Could Modifying the Skin Microbiome, Diet, and Lifestyle Help with the Adverse Skin Effects after Stopping Long-Term Topical Steroid Use?

Abstract

We set up this preliminary study to begin to evaluate one main question: could strengthening the microbiome have potential benefits for the skin condition of patients suffering with adverse effects after stopping long-term topical steroid use? We aim to turn it into a much larger study if the results show the interventions might help. After commonly being prescribed for eczema, cessation of topical steroid use, especially after long periods of inappropriate use, can leave lasting adverse effects on the body and skin, known by some as topical steroid withdrawal (TSW). This preliminary study involved seven human participants suffering with skin problems associated with TSW who approached Dr. Anja Gijsberts-Veens of their own volition because they were interested in more natural recovery methods. Five completed the study in full. Progress in skin condition was tracked by self-assessed symptom severity questionnaires filled out at the beginning and end of the five-month study. The skin microbiome was addressed by using a 100% natural product shown in previous work to significantly increase skin microbiome biodiversity. Three participants implemented dietary changes and supplementation in response to guidance after fecal sample analysis, with the aim of improving gut microbiome health. The average improvement in skin symptoms for all participants was 40%, and average symptom improvement ranged from 14% for Patient 5 to 92% for Patient 1. On average, the participants saw an improvement in 85% of their symptoms and stagnation or regression in 11% and 4%, respectively. Our results suggest that the interventions used might improve the skin condition of TSW patients, but the small sample size and the lack of a control group mean that more definitive conclusions should be reserved for our follow-up work, which addresses these issues. We also aim to swab the skin of participants to assess the effect on the skin microbiome from skin and gut treatments, as well as including a more in-depth analysis of skin and gut microbiomes.

Keywords

• topical steroid withdrawal
• topical steroids
• eczema
• atopic dermatitis
• skin microbiome
• gut microbiome