Trapped in the Topical Steroid Withdrawal Itch, Pain, Burn Cycle? Chinese Herbs  Offer a Pathway to Healing.

Eczema. For many, it's a familiar foe, a chronic skin condition that brings unwelcome bouts of itching, redness, and inflammation. But for some, the very treatment that brought relief – topical steroids – has become the villain, ushering in a new phase of misery known as topical steroid withdrawal (TSW) which is also known as red skin syndrome, topical steroid addiction and steroid addiction syndrome. 

 

TSW is a complex and often debilitating condition marked by worsening eczema symptoms after stopping or tapering long-term steroid use. While there still is no accepted diagnostic criteria for TSW, in my practice clients present when with symptoms that can include peeling or cracking, swelling, pus filled bumps, a red sleeve pattern on the arms and legs, pain, burning or stinging sensations of the skin and leaving them feeling trapped in a frustrating cycle. Many of my clients with TSW have a history of medium to high potency topical and/or orally ingested or injected steroids. It can cause an extraordinary burden on people such as loss of sleep, fatigue, depression and impact work and social life. While conventional medicine offers limited guidance, hope shines from the wisdom of Traditional Chinese Medicine (TCM).

 

Nature's TSW Warriors:

So, which herbal warriors stand ready to battle TSW? Here are a few key players:

• Chrysanthemum (ju hua  or ye jua hua are used): These cooling blossoms possess anti-inflammatory and anti-pruritic (anti-itch) properties, helping to soothe inflamed skin and calm the itch storm.

• Burdock root (niu bang zi): This detoxifying root clears rashes, red swellings and itchy pruritic skin and which calms internal factors which may contribute to TSW symptoms.

• Cortex Moutan (mu dan pi): This root bark clears blood heat and purges fire, drains pus and reduces swelling. Gallic acid is a major component of this herb. A 2025 study in the journal Molecules 2015, 20(9), 16388-16403; https://doi.org/10.3390/molecules200916388 concluded, “Gallic acid is the major active ingredient from Cortex Moutan that can dose dependently inhibit release of IL12-p40 and the functional surface markers expression of CD40, CD80, CD83 and CD86 from cytokine cocktail-activated moDC. Gallic acid could also lower the concentration of hydrocortisone required to inhibit the activation of DC. The current results agree with our hypothesis that gallic acid from Cortex Moutan may interfere with the maturation of dendritic cells from monocytes with altered cytokine secretions and functional surface marker expression” 

• Radix Rehmanniae (sheng di huang): This nourishing and heat clearing herb strengthens the body's Yin bi increasing fluids and moisture which are crucial for healing and recovery from TSW and eczema.

 

Note: Chinese herbalists might use Licorice root (gan cao) in herbal formulas. Licorice root is a greatly debated and misunderstood herb in the TSW community. Learn more about this controversy around licorice root and TSW here. 

 

Tailored Harmony:

The beauty and effectiveness of TCM lies in its personalized approach. Unlike the one-size-fits-all approach of steroids, TCM practitioners create custom herbal formulas based on your unique constitution and the specific nuances of your TSW journey to address the root cause from the inside-out. We also use an outside-in approach with calming herbal creams and ointments to aid the healing process, reduce inflammation, to soothe and protect the skin barrier. Think of it as an orchestra of herbs, each playing its part in restoring harmony to your skin and body.  The time it takes for herbs to work depends on the severity of your condition. In my experience it takes at least 3 months and up to about 12 months with changes occurring along the way. Herbs are ingested twice per day as a tea or as concentrated powders in capsules. 

 

 

Children benefit from Chinese Herbs too!

I love working with babies, children and teens and their caregivers. Kids with eczema gain great benefits from Chinese herbs for TSW or as a method to wean off topical steroids in order to avoid dependence and to avoid TSW. This study of 85 children showed significant improvements compared to the placebo group, no serious adverse effects and the total amount of topical corticosteroid use was also reduced by a significant one third in the treatment group! This is consistent with what I encounter with my clients except that a larger percentage of them no longer need steroids. The difference may be because this study was over a 12 week period and I usually work with pediatric clients for around 6-8 months depending on the case.

 

To learn more about how to heal, nourish and protect the skin barrier from the outside in download my free e-Book, Eczema Essentials: Build Your Natural Skincare Routine.

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A Guided Odyssey:

While the internet and social media influencers may tempt you with self-treatment shortcuts, remember: navigating the complexities of TSW with natural herbal remedies requires expert guidance. The internet and social media are full of misinformation and disinformation. And just because something is natural does not mean it is safe. Consulting a licensed practitioner of Traditional Chinese Medicine is essential. We can assess your individual needs, develop a safe and effective herbal regimen, and provide ongoing support throughout your healing process.

 

Hope Beyond TSW:

TSW may feel like an endless desert, but within its sands lies the oasis of relief. Chinese herbal medicine, backed by growing scientific evidence and centuries of tradition, offers a promising path to healing. So, take a deep breath, let go of the quick-fix mirages, and embrace the wisdom of nature's warriors. With the right guide and a blend of potent herbs, you can reclaim your skin and step onto a path of renewed serenity.

 

Ready to chart your course to clear TSW and eczematous skin? We can help! Juliette Aiyana, MTCM offers online virtual herbal consulting to people within the USA and Canada. She is a professional member of the National Eczema Association.  Reach out to us today to schedule. Remember, you're not alone in this and the path to relief, though sometimes winding, leads to a destination worth reaching. So, take that first step, and breathe new life into your skin.

 

Juliette Aiyana, MTCM Chinese Herbal Medicine & Holistic Health Expert takes her time to really understand your health, figure out what's causing your symptoms, and work out a plan for your long-term well-being. Plus, you can connect with her easily through video visits, no matter where you are. Herbs and supplements are mailed to you.

 

Experience Juliette’s two decades worth of expertise caring for clients like you with complicated and chronic diseases using Chinese herbs, vitamins, functional nutrition and attainable lifestyle adjustments. 

 

Sources:

 

• Topical Steroid Withdrawal Syndrome: What the Eczema Community Needs to Know, Now: https://nationaleczema.org/

• Tsang MSM, Jiao D, Chan BCL, Hon K-L, Leung PC, Lau CBS, Wong ECW, Cheng L, Chan CKM, Lam CWK, et al. Anti-Inflammatory Activities of Pentaherbs Formula, Berberine, Gallic Acid and Chlorogenic Acid in Atopic Dermatitis-Like Skin Inflammation. Molecules. 2016; 21(4):519. https://doi.org/10.3390/molecules21040519

• Uzun S, Wang Z, McKnight TA, et al. Improvement of skin lesions in corticosteroid withdrawal-associated severe eczema by multicomponent traditional Chinese medicine therapy. Allergy Asthma Clin Immunol. 2021;17(1):68. Published 2021 Jul 9. doi:10.1186/s13223-021-00555-0

• Cai X, Sun X, Liu L, et al. Efficacy and safety of Chinese herbal medicine for atopic dermatitis: Evidence from eight high-quality randomized placebo-controlled trials. Front Pharmacol. 2022;13:927304. Published 2022 Sep 27. doi:10.3389/fphar.2022.927304