Tuesday, 12 November 2013

Eczema and Steroid Withdrawal

This is a feedback I got from one of my many patients who relied on steroid for his eczema.

He came to see me for his eczema problem.  He said that he had eczema since his childhood days and had been seeing western GPs over the problem. Initially the eczema was mild and not serious. It comes and goes. He was given steroid cream to apply.  But slowly, his eczema worsened.  He was given steroid medicine to take orally. Over the years, he had been using steroid cream (Betamethasone) and steroid medicine (prednisolone) on and off for the last 35 years.  When the eczema was bad, he had even taken  a dosage of 30 mg of steroid.  

He said his eczema was not getting better over the years although he had been seeing Western doctors. In fact, it got worse and spread to more areas, such as the hands, legs, body and face. 

Lately, he researched on the internet and realized that steroid had side effects. So he was determined to stop using steroid cream and steroid oral medicine. Two weeks after he stopped using steroid cream and steroid oral medicine, his legs were swollen like elephant legs. They were red, swollen, dried and cracked (especially his sole). He could not even wear his shoes.  His body and palms were also swollen. He found that his skin was hot especially at night but yet he felt cold at the same time .His appetite increased and he consumed double the normal amount of food. Gradually, he noticed that his eczema was oozing more profusely with time. He was also perspiring profusely at night (had to change clothes 3 times a night). His perspiration was smelly. He felt very uncomfortable during this time and he had to take two months unpaid leaves to stay at home.

Two months later, the swelling of his abdomen, palms and face slowly disappeared. The swelling of his legs was the last to disappear. His appetite also returned to normal.  It took  two months for the swelling to go off. The cold and hot feeling also subsided.
But his eczema was still bad and oozing; it was so itchy at night that he could not sleep all night. He could not bear the itch any more.  One of his friends told him that one Western GP by the name of Dr. Tan was very good in treating eczema and someone was actually healed after taking his medicine. So he went to see the Dr. Tan.  To his dismay, this Dr. Tan also suggested steroid treatment for his eczema which he declined.  After that he realized that all Western doctors would likely describe steroid for eczema cases. So, he decided to come to see a Chinese physician.

This month his eczema starts to flare up again. But it is not as bad as before (3 months after he stopped steroid).  However, he still feels itchy especially at night. Previously, he seldom perspires, but now when he jogs, he does sweat. At times when he feels sleepy, he takes a bath. After bathing, he could not sleep.  The itchiness comes and goes. For example, at the beginning of the month it may be itchy; middle of the month, less itchy.  He still feels itchy especially at night.

He asked to try Chinese Medicine. I told him that eczema can be healed. But he has to refrain from certain foods. He also has to take Chinese medicine and apply Chinese herbal creams continuously for 3~4 months. He should be able to get well.


Symptoms of Severe Eczema 

Most severe eczema sufferers normally feel uncomfortable in hot weather and yet shun cold (怕热又怕冷). They do not like to be under the sun (which actually is good for their condition). They normally like to be in a room temperature around 24 degrees Celsius. These people seldom perspire and do not like to exercise because they feel uncomfortable when they sweat. Their skin is dry and they need to apply moisturizer daily. They do not sleep well especially when the eczema flares up and are easily irritated. After a bath they feel itchy and the eczema turns red. They usually have to apply moisturizer immediately. The itchiness is normally more intense at night than in the day time. Sometimes they could not sleep the whole night. Sometimes when eczema flares up, blisters, oozing, flaking and swelling can occur. When the eczema flares up, sufferers feel very itchy and when eczema gets well, they do not feel itchy (the itchiness is proportionate to the severity of the eczema 这是成正比). 


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