An eczema sufferer whose body was left red raw has made a dramatic recovery by ditching steroid creams and showering just once a week.
Holly Broome, 24, from London, has battled the skin condition ever since she was two weeks old.
The graphic designer went to a GP but in 2017 following a bad flare-up – but claims she was only told it wasn’t ‘that bad’, to moisturise more often and use a stronger topical steroid than she had been her whole life.
But her skin seemed to be getting worse. Her skin oozed yellow pus in the bed sheets, and her boyfriend would hoover up her flaky skin from the floor of their apartment.
She was constantly sore and it hurt to shower. Ms Broome had to move back into the comfort of her parents home in Gloucestershire because they had a bath.
In 2018, she stopped using steroid creams because she feared her skin was addicted to them. Withdrawal caused her skin to become even worse.
She began no moisture therapy (NMT), which involves avoiding any form of moisture in the aim of helping the skin produce its own moisture.
Although she is not ‘cured’, Ms Broome says her skin is finally under control – and she is campaigning to stop doctors handing out steroid creams ‘like candy’.
Holly Broome, whose body was left red raw due to eczema, has made a dramatic recovery by ditching steroid creams and showering just once a week. She is pictured a year apart
Ms Broome is not ‘cured’, but says her skin is finally under control (pictured). She is campaigning to stop doctors handing out steroid creams ‘like candy’
Ms Broome started no moisture therapy (NMT) in June 2018 (pictured) which involves avoiding any form of moisture in the aim of helping the skin produce its own moisture
Topical steroid addiction (TSA) is when eczema is uncontrollable, becoming resistant to topical steroid creams.
When topical steroid medication is stopped, the skin burns, itches, swells and oozes pus for a period of time known as topical steroid withdrawal (TSW).
Ms Boome said: ‘I stopped using any kind of steroid in April 2018. Over the next month my skin deteriorated rapidly.
‘I could no longer sleep at night due to night sweats and the constant itch that moved around my body.
‘I shed vast layers of skin every night and my boyfriend had to hoover the flat every day, as well as the bed every time I slept in it.
‘Underneath the layers of the skin that were peeling off wasn’t new skin, it was raw, damaged skin that oozed a yellow liquid.’
Ms Broome began NMT in June 2018 and saw her skin improve ‘after a few weeks’.
She said: ‘The redness went right down, my skin stopped oozing and many of my open wounds started healing.
‘By August I was well enough to move back to London and go back to my job.
‘Since then my skin has been constantly healing. It still flares every now and then, but I just leave it alone and within days it’s back to normal.
‘I no longer moisturise, and my skin is less dry than when I was moisturising. I stick to one or two cool showers a week and my skin is thanking me for it.’
Ms Broome said she ‘shred vast layers of skin’. Pictured in 2018 after ditching steroid creams
During the summer of 2017, Ms Broome’s eczema returned after years of having it under control. It spread like ‘wildfire’ across her back and body (pictured)
Recalling her childhood, Ms Broome says she took oral steroids from a young age after being diagnosed with eczema as a newborn.
She was hospitalised aged five because her scratching was so relentless her parents didn’t know how to help her anymore.
Ms Broome said: ‘I was wet wrapped in steroid bandages and was constantly on oral steroids and antibiotics.
‘I remember waking up every night and scratching until my bandages fell off. My skin never responded particularly well to steroids, it was always so red and burning hot.’
By the time she reached her teens, Ms Broome’s eczema had become better and she wasn’t using topical steroids.
But then she became incredibly stressed during university in 2017 which triggered an eczema flare-up on her back, legs and arms.
She said: ‘At the same time my mum was diagnosed with a brain tumour.
‘Stress is my biggest trigger so throughout this stressful period my skin kept flaring, and I did what anyone else with eczema would do: I went to the doctors.
‘The GP took a quick look at my skin, which by that point was the worst it had been in years, and told me I wasn’t moisturising enough, that I wasn’t using a strong enough steroid and she said “it’s not that bad, I’ve seen worse”.
Ms Broome’s boyfriend had to hoover their flat of flakey skin every day
By 2018, Ms Broome’s skin was constantly sore, her skin radiated heat and it hurt to shower. She is pictured in June when she had given up steroid creams for two months
‘I left that appointment feeling completely deflated. She had dismissed my suffering based on other people’s eczema which was completely unfair.’
Despite taking all the usual precautions, Ms Broome felt she was made to feel like she wasn’t doing enough.
She started to use the steroid cream Eumovate which cleared her skin for only a few months.
During the summer of 2017, while interning in London, Ms Broome said: ‘My skin was getting worse.
‘The rash on my back started spreading like wildfire onto my torso, all up my arms and onto my face – somewhere that hadn’t been affected since I was little.
‘I struggled to get out of bed in the morning, my skin oozed fluid all over the bed sheets, I was flaking, and my skin felt hot to touch.’
More prescriptions of steroids and antibiotics failed to work for more than a couple of months, and by the start of 2018, topical steroids ceased to work at all.
Ms Broome even tried a diet of just rice, chicken and cabbage as an alternative way to heal her skin.
She said: ‘While reading the Eczema Diet book, I came across a term I’d never heard before. That was TSW.
‘I found horrifying images of people whose skin was unlike anything I’d seen before.
‘Initially I was in denial that TSW was what I had, I used steroids as the doctors instructed so I couldn’t be that addicted to them.
Soon the eczema covered 70 per cent of Ms Broome’s skin, she said. Pictured on June 2018 when she first began NMT after stopping steroid creamsin April 2018
Ms Broome said: ‘Underneath the layers of the skin that were peeling off wasn’t new skin, it was raw, damaged skin that oozed a yellow liquid’
‘I was wrong. I couldn’t possibly have been prepared for how bad my skin would get.’
There is debate among medics about whether TSW or topical steroid addiction is ‘real’.
TSW is thought to occur when steroids have been abruptly discontinued after a prolonged or inappropriate length of administration.
After hearing about TSW in February, Ms Broome researched the condition before stopping all steroid use on April 19, 2018 .
The effects of coming off steroids resulted in Ms Broome moving back in with her parents so she could be taken care of six weeks into her withdrawal.
She said: ‘I could hardly shower anymore due to the pain of the water jets and the towel.
‘Eventually I had to move home with my parents in Gloucestershire as I couldn’t look after myself anymore and needed access to a bath.
‘I was now red over 95 per cent of my body, my adrenal gland was messed up and not functioning properly due to its dependence on the synthetic hormones I’d been rubbing onto my skin.
‘I was in an unbelievable amount of discomfort. I didn’t recognise the face in the mirror anymore and I didn’t leave the house for months.’
The graphic designer went to a GP but claims she was only told it wasn’t ‘that bad’, to moisturise more often and use a stronger topical steroid than she had been her whole life
Ms Broome’s back is pictured left, while using steroid cream, and right, after stopping
Desperate, Ms Broome began NMT, developed by a Japanese doctor called Dr Kenji Sato, in June 2018. It is not scientifically proven to work.
Now with much calmer skin, Ms Broome said: ‘I don’t want to claim that I’ve healed my eczema, but I’ve found a way to control the condition which goes against any advice my doctors gave me.’
Ms Broome feels doctors are reluctant to advocate for TSW but she, along with friends she’s made in the TSW community, have started a campaign called Scratch That to raise awareness.
‘TSW isn’t currently recognised in the UK but there’s a massive online community of people suffering from this condition,’ Ms Broome said.
‘Currently, steroids are handed out like sweets with little instruction on how to use them properly or when to stop.
‘The aim is to campaign to get the prescription of topical steroids more controlled and to get topical steroid addiction diagnosed and treated properly.’
A British Skin Foundation dermatologist said: ‘There is growing evidence that topical steroid withdrawal is genuine problem for some patients.
‘But topical steroid withdrawal needs to be distinguished from patients who have atopic eczema which is undertreated, and which is flaring when patients stop using their anti-inflammatory ointments.
‘Also there are some patients who have a lot of anxiety about using steroid ointments (steroid phobia). Patients who do experience topical steroid withdrawal describe how awful living with this problem is, as it affects their skin, general and psychological health.’
To see more, visit Ms Boome’s Instagram and the campaign page Scratch That.
IS TOPICAL STEROID WITHDRAWAL REAL?
Many have called topical steroid withdrawal a fad, however, it has been recognised by the National Eczema Association since 2013.
Also known as red skin syndrome, the disorder does not have many statistics to show how common it is.
One 2003 study from Japan, found that 12 per cent of adults who were taking steroids to treat dermatitis developed RSS.
Last year, the medical journal Dermatitis published the results of a three-year study of Australian patients presenting with TSW and acknowledged that it is often dismissed as being a result of over-use of steroids, or even steroid phobia.
The British Association of Dermatologists accept that doctors still do not recognise this condition.
BAD spokesman, Dr Anton Alexandroff, said: ‘In rare circumstances, overuse of strong steroid can lead to thinning of the skin. This overuse doesn’t make the eczema worse, but it can sometimes trigger an acne-like problem, particularly on the face, which then flares up when steroids are stopped.
‘Some people refer to this as steroid withdrawal or steroid addiction, however, this isn’t something that is formally recognised by dermatologists.
‘The differing opinions come down to whether this skin reaction is caused by stopping steroid treatment, or by a flare-up of the underlying disease because the treatment has stopped suddenly. Dermatologists believe it is the latter.’
Symptoms of TSW include:
- Redness, particularly on the face, genitals and area where the steroids were applied
- Thickened skin
- Swelling and puffiness
- Burning or stinging
- Dryness and cracked skin
- Excessive wrinkling
- Skin sensitivity and intolerance to moisturisers
- Frequent skin infections
Excessive sweating and itching is a sign of recovery. Many sufferers also develop insomnia.
Treatment focuses on anxiety support, sleep aids, itch management, infection prevention and immunosuppressants.