQRF9s7FHcOPvREBzFtNTsNw9olm-yUBldWMV-9ajNWPe2rCZ4AIOfCxBbbnm_mLFJLgruRei9ksEJJuzQL41U6dE4vdtPGBZQ4I-gf6X4ZIEkrYh3_RuwTZs51U74nekndIB6/s1600/%E5%86%99%E7%9C%9F(1).jpg" width="124" /></a></div>
The latest pic of me (literally took a few seconds ago, wearing absolutely no makeups).<br />
<br />
That's my report for now. <br />
<br />
I would like to say a big thank you to everyone who signed <a href="http://www.change.org/en-GB/petitions/%E6%97%A5%E6%9C%AC%E7%9A%AE%E8%86%9A%E7%A7%91%E5%AD%A6%E4%BC%9A%E4%BD%9C%E6%88%90-%E3%82%A2%E3%83%88%E3%83%94%E3%83%BC%E6%80%A7%E7%9A%AE%E8%86%9A%E7%82%8E%E8%A8%BA%E7%99%82%E3%82%AC%E3%82%A4%E3%83%89%E3%83%A9%E3%82%A4%E3%83%B3-%E3%81%AE%E5%86%85%E5%AE%B9%E3%82%92%E6%94%B9%E8%A8%82%E3%81%99%E3%82%8B%E4%BA%8B%E3%82%92%E8%A6%81%E6%B1%82%E3%81%97%E3%81%BE%E3%81%99?lang=en-GB" target="_blank">Atopic's petition</a>. It has reached 10,000 petitions and it's been handed to Japanese Dermatology Association this week. They are still collecting the petition (the more, the better!) if you haven't signed yet. Thank you very much for showing your support and taking your time.<br />
<br />
What I believe we need is one example of a country where it acknowledges TSA and supports TSW. If a precedent is set, other countries would consider the option more positively and seriously.<br />
<br />
It has been more than 6 years since I first withdrew from TS and Protopic. I feel I have been handling my withdrawals rather <span class="midashi"><span class="redtext">clumsily</span></span>. Over the last few months, my focus shifted to overcoming TSW emotionally (rather than physically). I'm inspired by my friends, TSW bloggers and readers of my blog.<br />
<br />
xTommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com8tag:blogger.com,1999:blog-1632585507201168859.post-32274775973126767162014-05-24T06:20:00.000-07:002017-03-24T15:15:58.936-07:00Meeting with Dr. Kenji Sato <div dir="ltr">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJhWUp6U6NwrSIde3lbUn88jcMXnh2KQbEwFFWNSBxbBtQv9n1klJmQQdcf9bBCk3rSSGM_cJgnKxlRmwGUfMOi-ylsCtmUBp83x8qGJTFe84PEULhdaeL9HTxyZPdHtPItMg2oGUWaD9-/s1600/osaka.jpg" imageanchor="1" style="clear: left; display: inline !important; margin-bottom: 1em; margin-right: 1em; text-align: center;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJhWUp6U6NwrSIde3lbUn88jcMXnh2KQbEwFFWNSBxbBtQv9n1klJmQQdcf9bBCk3rSSGM_cJgnKxlRmwGUfMOi-ylsCtmUBp83x8qGJTFe84PEULhdaeL9HTxyZPdHtPItMg2oGUWaD9-/s640/osaka.jpg" width="640" /></a><br />
<br />
I know that I haven't blogged about my skin condition
for ages. To be honest it's because I wasn't sure what was going on
with my skin.<br />
<div class="im">
<br />
<table cellpadding="0" cellspacing="0" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZ98FIIjHci9nziDnRVROtyKWrKBWYLVNevQld3YyC-8mf6j1b8Zhn9K0-610K-GSVjJ1PpaCrlza4-ZMGRM3gS0hGp3Z9u-ILxd4JgUAPyaajD4kQXM8ra3Ooj9O9uZWwh4SrhnMUFhW7/s1600/pic1.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;" target="_blank"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/proxy/AVvXsEh5TfECmW09PkHaL18kPE8lmlKdDA0ZnWuvDSw1ISVWGdJpW6nXvHuTj0dr3lNm83uEWu3RRrOat9nndPwHDvs2D4mUX4jQ6ovbHdAu7SuaekKuJ8zNSiLYaAsmb1RC_zs1xRkw3mcvQrKlXTsgxl6UEyrRCnpbkJPQLBnTpCq90kiy85VXf8VE87uqPN7Y1bEaU6OvU6nohpCpo3BGlkOTgb04Y1W7Sly34a_Nl6s62yb5MNHaSTu2cgGxV3TDRkubl-vAvmYFfxLe8Rkcdu2OXqz-hbmVszUYGEZehoDrnWQuJUkBodC1a-sev7ZRaoiJUN2WqMZatsQlZp5mvhgjgJy576hx3jNFrTGM-yZA7EThMbXdWwdF8Xq2d-3wfHXG0vTUku0P=s0-d-e1-ft" width="162" /></a></td></tr>
<tr><td style="text-align: center;">20 January, 2014</td></tr>
</tbody></table>
<table cellpadding="0" cellspacing="0" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKxpRt-CeXKt4NYG8hASq6PhcrUb9Ta1QmROtBVdY5W5uwDMA3oYcIFRKAVZvyMI0RnRKvGSyrb5AURYGkVwhEDfOcLz68JXSaFm_C0Uoca3r8dEuCoMFjan7A5QGxnft96O5j3m_GirBw/s1600/pic2.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;" target="_blank"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/proxy/AVvXsEhFMMbl61DUpMWjKIQ1OJEe5J1nsDPBWsLPElW5asXdU8Dgy_S2Vx1kZIquFOVp_OplwJG2k145eiqjMifefwqmTXYRUbxHR9XoE-2NyJjkdHN1K0YlVQTdbrxgTiMPPmnguq2Js1fAmIxGeWtnOHguD5I4et7vveYeP1rFS8ZZ0hnF3aZzISWvc4U-EWYDG5PBLsz3V7Waj7GwUS-bOtsGoLA6m6LsJNQv6_-49FvqwyEZuNLCmUzM4M7XFPD9vTu059nM4X1h9n56x3TxNO2gEBjzRlDJPfhOCDI003Ppr4nRFSiYnnrSuPMcNJoWIEMl2dliM3wbtbUTSxH0YTeBsZcCaw-SRNfRpzki_kcOcvQSGLuIrn6dpwhU8T1Y9EpkJnTQQ91t=s0-d-e1-ft" width="151" /></a></td></tr>
<tr><td style="text-align: center;"><br /></td></tr>
</tbody></table>
</div>
Since November last year, my skin gradually
became more and more aggravated. I was confused because the way my
skin worsened was somehow different from any of the other times I'd
experienced
before.<br />
<br />
I felt that I needed to see someone who could
give me advice on this. I've been fighting TSW since 2008 and I decided
that it was the time to ask for help.<br />
<div class="im">
<br />
<table cellpadding="0" cellspacing="0" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjESUYKYGf8ZEEv8p2Sb1MCrbs5hUaBM4h5IKXETLyS9EHvmTihYAa9tX8moC7JNzpJQ3EhjF37o7l2W5ElX2EOwHyGYhtH4YokxMaSRQS0_NhDnUYmwguMuxAllHpZEIvPI7mRAl-YkXrw/s1600/-1.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;" target="_blank"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/proxy/AVvXsEi6evFll_BHKqWi1V2so1EiMgciU6qZQ4h76buDNDOqJh25c_VXfvbRhNB5v_tNz1-fvvsLt4U8Q5EhMbMBqMrLzZoy2AD7c831F4RURtiCNMD_Fvb35cTXfIUadHv7h6g_4db4vadrKpzEVdFob8BYrsWet0yblPEE5n7fZ9BnmdybSLrnNG1TWfj43sJuvlmRt0ga3nlWIeDnRvLl0Ct8FZgAwjVAneCsAqUaoa1hXoEIaxnguW3LBYfesLdny2C8r2JyeDdqmWAgqLz0P6uFmw2NOcXoqswNYhMJ0Ui7L665VnkXUT2xtjJg5q6-kAp7idd0AVcNKuCZykpG5LfHQNTG9DiD09kgw16G4oP2QoS2HwRFVAnISwwBkAj66oiqQOhwfQ=s0-d-e1-ft" width="240" /></a></td></tr>
<tr><td style="text-align: center;"></td></tr>
</tbody></table>
<h2>
The New World</h2>
</div>
So I booked a flight to Japan, then hopped onto a coach. 21 long hours later, I was in 'The New World'.<br />
<br />
Well, this chaotic place is actually called 'The New World(新世界)' in Osaka, Japan. Yes - I was there to see <a href="http://skinofrose.blogspot.jp/2013/09/another-tsw-doctors-to-know.html" target="_blank">Dr. Kenji Sato</a>.<br />
<br />
I
was very nervous. I wasn't originally too keen on meeting him as a
patient. I had seen so many dermatologists and every single time I had
ended up disappointed. EVERY SINGLE TIME! What if this ended up just
like all the other experiences? What if he says my skin won't
heal or
improve for some reason? Feeling like I was facing that kind of
verdict really gave me butterflies in my stomach.<br />
<div class="im">
<table cellpadding="0" cellspacing="0" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimCrQeFb7Zpu2SUIzIjMcwe2nkFYSo-_3bPUPF-Xosgn4eGMdzR2TkdmgQ5iLSYK3o0lzvl5FpVHAMMn4_CnqcA94Kp6u2Bk3OvlfLMO595Gicpvdem_JcwsM0-zKXi046s3ihW9LqkNKF/s1600/-2.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;" target="_blank"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/proxy/AVvXsEgDBWdd9HGHIUdHLD_yQC7v8Z6g63RqrKGsNGl8WxgFWNnQL9MP21gjk9lPlRtVcJdnX0bomg9_QDzoNtmQ9KRtCwUE0_ExXoKfPXdgJV8z2VG5dJg69SD_NhYMO8XiNVkh3C7oKAmVUh5CCRZKKv9orPWRGN2pGpYXSCY9Ew7zJKYINw_uGDsLb2NoncGIv6m02yAjw3-SNV4fdmGqCA6C4fwpehoLAONvIZyA4d8wP9TNl8Qrv8qlCAT7Jhi5_pMZfb7iE7ZKqHjWo1eNmOwF_gA8kcbu0bRpG_h-e7nlYW8G3cdtT6S-ZKgwAvNlnLUwIkywOtSkh7YABGIh4SOTeqE1DPgtKB_cb5uJJoU1ECOdTlzYTfSI86weCjwC9ae47vAK3A=s0-d-e1-ft" width="240" /></a></td></tr>
<tr><td style="text-align: center;">Hannan Chuo Hospital in Osaka, Japan</td></tr>
</tbody></table>
<h2>
At Hannan Chuo Hospital</h2>
Hannan Chuo Hospital is a relatively big
hospital. Their dermatology
department was located on the ground floor. I was escorted from the
reception to the waiting room by a friendly nurse. I handed in 4 pages
of my skin history beforehand. I was called in Dr. Sato's office at
10:00 sharp.<br />
<br /></div>
There he was - Dr. Kenji Sato greeting me
briefly. There was then a moment of silence. He was flipping through the
papers of my skin history marking certain lines in red ink.<br />
<div class="im">
The first
thing he said to me was that I was the first case he ever saw who
got withdrawal symptoms from Protopic alone. He said that he'd seen
many people used Topical Steroids and Protopic together and then got
withdrawal reactions. He thought that Protopic alone would cause as
severe withdrawal reactions as topical steroids, and I happened to prove
that his presumption was correct.<br />
<br /></div>
Dr. Sato then asked
about my life style in detail - how often I exercise, what I eat and
how long I work etc. My answers to these questions seemed mostly fine -
except I work too long hours (normally 14 hours/day. Dr. Sato told me
to cut it to 10 hours/day). Also, he diagnosed me with seborrhoeic dermatitis
by looking at my face. And, this was the reason why my skin was
looking strange. He recommended me to put soap
foam on my face for literally a second (I hadn't used a soap on my face for
ages) to deal with infections. He didn't prescribe Nizoral, let alone
topical steroids for it unlike other dermatologists.<br />
<br />
I
took out my small notebook and quickly jotted down every bit of advice he gave
me. Also, Dr. Sato kindly and patiently answered every single question I
asked (it wasn't few).<br />
<div class="im">
<h2>
The Q&A</h2>
Here is the list of the Q&A. (Q.s are my questions and A.s are Dr. Sato's answers) <br />
<br />
<b><span style="color: #e06666;">Q. Have you seen any cases that patients healed from Protopic Withdawal?</span></b><br />
A. Yes, but Protopic Withdrawal appeared to take longer to heal than Topical Steroids Withdrawal. But it will heal. <br />
<br />
<b><span style="color: #e06666;">Q.
I feel that my immune system became low after withdrawing from topical
steroids and protopic. Would my immune system eventually return to
normal?</span></b><br />
A. Yes, it will.<br />
<br /></div>
<b><span style="color: #e06666;">Q. I know you recommend Moisturiser Withdrawals. But what happens if you have dry skin? Does 'dry skin' actually exist?</span></b><br />
<div class="im">
A.
Some people, especially some babies, have dry skin where you can see
very small flaky skin. In such cases, applying moisturiers can improve
their skin condition. However, using moisturisers for people who used
topical steroids for a long period usually delay healing, so it is not
recommended.<br />
<br />
<b><span style="color: #e06666;">Q. My general skin condition became so much worse since withdrawal. Does that heal too?</span></b><br />
A. Yes, it will heal.<br />
<br />
<b><span style="color: #e06666;">Q. I feel that my skin gets worse during in cold weather. Would it affect healing?</span></b></div>
A. From what I've seen, it looks like cold weather can slow healing a little. <br />
<b><br /></b>
<b><span style="color: #e06666;">Q. I've been having a lot of eye mucus since several years ago. Does this heal?</span></b><br />
<div class="im">
A.
I just had a patient with the same symptom. The patient got better by
the time he left the hospital. So yes, it should go away. (He then
prescribed anti-bacterial eye drops.) <br />
<br /></div>
<b><span style="color: #e06666;">Q. After patients are healed after withdrawal, it is okay to wear make-up?</span></b><br />
A.
Try not to - as make-ups can moisturise skin and some people have
another rebound because of that. But, I tend to say that it is fine to
wear lipsticks and eye liner as they are only small parts of your face. <br />
<div class="im">
<br />
<b><span style="color: #e06666;">Q. Is it okay to apply sun screen?</span></b></div>
A. No, it is not
recommendable as sun screens can work as moisturisers. If you want to
block sunlight, please use long brimmed hats and sunglasses.<br />
<br />
From what I saw, Dr. Sato's style was to discover what is hindering
healing by looking into your
life style and medical history. He doesn't apply one-to-fits-all
solution (because there isn't one), instead he listened to each patient
and provides specific medical advice. When he thinks that medical help isn't
necessary, he would just
leave it as it is. For example, he said that my anemia and low blood
pressure shouldn't need treatment and suggested I stop taking iron
supplements as they sometimes affect stomach and skin badly ("Of course there are
cases where you do need those supplements and treatment", he added.)<br />
<h2>
Topical Steroids for Acne?</h2>
During our conversation, Dr. Sato asked if I had acne before. The question was
somewhat unexpected. I said yes - in fact, I had terrible acne when I
was a teenager. "Did you use topical steroids for the treatment?" asked
Dr. Sato. I silently blinked several times - I remember having to use
so many tubes of "some ointment" to treat my acne (and how utterly
useless they were), but I couldn't remember the name of it. It was more
than 15 years ago anyway. "I thought you wouldn't usually prescribe
topical steroids to treat acne." "Actually, some dermatologists do
prescribe topical steroids for acne. I personally thought it was a
problem, so asked a council to stop that. They banned topical steroids
to treat acne, but then they took the decision back the next year." The
possibility is that you were prescribed topical steroids for acne
without knowing what it was. I thought that that could've explained why
I've been still suffering from TSW after 6 years of my first withdrawal
- but I'm still not sure.<br />
<div class="im">
<h2>
After Meeting with Dr. Sato</h2>
<table cellpadding="0" cellspacing="0" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLyxjIoz4qumvSv6R7J6Lc8ggMfVadtvkEkiZ2HLsYFtZn1xghpXXS2b7KpZbYrkuSXyPixJysjiR9JyVEN21g-J8GD3YSgHCWhFLwZnOvMTYPrcStuxAqsOau1i96TUf9Nybf-thnePqj/s1600/%E5%86%99%E7%9C%9F(5).JPG" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;" target="_blank"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/proxy/AVvXsEjqdqZZ8Pq9mVibYTIwrNT71rI_4fT7DLe77e0NScVxZC7hXG6vSEOYNKhA91j8POmO0HXWwUTIT86KzhnLLPGsHek17z7MxxStZFY4RWv0Kqs_H2dBfPdRvKJGfXUOcFD8IzwEjuoCRNTCgIbIbsh5oESn2yhu2ygSOGjvDIUaGTTQ7UESTlC8JAryNC4RLTKrV-QO2PbojjAcijeiaO5_MNwI_0QlvkGvN_jvz83Irz2crCDHjkzPnEu5Hnu9OVnqcmUDOzrr74sQfkcZ49Yv6-lW0hP6bBjo9I4o6xhG8_SkR6wadVlChzQas0ZfWq9N97G6rvV_0myudoTOL2YtjZXAd3CnDWml_gra3270eTrE-Gt0WJj6OkWQME29D-OLISCXtn2WC3c2vikuKgTZO6Z49F8qExm7DwmF3bLFHYUbx6BmEbAi=s0-d-e1-ft(5).JPG" width="150" /></a></td></tr>
<tr><td style="text-align: center;">Eye Drops (Levofloxacin)</td></tr>
</tbody></table>
</div>
When leaving his office, although all I was given by
Dr. Sato was a prescription for anti-bacterial eye drops, I felt that I
was given exactly what I needed - the confirmation that a hope is still
there and that I'm on the right path and I can heal. <br />
<div class="im">
<br />
I visited
Dr. Kenji Sato in March. And it's been 2 months when I'm writing this
post. I would like to share how I'm doing now in another post hopefully
sometime soon.<br />
<h2>
Please sign the petition!</h2>
Atopic (Dr. Sato's patients group) are
gathering petition signatures online to change the atopic dermatitis
treatment guideline by Japanese Dermatological Association. <br />
<br /></div>
Atopic has been asking for people to sign the petition on the street as well as online. <br />
<div class="im">
I would really appreciate it if you sign the petition.<br />
<br />
<a href="http://www.change.org/en-GB/petitions/%E6%97%A5%E6%9C%AC%E7%9A%AE%E8%86%9A%E7%A7%91%E5%AD%A6%E4%BC%9A%E4%BD%9C%E6%88%90-%E3%82%A2%E3%83%88%E3%83%94%E3%83%BC%E6%80%A7%E7%9A%AE%E8%86%9A%E7%82%8E%E8%A8%BA%E7%99%82%E3%82%AC%E3%82%A4%E3%83%89%E3%83%A9%E3%82%A4%E3%83%B3-%E3%81%AE%E5%86%85%E5%AE%B9%E3%82%92%E6%94%B9%E8%A8%82%E3%81%99%E3%82%8B%E4%BA%8B%E3%82%92%E8%A6%81%E6%B1%82%E3%81%97%E3%81%BE%E3%81%99?lang=en-GB" target="_blank">http://www.change.org/en-GB/<wbr></wbr>petitions/%E6%97%A5%E6%9C%AC%<wbr></wbr>E7%9A%AE%E8%86%9A%E7%A7%91%E5%<wbr></wbr>AD%A6%E4%BC%9A%E4%BD%9C%E6%88%<wbr></wbr>90-%E3%82%A2%E3%83%88%E3%83%<wbr></wbr>94%E3%83%BC%E6%80%A7%E7%9A%AE%<wbr></wbr>E8%86%9A%E7%82%8E%E8%A8%BA%E7%<wbr></wbr>99%82%E3%82%AC%E3%82%A4%E3%83%<wbr></wbr>89%E3%83%A9%E3%82%A4%E3%83%B3-<wbr></wbr>%E3%81%AE%E5%86%85%E5%AE%B9%<wbr></wbr>E3%82%92%E6%94%B9%E8%A8%82%E3%<wbr></wbr>81%99%E3%82%8B%E4%BA%8B%E3%82%<wbr></wbr>92%E8%A6%81%E6%B1%82%E3%81%97%<wbr></wbr>E3%81%BE%E3%81%99?lang=en-GB
</a><br />
<br />
<br />
<table cellpadding="0" cellspacing="0" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilHqS4aDo05DXb3CKrWo4El-5jFU6s0g-R_nyjfhZT_YrBQIfh2u0Yiv1Yn9LUnqphTBfeInL9UXefSUneIu3eOrM77bRdihluu5f22PaEh_ZngLVMw6j69e39NzY_im4iWxTgNiY4Hspl/s1600/mag1.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;" target="_blank"><img border="0" height="254" src="https://blogger.googleusercontent.com/img/proxy/AVvXsEhNGfebDR9GwYrkNXU2EpSi4foRtSLnXmHCEBP9qR8elfIQPYkZRYmfmuKRM6R2E1ioV5mYdlxE5bLE4gumTrmoenHcC-NIhcxs7yKivQQawMcD7t4U34eY5b8dJGof6xjqLlVPnlIBHFKehf_jrLbVkdvLagGzxemcxCh4kunCy5Pl9PR0DKB1DuEwZ1wFFjPcEynmxTJa2xFZdnI0v9Bt9EVQfZJpWrKrK7U3pNhdvpHcn8UifhGL32xQnwy8sxKkhmAcIDx3RP3_W_4F5bgC4kUKuxYA_HBEx0FI1DtCfpQ2m9tgmnZ-7ENxuP0PfMcgYTl74_oBfMXTn7-0ekndnxZQtWZxJD2XiWayyvEwOcqvPasEClJli4eer9fsi1vetRB8MjU8=s0-d-e1-ft" width="320" /></a></td></tr>
<tr><td style="text-align: center;"><br /></td></tr>
</tbody></table>
</div>
Some people said to me that Japan is advanced when it
comes to TSW - the
reality is that many doctors prescribe topical steroids too carelessly
here (perhaps in your countries as well). Even a beauty magazine, which
I picked quite randomly, recommends medium class topical steroids for
rough skin. <br />
<div class="im">
<br />
Atopic and Dr. Sato are trying to change
the guideline, so that non-TS treatments for atopic dermatitis will be
officially accepted by Japanese Dermatological Association when TS-based
treatment isn't working for patients.<br />
<br />
<br />
<br />
<div style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgeB3gWrBPN7Hkc4xluHh6ZsxRDFHU8n8KzCLzxqZyyQE0QnkOjGqAcJmhO3Ym8aARSwQlHfgPTg17ZNpgV42zV7hcgyFXmAGy-NN_nZPWjyxlYvl491vkUGKC94_TJqt1Rdvfz6I-mPFP-/s1600/mag2.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" target="_blank"><img border="0" height="274" src="https://blogger.googleusercontent.com/img/proxy/AVvXsEiun2DEtv_ej94VnWgO7Kza139jTMGORVvpeMRVOtXUoszQGixCO11hZ-zHJk4x4CZxx6RnTEg_n2TTd7YzcmespIje2MCnHTUe1srbdrSw0DR6j-YIv1Lx4MxGVKuUpm0VeOVQqTtFBxTTpFH_dQRdsmP2F_yTVdSaiDwn6B8lRTeS9nwJ4tGjyZlUm7v6ktsQXr0LRn_P9ioey5SlzqmJS9qswyzLNVjQThRyCnRphwYsf9jVz928hof3amSYftI9StfbpEAOIG9789f3OtF-FYUamYpjSKdyjiIPAFkoCAsYQQIhkxkwM7x6q1v3hmkNOd2NOI1fu62rWo6fZRry2BvbKhoq_9p8HOitObsw3KIXWYmnjuMAFZZ6MM0Ck5UaKIBHQKRU=s0-d-e1-ft" width="320" /></a></div>
Your signature on the petition will be a great help. <br />
<br />
Thank you for reading my post. <br />
<br /></div>
I wish you steady healing and peace in your life.<br />
<br />
xxx</div>
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Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com28tag:blogger.com,1999:blog-1632585507201168859.post-82267538825240365352014-04-13T21:58:00.001-07:002017-03-29T10:58:42.153-07:00How Topical Steroid actually affects your skin - follow-up post<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjo38Z8Sm9iOW_fFGkvsblhdilUoTwdG5e6Om9El4PToC5zdtr-oZxRT1gpRBGLOsjUqsatXUaB36TI3VNEP9sxXNTjyf9-LRcQwgqnygUrH6O-76UJPvbKQjdUaz08Gh5itVAkU3jzjmD1/s1600/blogfukaya.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjo38Z8Sm9iOW_fFGkvsblhdilUoTwdG5e6Om9El4PToC5zdtr-oZxRT1gpRBGLOsjUqsatXUaB36TI3VNEP9sxXNTjyf9-LRcQwgqnygUrH6O-76UJPvbKQjdUaz08Gh5itVAkU3jzjmD1/s640/blogfukaya.jpg" width="640" /></a></div>
This is just a quick post.<br />
<br />
After submitting <a href="http://skinofrose.blogspot.co.uk/2014/01/how-topical-steroid-actually-affects.html" target="_blank">this post about Dr. Fukaya's experiment</a>, a few people asked me how long it will take to recover from the damage of topical steroids(TS). Dr. Fukaya kindly gave us some answers to this question. <br />
<br />
He hasn't examined his skin under the microscope, but he shared one of his articles written in 2009. It was about the same experiment done at Pennsylvania University. Dr. Fukaya translated his article to English and you can read it <a href="http://topicalsteroidaddiction.weebly.com/chapter-1012288result-of-6-week-dermovate-application-on-healthy-skin.html" target="_blank">here</a>. <br />
<br />
In the article, Dr. Fukaya says: <br />
<br />
<i>"Having been conducted on <b>healthy subjects, inflammatory response was not seen </b>and skin atrophy recovered soon. <b>Atopic skin would have manifested strong inflammation in response to irritants.</b> "</i><br />
<br />
He also said that after TS is applied to healthy skin, after a month or so, it would be temporarily thickened and then return to normal skin.<br />
<br />
Wishing you all the best for your recovery x Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com2tag:blogger.com,1999:blog-1632585507201168859.post-11834462344780089222014-03-12T19:11:00.000-07:002017-03-29T10:55:45.150-07:00The basics of Topical Steroids Withdrawal - Dr. Satoko Minaguchi<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIWsrSNr3LwTCQ1el_jvGDzuJP-dfguWJY4Q5xqa3yS8hrs8dpOYruovvdVSsDOak6AYTt44vgIuwnJlhCu-U8Iob9xWzaBDxC2I_n2UJjyMErgfaq-YEaqYQZ0Y5cV3Q5ECJsXvJ3ilYR/s1600/blog3.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIWsrSNr3LwTCQ1el_jvGDzuJP-dfguWJY4Q5xqa3yS8hrs8dpOYruovvdVSsDOak6AYTt44vgIuwnJlhCu-U8Iob9xWzaBDxC2I_n2UJjyMErgfaq-YEaqYQZ0Y5cV3Q5ECJsXvJ3ilYR/s640/blog3.jpg" width="640" /></a></div>
<br />
Here is the very basics of topical steroids addiction and withdrawal. Dr. Satoko Minaguchi showed this during <a href="http://skinofrose.blogspot.co.uk/2013/09/tsw-event-report-from-japan.html" target="_blank">the TSW conference</a> and explained where TSA and TSW stand in the arena of atopic dermatitis treatment. She is a TSW dermatologist working in Saitama area in Japan.<br />
<br />
This is the photo of the chart she showed during her powerpoint presentation.<br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgL28TvDZC5wGDb3HugqCzp6Wu9U6XZMebo74gpAWquQNRB285b-_pumr4xDHLaHql5yplC-ADwOMhwhP_LncT-PuYQi5UjMwd4aYw_Q2qUvTLJvdjCC2UZLLk00YpoNWJ8fkLxM-pJhAmU/s1600/Screen+Shot+2014-03-04+at+17.34.12.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="280" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgL28TvDZC5wGDb3HugqCzp6Wu9U6XZMebo74gpAWquQNRB285b-_pumr4xDHLaHql5yplC-ADwOMhwhP_LncT-PuYQi5UjMwd4aYw_Q2qUvTLJvdjCC2UZLLk00YpoNWJ8fkLxM-pJhAmU/s1600/Screen+Shot+2014-03-04+at+17.34.12.png" width="400" /></a></div>
<br />
Here is the translated version for you.<br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzAOH9f6TmQ-xT0WUlTsrpe5ts1uYkNrCfPcmIZhLTtj9hpHhQLKnMgHAFbZXbL3u0wBOQFhYHjdNn2Sw5evq3BE_kfB7ozNCXoQD4I2Sib-4GLlG3omRZcNClXFGruKFbULOObRN0_WkC/s1600/Screen+Shot+2014-03-09+at+21.10.04.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="476" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzAOH9f6TmQ-xT0WUlTsrpe5ts1uYkNrCfPcmIZhLTtj9hpHhQLKnMgHAFbZXbL3u0wBOQFhYHjdNn2Sw5evq3BE_kfB7ozNCXoQD4I2Sib-4GLlG3omRZcNClXFGruKFbULOObRN0_WkC/s1600/Screen+Shot+2014-03-09+at+21.10.04.png" width="640" /></a></div>
<br />
<h2 style="text-align: center;">
TSA shouldn't be discussed as an opposing idea to the orthodox TS based treatment.</h2>
Dr. Minaguchi's message was that TSA shouldn't be discussed as an opposing idea to the orthodox TS based treatment, because TSW is a method of a treatment to remove side effects. The opposite therapy to the TS based treatment should be a non-steroidal treatment, in other words 'natural healing'.<br />
<br />
It's clear that the most of the TSW patients,
including myself, went down on the Y route on the chart. We are now back on the
route to simple atopic dermatitis or other skin condition we originally had. What I found concerning is those who are in Y'. People in this category thought their eczema was completely cured, and one day, Bam! - they found themselves with TSA. People in X' are lucky ones. Dr. Minagchi told the audience that a factor of 'no rebounds'
is currently unknown. (She indicated that it seemed to be just a matter of luck). <br />
<h2 style="text-align: center;">
Some people do not experience the side effects of TS at all.</h2>
Another interesting point this chart shows is that some people do not experience the side effects of TS at all. I know people who used TS and Protopic(PT) and had no adverse effects after they quit. For them, "Topical steroids (or Protopic) worked well." I'm happy for them, not cynically but genuinely. When you begin the TSW/PW, it's easy to see TS/PT as an invention of evil. But I think that refusing TS/PT all together, which is steroids/tacrolimus phobia, can make your already-hard journey harder. There's such a big difference between experiencing the side effects and steroids/tacrolimus phobia. I acknowledge that TS/PT work wonderfully for some people, just not me, sadly.<br />
<br />
Once we are done with TSW and get rid of the side effects, some people may face a question - "what should we do with simple atopic dermatitis?" Most of TSW doctors, including Dr. Kenji Sato and Dr. Mototsugu Fukaya, believe that atopic dermatitis would often go away naturally. <br />
(it's interesting to visually compare <a href="http://www.mirai.ne.jp/~seisinc5/fmokuji.htm" target="_blank">simple atopic dermatitis pictures </a>and <a href="http://www.mirai.ne.jp/~seisinc5/fmokuji.htm" target="_blank">steroids induced atopic dermatitis</a> on Dr. Tarao's website)<br />
<br />
Wishing you all a good recovery and a beginning of the lovely new season x<br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com13tag:blogger.com,1999:blog-1632585507201168859.post-88570369041047185392014-01-23T15:10:00.000-08:002017-03-29T11:07:36.940-07:00How Topical Steroids actually affects your skin<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwbxTxtPOStmJl4JX0KoUOimh5Uiz51R9fZ_4_ihczivA1LtL8t91LuU_lvplZLLwF-v2NdYrOopchjFtE8TpJIvUQokxLZ3mZkqRQb9GX42mkjNeXuxMDh5Q16zkXe1QemU-kCxmDx8MD/s1600/test.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwbxTxtPOStmJl4JX0KoUOimh5Uiz51R9fZ_4_ihczivA1LtL8t91LuU_lvplZLLwF-v2NdYrOopchjFtE8TpJIvUQokxLZ3mZkqRQb9GX42mkjNeXuxMDh5Q16zkXe1QemU-kCxmDx8MD/s640/test.jpg" width="640" /></a></div>
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Here's a fascinating story by Dr. Mototsugu Fukaya. </span><br />
<span style="font-family: inherit;">Dr. Fukaya applied Dermovate (strong TS cream) on his arms for 2 weeks to see what's actually happening in the skin. The</span><span style="font-family: inherit;"> result is spectacular. </span><br />
<br />
<span style="font-family: inherit;">Here is the translation. Enjoy!</span><br />
<span style="font-family: inherit;">---------------------------------------------------------------</span><br />
<span style="font-family: inherit;">This picture is the skin of my forearm with immunostaining. The brown dots are proliferating cell nuclear antigen (PCNA). <b> </b></span><br />
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<span style="font-family: inherit;"></span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhT9AehlocZITuN0vM23EJiQyHKnpX0JGrrYGc1c-s7IpjoOYIRxnkzZwI5gSOxZk6mrKddAR4Vt0UuqAVOOL-Y5EHo5vIT2m5R_hlRRn24gaunnqSXjRkfB4MNQ_Fs7KPXH3BKc3-3BigV/s1600/PCNAbefore.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="144" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhT9AehlocZITuN0vM23EJiQyHKnpX0JGrrYGc1c-s7IpjoOYIRxnkzZwI5gSOxZk6mrKddAR4Vt0UuqAVOOL-Y5EHo5vIT2m5R_hlRRn24gaunnqSXjRkfB4MNQ_Fs7KPXH3BKc3-3BigV/s1600/PCNAbefore.jpg" width="320" /></a></div>
<span style="font-family: inherit;">After applying Dermovate cream twice a day for 2 weeks, it became like the below picture.</span><br />
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<span style="font-family: inherit;"></span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSuKiNx6N6_8jwDNazgpCUjMzK8aSIs1b2oSysSQoHA9RlNHM6udAjE2I8fdtfBp2RJvyTmgqf7D6L9JD4kUICzi3gJD3VsBBcgBqYTzGi_3kSnmQsGJODyMZWBw_EGCqnJN3gNhCpiZXi/s1600/PCNA2wH-.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="160" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSuKiNx6N6_8jwDNazgpCUjMzK8aSIs1b2oSysSQoHA9RlNHM6udAjE2I8fdtfBp2RJvyTmgqf7D6L9JD4kUICzi3gJD3VsBBcgBqYTzGi_3kSnmQsGJODyMZWBw_EGCqnJN3gNhCpiZXi/s1600/PCNA2wH-.jpg" width="320" /></a></div>
<span style="font-size: small;"><span style="font-family: inherit;"><span style="font-family: inherit;">I was surprised. </span><br />Although I knew that my skin would be atrophied as Zheng reported *, what really surprised me was the fact that there wasn't any difference in the appearance or feeling on my skin at all. If you, however, take a tissue and look into it, the epidermides are clearly atrophied and the amount of PCNA are reduced.</span></span><br />
<span style="font-size: small;"><span style="font-family: inherit;"><br /></span></span>
<br />
<span style="font-size: small;"><span style="font-family: inherit;">I never had atopic dermatitis, hay fever or asthma in my life. Nor does any of my family members. As my patients know, my skin has always been very good (this is one of the reasons I can practice in plastic surgery and aesthetic dermatology). In the old days, my patients used to joke how 'ironic' my skin was. </span></span><br />
<span style="font-size: small;"><span style="font-family: inherit;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: inherit;">Yes, my skin is strong. And that strong skin was so much atrophied after only the 2 weeks of topical steroids use.</span></span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzrf2fyaE7i9NOvNTx311IixjIYMspR2P2MImTmjbbnNa1QS-q6CBjfgLD2omI4vumDDQNUpnnaG7YwJ1nqpwsE5XmbFoxBAiBvFxJ5YBDIKnv8Vx9TC2uVE5sIFLMkmqNSblz4nFHEWK5/s1600/PCNAH%252BH-.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzrf2fyaE7i9NOvNTx311IixjIYMspR2P2MImTmjbbnNa1QS-q6CBjfgLD2omI4vumDDQNUpnnaG7YwJ1nqpwsE5XmbFoxBAiBvFxJ5YBDIKnv8Vx9TC2uVE5sIFLMkmqNSblz4nFHEWK5/s1600/PCNAH%252BH-.jpg" width="312" /></a></div>
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<span style="font-family: inherit;">*Morphologic Investigations on the Rebound Phenomenon After Corticosteroid Induced Atrophy in Human Skin</span><span style="font-family: inherit;"> Peishu Zheng, Robert M Lavker, Percy Lehmann and Albert M Kligman</span></div>
<div class="MsoNormal" style="margin: 0mm 0mm 0pt;">
<span style="font-size: small;"><span style="font-family: inherit;">J Invest Dermatol 82: 345-352 (1984)</span></span></div>
Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com18tag:blogger.com,1999:blog-1632585507201168859.post-47994771782893280932013-12-18T04:40:00.006-08:002017-03-29T11:03:04.388-07:00Month 25<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR4LqoK2KaYOcEEHKECOAkTeQprVHOpHBvmGLkvJ14buES9P6WrMkb-ui_p2qjf1Nk9gWcSbnxQLftup9OSH6jWindNlqEs7_lkoWXrzxzPixn_ap8BCuNcMMa-O9rbKkp8hERw_WNxtBV/s1600/2013dec.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR4LqoK2KaYOcEEHKECOAkTeQprVHOpHBvmGLkvJ14buES9P6WrMkb-ui_p2qjf1Nk9gWcSbnxQLftup9OSH6jWindNlqEs7_lkoWXrzxzPixn_ap8BCuNcMMa-O9rbKkp8hERw_WNxtBV/s640/2013dec.jpg" width="640" /></a></div>
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This 25th month has not been my favourite one. It's subtle, but I can feel that my skin is regressing a bit. Until last month my skin was clear, but as the weather turned chilly my skin started showing some reactions. To be more precise, I'm getting some small red patches, itches, flaky skin and random spots/flares. It's possible that I wore make-ups a little too often recently - but this month I got back in contact with some old friends whom I couldn't see during the withdrawal, so I wanted to look presentable.<br />
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This is me last month (no makeup).<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuaa5pUdxpnr9lb8eNdekLFtcMJqnEWTUBULMVExWXlARh8_ZQiD4NwxyW1GvWYhwROizxALxePlGFuJdjGz33lKGRJj5_7pyUDvY2PFbtWC-UIloKgpExQuc6FED1BrljLi4vLxA0RvTV/s1600/11.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuaa5pUdxpnr9lb8eNdekLFtcMJqnEWTUBULMVExWXlARh8_ZQiD4NwxyW1GvWYhwROizxALxePlGFuJdjGz33lKGRJj5_7pyUDvY2PFbtWC-UIloKgpExQuc6FED1BrljLi4vLxA0RvTV/s320/11.jpg" width="220" /></a></div>
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This is me this month (again, no makeup).<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwxE7kG4d5b_PFELxolbOCKL1iTtEZZnjlmhb0ikbqiTShcR1zkqZnBf6378lLYG8Qfzr9_90lc-n4GpflaJvVQqKu0JMWLC6kncJXcAuSaFb5b271-qi43uGzc_SnBuemRaQdUTH_x-vO/s1600/12.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwxE7kG4d5b_PFELxolbOCKL1iTtEZZnjlmhb0ikbqiTShcR1zkqZnBf6378lLYG8Qfzr9_90lc-n4GpflaJvVQqKu0JMWLC6kncJXcAuSaFb5b271-qi43uGzc_SnBuemRaQdUTH_x-vO/s320/12.jpg" width="201" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoX-kpWgcPr25smorvl3gfEJWZ5Gsg7MdRO7DTmJRq0xLnKHUyb7iTe3eI89SwIHfalZVImxyn1kHmcgn-Rcj-7RyW-p5imUPkYn7pWV65gaH41ITt3mIe0JQ_LkOjYf0hPCfyZgU6AvDO/s1600/12-2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoX-kpWgcPr25smorvl3gfEJWZ5Gsg7MdRO7DTmJRq0xLnKHUyb7iTe3eI89SwIHfalZVImxyn1kHmcgn-Rcj-7RyW-p5imUPkYn7pWV65gaH41ITt3mIe0JQ_LkOjYf0hPCfyZgU6AvDO/s320/12-2.jpg" width="259" /></a></div>
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I'll see what happens...<br />
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Thank you for reading and commenting on my blog this year. It is encouraging to know there are people going through the same skin condition and yet staying positive, strong with beautiful minds.<br />
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I wish everyone a wonderful Christmas and New Year!<br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com6tag:blogger.com,1999:blog-1632585507201168859.post-88535952035486446302013-10-29T04:38:00.001-07:002017-03-25T15:59:40.839-07:00Month 23<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcGwSxEa4pFQ0t-vHnL85Z2DGWaGHkUOTsCWQLg4TzcAqPmzoKPBVmJAV6efLEDO4VSclRYoQ7SGr97mLa7ne2VI_PGyeWjgd5vimW3dnkw4CdMuihHWDDo-MAI07Lgjclb1wRZddApbdI/s1600/2013oct.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcGwSxEa4pFQ0t-vHnL85Z2DGWaGHkUOTsCWQLg4TzcAqPmzoKPBVmJAV6efLEDO4VSclRYoQ7SGr97mLa7ne2VI_PGyeWjgd5vimW3dnkw4CdMuihHWDDo-MAI07Lgjclb1wRZddApbdI/s640/2013oct.jpg" width="640" /></a></div>
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Just a quick update on my latest TSW progress on month 23.<br />
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It's been okay. Not perfect, but I'm happy in general. I wore full make-up several times in September and I think that was a bit too early. I got dry red patches on my face and that reminded me of the restart of TSW. After I stopped using base make-up and a soap on my face, luckily it's calming down now. <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgE-vQEEIwcYQ1G0U-zEbCVtiNB37EvnVONhtG0_p3R3MHmEvuytj1VEfiMPScgV8ZhZ1yH2h-8nXm-xul686XFtl5shUuSE2lB8Rkyj4MLcII0vY9HEG4ANI1PCJBwFnPayJ3oZEC24ZWl/s1600/face10.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgE-vQEEIwcYQ1G0U-zEbCVtiNB37EvnVONhtG0_p3R3MHmEvuytj1VEfiMPScgV8ZhZ1yH2h-8nXm-xul686XFtl5shUuSE2lB8Rkyj4MLcII0vY9HEG4ANI1PCJBwFnPayJ3oZEC24ZWl/s200/face10.jpg" width="128" /></a> 19/10/2013<br />
My face looks a bit more unstable and pigmented in reality than this picture. <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAWCwMTxMnlmJDMmoCLGfJWi016fltIbaSuUCEcrZaUiBEUgLafgA891tzHD0SgRXbQoIXFmPyPTVAu1v62R_KioxsCq4Q30rWGY5MJgB3jSw2hHvsg2Tohp70d9aqm_4HLlyV8ejbeRRP/s1600/wrinkles10.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAWCwMTxMnlmJDMmoCLGfJWi016fltIbaSuUCEcrZaUiBEUgLafgA891tzHD0SgRXbQoIXFmPyPTVAu1v62R_KioxsCq4Q30rWGY5MJgB3jSw2hHvsg2Tohp70d9aqm_4HLlyV8ejbeRRP/s200/wrinkles10.jpg" width="120" /></a></div>
With some base make-up on, you can see fine wrinkles especially when I smile. <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEhhy4XTfFDRYGR4IcZzZrOqIg5tdScUcMGnKDJDqX4SxB29bEITIdakpNKC3Zu3fGXdxFv3BmpjfDzmv5zj4RJUOI1QmkqwHASZW7E0AIsl5OecDLwvz1DP3mY1GoVkbSoEnRGjevWVkz/s1600/neck10.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEhhy4XTfFDRYGR4IcZzZrOqIg5tdScUcMGnKDJDqX4SxB29bEITIdakpNKC3Zu3fGXdxFv3BmpjfDzmv5zj4RJUOI1QmkqwHASZW7E0AIsl5OecDLwvz1DP3mY1GoVkbSoEnRGjevWVkz/s200/neck10.jpg" width="135" /></a></div>
My neck is fine. <br />
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Next month is going to mark my 2 years anniversary of my latest TSW.<br />
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I hope everyone is seeing some steady progress. xxx<br />
<br />
<br />Tommyhttp://www.blogger.com/profile/13556416359993220028noreply@blogger.com14