I have a lot of respect for Dr. Peter Lio — at least he is trying to learn about and raising awareness about TSW — but this article is wrong on a couple fronts, already pointed out in other comments. This article puts the blame on patients for misuse of topical steroids, but the reality is that many doctors (the majority it seems) either don’t know about or don’t believe TSW is real, and they ignore the risks of steroids noted in the drug inserts. Many patients end up with TSW after relying on their doctors’ guidance. We did.
Topical steroids are available as creams, lotions, gels and ointments; selection of an appropriate product can also provide good moisturization of the skin. The wide spectrum of potencies and bases allows these mediations to be used both effectively and safely while under the care of an experienced physician.
During flares, over-the-counter moisturizing preparations that include a topical corticosteroid (such as clobetasone butyrate and hydrocortisone) are helpful to control inflammation and restore the skin barrier. The intensive use of emollient-based products can reduce the need for topical steroids.