Friday 13 December 2013

Final Thoughts After a Week of Not Moisturising My Skin

Hi folks! I'm finally at the end of my week-long experiment with no moisturisers. Here is today's photo.
...and yes...it does look exactly the same as every other photo I have posted this week.

I have seen ZERO improvement in my skin and to be honest, it has got a little worse, with dry patches spreading into previously good areas of skin.

Which either means that MW just isn't working for me, OR that I would have to give it a lot longer than one week to see any improvements. Some people have suggested giving it a month. Do I want to look like this for another month? Hmmmm..I will have to give it some thought....

So how have I found this week? In a word: Terrible. I absolutely hated it. I hated the tight feeling of my skin. I hated the way it looked and I hated the way it felt. The skin kept flaking in very thin papery flakes, which rubbed away to reveal raw, wet skin underneath. The wet skin would flake over and the whole cycle would repeat itself, which is why my skin looks no better today than it did last week.

The last time I got the papery scabs was at the beginning of TSW, on my legs. At the time, no attempt to dry them out worked. they just kept papering over, dropping off and revealing new wet skin. The only thing that helped at the time was the moist wound method, which is the polar opposite to MW. The idea of moist wound healing is that a moist environment promotes healing. And it did. for me, it worked and my wet wounds healed up, revealing healthy skin.

I really don't think MW is the way to go for me personally. I know it works great on some people, but the problem is that you get a handful of people who have seen vast improvements through this method and then they assume it works for everyone. TSW works very differently for individuals. Some like baths, some showers. Some like heat, some cold. Some like moisturisers, some don't. Nobody is right or wrong. We are all just different. In my case, my skin just craves sunlight. If you look at my photos from summer this year, you will see that I had lovely smooth skin, without having to resort to anything as extreme as this. And just because sunlight works for me, I wouldn't tout it as a cure-all for everyone, as I know that some TSW'ers react badly in sunlight. That's my point. We are all different and all have our own ways to cope with TSW.

So...on to the results of my poll. Drumroll please......

Here are the results of 56 votes.

I asked TSW'ers if they had tried moisturiser withdrawal and whether it worked for them.

33% said no, they hadn't tried it.
10.5% had tried it, but it didn't work for them.
17.5% had tried it and it worked great.
19.3% had tried it but were still undecided about whether it helps TSW.
19.3 tried it but cheat occasionally.

I hope you find the results of my poll interesting. and again, it just goes to show that whilst MW is fantastic for some people, others remain unconvinced.

Over the week, I have read a lot of quotes and comments about the subject of MW and before I close the topic for good (I'm getting really bored talking about it now and feeling like a stuck record!). I will close my piece with some quotes from various sources, giving both positive and negative views of MW. I hope that in reading these quotes and reflecting on my experiences this week, readers can come to their own conclusions about the efficacy of moisturiser withdrawal.

Positive Quotes About Moisturiser Withdrawal

"It takes at least a month for normal skin to fully adjust to moisturizer withdrawal. Let alone tsw damaged skin, or skin in the midst of a flare. However mw makes the entire process much better in the long run and as per the Japanese studies, shortens tsw...after completing my tsw I was 100% fully healed at 15 months, without needing any moisturizers whatsoever. I cannot fathom going at this for years."

"from not using moisturiser parts of me that were disaster areas have actually miraculously healed pretty fast"

"For me "dry and itchy" was better than "moist and itchy" because if I scratched soft, moist skin I tore it up and inflamed it more than if I scratched dry skin--this was an immediate improvement. My skin does seem to have toughened better without "moisturizers", but like everyone else I am not my own double-blind study, so I don’t know what would have happened if I hadn’t stopped. "

"I decided to quit using moisturizers. Turns out, it was the best decision I've made so far. Within 3 days all the oozing completely stopped. The places that would not heal are healed! I am still red, itchy and flaking, but nothing like before. I'm not lying on the couch all day and I'm sleeping at night. I hope this progression continues, but you never know with tsw. The first week sucked. I looked horrible and felt worse. I had to keep splashing cold water on my face and legs to help with the dryness and pain. I was shedding like crazy. It was like stopping steroids all over again. But, it was totally worth it. to see such a big improvement in 2 weeks is a welcomed change."

"By the fourth day however, I am starting to feel pretty good! My face looks like the desert and my whole body is shedding like crazy but feels ok and the skin underneath is soft. By the end of the week I can get in and out of the shower and not feel like I am shriveling up after. My skin has gone from feeling like leather to as good as it was when I was using moisturisers! Only my face is still badly scaly but it is anyway after a flare – regardless of what I use. It is so exciting to see it producing its own oil and I am so glad I put faith in my body – the feedback mechanism worked!!"

" TSW patients who recover well are usually doing moisturiser withdrawal strictly, according to the doctors."

"My wife has the most silky smooth awesome skin imaginable and she takes lukewarm showers and never ever has used moisturizers in her life"

"After two weeks it was soft almost everywhere. One month it's fantastic and the best part is 1) saving money on creams 2) no greasy bed or clothes 3) no redness. I'm still tight around my hinges but not red. "

"So excessive moisturizing do harm to skin recovery by delaying keratinocyte proliferation. I reccomend you should use no or less moisturizer if you want to advance recovery of the skin barrier" -Dr Fukaya


...And the Other Side of the Argument...

"So if utilizing any moisturizer is comfortable for your skin, it is not necesarily wrong to apply it."-Dr Fukaya

"Last week I was lucky enough to have a holiday in warm, sunny, humid Gran Canaria. My skin was instantly happier. I practically stopped all moisturising immediately I got there. My skin was perfectly happy for me to do that and did not 'crave' the vaseline in any way. Now I'm back in cold, arid UK, my skin is totally prone to dessicating again, and I'm finding I need the Vaseline once more. I am confident that once my skin is happier, I will be able to stop using the vaseline without any problem at all."

"Personally, I would not have made it through TSW if I couldn't moisturize/lubricate. My skin felt 5 sizes too small and I often couldn't turn my neck (dangerous to drive) or bend my fingers without some good lubricant usage. "

"I've seen so many heal while using moisturizer and not one came back and said they now have to use it daily to keep their skin from flaring etc.... I use no emollient on my healed skin and never need it period in those areas and used buckets and buckets of white palm oil and various other non-chemical emollients."

"I would agree that trying the non moisturizing thing was terribly uncomfortable and I couldn't stick with it. On the other hand, I did have that experience where putting on too much moisturizer made my skin's integrity feel compromised somehow and since TSW started I've been very concerned about all the additives we're unaware of in lotions these days.

To that end, I decided to make my own cream (blogged about it if ur interested) and have been relying on it for the last month or so and it has been working great. Also use Dr. F's hyaluronic acid on my healed bits once a day. I only moisturize once a day now and try to last till the next morning even if I feel a bit dry and I think that moderation has helped strengthen my skin.

I think it comes down to a balance of everything. Going extreme in one direction or the other is not a great thing for our bodies and it's interesting to read these empirical descriptions but in the end take them with a grain of salt to find what works for us individually."

 
I hope you all enjoyed reading the quotes and the results of my week experiment. For my final quote, I have chosen the one that mirrors my own feelings most accurately. It is from the moisturiser withdrawal thread on the Itsan Forum:

"Personally, I don't think there's a single answer that applies to all of us. Just like we have found different ways to deal with all of our symptoms, moisturizers (more than one type) are just more items in our bag of tricks. It may work for some of the people some of the time - or like me right now, on certain parts of my body but not others. Or certain moisturizers might work for some people and not others. And it might depend on severity if symptoms on any given day, or temperature/climate or a lot of other variables.

The only constant in this whole crazy experience seems to be that there are no absolutes. I am experimenting every single day to figure out what works best. Whatever works today, tomorrow might be different. And what works for me might not work for you. And so on..."



I wish happy and swift healing to all those going through the hell of TSW right now, whatever method they choose....

*Since I posted this, Dr Fukaya, a leading TSW doctor has been quoted as saying:


Mototsugu Fukaya2014年1月22日 8:43
It is not a so complicated problem. Some patients become addicted by topical steroids while others not. It is the same thing that there are some patients whose recovery can be accelerated by disuse of moisturizers. I admit that it is a fruitless effort for the others to refrain from moisturizers. Disuse of moisturizers is not suitable for all patients but worth to try if recovery from TSA is extraordinary delayed or the patient intends to withdraw from TSA as rapid as possible regardless of hardness. (It is my opinion. Dr .Sato recommends disuse of moisturizers more strongly than me from his own experience. Most dermatologists will think that disuse of moisturizers is crazy. I am between the two. )

I couldn't agree more.














12 comments:

Leslie said...

Its such a waste for you to stop now and go back to moisturizers. I only wished I could have taken pictures of my horrid skin prior to MW and prove it to the world visually. It took a good 3 weeks before the skin toughens out.

The reason for the massive drying and flaking is because of two issues: 1) TS withdrawal, 2) lack of moisture from environment as you had been moisturizing before. Once the layers flake off repeatedly, there will come a time when your new skin integrity is stronger and tougher.

It is really an issue of instant gratification vs delayed gratification. If you can trust my advice, give it a go for a good month or so. If it fails and does not work out for you, you can publicly ridicule my views on my blog or your blog and I'd not advice anyone ever in my life. This is how confident I'm with respect to moisturizer withdrawal.

Nonetheless it is your skin, your life and any decision you take will be respected.

I wish you progress again.

Cheers,
Leslie

Leslie said...

This is a reference for you for the timeframe and expected results from skinofrose blog:

Dr.Sato recalls in his book "when I stopped applying moisturiser for children with eczema who were in the process of topical steroid withdrawal, they had a strong withdrawal reaction on the first week. This continued for the second week, but their skin appeared to start slightly drying and healing. On the third week their skin became obviously dry up which gave me a positive perspective. I was relieved. And their skin became strong so that scratching didn't leave scars any longer." I must add that in his book he doesn't say moisturising is bad for your skin at all or recommends no use of it for ever. But from his experience he seems to think that it is worth doing at one point of the steroid withdrawal process.


1 week isn't enough. your symptoms are expected, predicted and experienced by similar people who have gone through MW. This is good science more than anything.

Leslie

jsan said...

It is a tough process to try especially mid-flare. It took me several failed attempts to finally do it. My husband said exactly what Leslie has, that after a week it would be a waste to stop. At two weeks when I wanted to use something again he said it would be a waste. Finally a month had passed and most of my skin didn't just look normal, but felt completely normal, strong, resilient and smooth. After a week there is really nothing you can confirm with regard to this method, except that it is hard. I wish you a speedy recovery.

Louise said...

If you read my post you will see that I haven't said anything in there about going back to moisturisers, just that it is the end of my week-long experiment.

The kids break up soon from school and I have no intention of blogging and posting daily selfies for another month. Plus, I think it would bore everyone to death.

Leslie. I have no intention of publicly ridiculing anyone's blog. What would be the point? As as I see it we are all in this together and I have not done this experiment with the intention of belittling anyone's views of the subject. I respect that everyone has different opinions on this topic.

What I would ask though, is that people take a look at the photos I posted this summer. You will see that at the time, my skin returned to normal and I did not need to moisturise. I believe that this healing period was to do with sunlight more than anything else.

Leslie said...

Louise,

I wrote that ridicule part as a context to show how much conviction I have with regards to not moisturizing, after all you have been through, I felt it is a great waste.

Not sure if you realised, but your post did sound somewhat skewed towards MW not working despite providing opposing views and arguments to balance.

Here is my latest piece on my views on MW.

http://saynototopicalsteroids.wordpress.com/2013/12/14/what-happens-when-we-withdraw-from-moisturizers-immediately/

Bless.
Leslie

Louise said...

Leslie, again I can only repeat what I said in my earlier comment which is that I have not said anything in the post about going back to moisturisers, so I'm not sure how you came to the conclusion that I have!

Yes, I had a bad week, which I have been honest about and the pictures tell a thousand words. If someone is going into this, I would rather they have a realistic idea of what to expect in the first week, so they go into it with eyes wide open,

I then balanced the post out with quotes from those who found it successful. If you count the quotes, you will see that there are actually MORE quotes in favour of MW than there are against.

I'm sorry if the post came across as skewed to you. That was not my intention at all. I wanted it to come across as balanced and fair.

Elaine said...

HI Louise
thanks for posting your experiment for us all to see. I found it very interesting. I am rather like you - somewhat undecided. I think you are brave to do it - especially in the run up the Christmas in the UK winter! As you say, in the summer in the sun, you looked great! You've battled this for (literally) years now. I dont blame you for feeling ambiguous about MW. Perhaps a dab of moisturiser now and again, so as to feel 'normal' and another bash at MW in the spring, when the sun re-appears (unless you seek out a light-box and try some artificial UV?)
all the best. Thanks for posting so regularly.... Hope things improve soon. xx

Louise said...

Thanks Elaine! Glad you enjoyed following the posts and found my experiment interesting.

It will be a relief to go back to blogging about normal stuff again next week!

And yes, I would love to try the UV box. Unfortunately, I think that the only way to access one at the moment is via the derm at the hospital, but I will definitely look into other ways...either that or a holiday somewhere sunny...oh yeah!

Lisa Leung said...

hi louise,
i was reading everyones comments,
and i have been in MW since beginnign of Oct for the second time. the first time i did it was summer and it worked really well...
second time i am doing this.. it hasn't been too ideal.
not sure if its the course of tsw or the mw itself or even cus its winter here in canada, but i get better and get worse.
right now... at about.. almost 3 months into MW, i am very bad.
probably worse off oozing everywhere, itchy, dry, red inflammed swollen. everything.
maybe its tsw course, but... i still dont moisturise. i have done spot checks. like put a bit of dr. f lotion on one area and see if it makes a difference, but nothing makes a difference.
i can say this.. once you start the MW, liek you have a week, its so hard to go back to moisturisers and have smooth skin. your skin will be rough for a long long timeeeeeee.... my face is so rough and scabby even after 3 months of this MW.
its sad. my nose a bit oily and it makes the scales all yellow and gross like seb derm. maybe i have that. i don't know. but i do agree that MW works for some and might not work for others.
i am rambling..
sorry.

Louise said...

Thanks for sharing your experiences Lisa. Sounds like you have had a rough time with the Moisturiser withdrawal method!

Hope you get a break soon and see some improvement. You are brave to have stuck it out for this long.

Hats off to you and massive respect. X

Unknown said...

I think it all depends on your lifestyle choice too as to whether you can commit to MW. I keep falling on and off the bandwagon but the reality is I want to feel comfortable when I'm out at work for a full day serving the public. I don't want my skin to feel tight and itchy. I just go by whatever it dictates to me that day if I'm being honest.

Of course I did find that too much moisturiser causes me to break out with various infectious diseases, no matter how clean and vigorous I am at applying it... but that has just made me only apply the smallest amount when I feel I absolutely need it.

/ramble ramble

To cut a long story short: moisturise if you want, don't moisturise if you want. Just don't be excessive in either direction.

Louise said...

Hi Jenny, great to hear from you.

Hope you are doing OK and keeping the EH at bay.

Totally agree with your comments, in fact, since I posted this blogpost, several people have told me that they have been moisturiser-free for 3 months or more and are still flaking and flaring.

In my own case too, there are areas like my belly, legs and inner arms that I havent moisturised in over a year, but they are still dry and flaky, so moisturiser withdrawal hasn't done anything spectacular for me.

Moderation seems to be the key, with minimal use of moisturisers as needed, especially when facing people!