TSW: What to Expect

TSW: What to Expect

Everyone's TSW healing time varies depending on:

  • the length of time you were on steroids, topical and oral
  • the potency, or strengths, of steroids
  • where the topical steroids were applied and for how long

Every individual is different and while some people recover in less than 12 months, others may take more than 12 months, or more than two years.

Common symptoms:

  • red burning skin, or what looks like red sleeves and red legs, from blood vessels opening up after being constricted from topical steroids.
  • eczema rashes
  • swelling of the skin
  • oozing and crusting of the skin due to leakage from blood vessels
  • intense itch
  • body temperature may run hotter than normal or you may feel chills
  • enlarged lymph nodes
  • hair loss or thinning of hair
  • shedding or flaking of skin
  • difficulty sleeping, or insomnia, due to itch and pain


Have a support system! Suddenly stopping steroids after long-term use is never recommended, as it can be life threatening. Find a supportive doctor to properly guide you through TSW.

It is crucial to have a supportive partner, or friend; someone who will help you cope during hard times because it will be hard.

You may choose to continue to moisturize, or go through moisture withdrawal (taking away all moisturizers). Here are a few things to consider:

  • Moisturizing does provide comfort in dry, cracked skin during TSW.
  • Moisturizing encourages the growth of staph bacteria on the skin. If you stop using moisturiser you don’t give the staph an opportunity to thrive and spread.
  • Moisturizing can cause stinging or burning sensation, but not moisturizing may be just as uncomfortable.
  • Moisture withdrawal allows your skin to produce the natural oils on its own again.

Be prepared to...

  • stay home or take time off from your profession because TSW may become debilitating. Recovery takes time.
  • change your routine.
  • lose sleep.
  • feel uncomfortable and itchy for an uncertain amount of time.
  • not shower/bathe daily, so your skin has time to generate its natural oils.
  • still have eczema, or other skin conditions, after TSW.
  • not know when and why your skin continues to flare (the return or increase of common symptoms listed above).
  • go through a lot of ups and downs. TSW is challenging, physiologically, emotionally, physically, mentally.

More on the skin

Expect your body to gradually turn red and oozy from a small portion of your body to the entire body, depending on where and how long you were using steroids.

Do your best to cover up your  skin. The less you disturb the skin, the quicker it can heal.

The redness and ooze will peak at some point during TSW. After the height of your redness, the dry and continuous itch stage follow.

You will shed, or your dry skin will flake off, all the time. This is good! It's a sign of healing. Have a vacuum ready.

The itch!

You won't be able to escape the itch. It is part of the healing. Here are some ideas to manage it:

  • trim and file fingernails smooth, in case you do scratch, you don't break skin
  • ice packs to reduce the redness and itch
  • cover up the skin to protect your skin from damage from scratching
  • stay busy to keep your mind off the itch
  • keep hands busy
  • apply pressure, or squeeze the itch, rather than scratch
  • wear cotton or bamboo gloves
  • eating cold foods, such as ice cream and popsicles, to cool body from inside out
  • positive thinking: the itch will decrease and does stop one day.