Topical Steroid Withdrawal - Healing in Waves

If you spend any time reading about topical steroid withdrawal (TSW), you’ll almost certainly come across diagrams or posts describing topical steroid withdrawal stages. Some even suggest how long each stage should last, outlining expected durations for different phases of TSW recovery.

These models are shared widely, and I understand why.

When you’re in the middle of topical steroid withdrawal, uncertainty can feel just as distressing as the symptoms themselves. The idea of clear TSW stages offers something solid. A sense of order. A hope that if you just get through this phase, the next one will be easier.

When I was going through it, I wanted that reassurance too.

But over time, through my own experience and through supporting hundreds of others navigating topical steroid withdrawal recovery, I began to notice something important:

Most people don’t move through topical steroid withdrawal in predictable stages and when they try to force their experience into a TSW timeline, it often creates more anxiety than clarity.

 

My experience: healing came in waves

My recovery from topical steroid withdrawal wasn’t linear. It didn’t progress cleanly from one phase to the next.

It came in waves.

The first few months were a huge shock. I had lived with eczema, sometimes very severe, but I had never experienced the level of burning, endless oozing and skin instability that TSW can bring. That alone was overwhelming.

Symptoms would settle for a while. I’d feel cautiously hopeful. I’d start to believe I was “moving into the next stage.”

Then, without warning, everything would flare again.

What made this so hard wasn’t only the physical symptoms. It was the unpredictability.

You don’t know a wave is coming.

You can’t plan around it.

You can’t confidently say, “I’ll be okay by then.”

That uncertainty wears you down. If you’re in that space right now — wondering whether your skin will ever stabilise — I’ve written more personally about that feeling in [Will My Skin Ever Heal?]

Over time, though, I noticed something subtle but important.

The waves still came, but they weren’t identical. Flares gradually became shorter. The intensity slowly reduced. My baseline improved.

The overall direction was forward, even if the path wasn’t smooth.

In a rigid stage model, a flare feels like going backwards.

In a wave model, a flare can still sit within progress.

That shift in perspective changed everything for me.

 

Why this still matters

Although I healed years ago, I still spend a great deal of time supporting people navigating TSW.

I regularly see posts in Facebook groups where someone shares photos of their skin and asks:

“What stage am I in?”

“Which month of TSW was the worst?”

“Is this normal for this point in recovery?”

These questions usually come from fear and exhaustion. People want reassurance. They want confirmation that what they’re experiencing fits within a recognised TSW timeline.

But having now watched hundreds of individual topical steroid withdrawal recovery stories unfold, I’ve rarely seen two journeys follow the same pattern.

People at very different points can look remarkably similar. Others move back and forth between symptoms supposedly tied to completely different “stages.”

When someone’s experience doesn’t match a stage theory, it often leads to thoughts like:

“I should be further along by now.”

“I’ve gone backwards.”

“I’m never going to heal.”

 That additional pressure and stress can be heavy, and completely unnecessary.

 

The limits of rigid TSW stages

The commonly shared topical steroid withdrawal stages were originally observations, not clinical laws.

Over time, they’ve been repeated so often that they can start to feel like established facts. But there is no medical research confirming a universal sequence of TSW stages or a guaranteed topical steroid withdrawal timeline.

In reality, symptoms overlap. They repeat. They disappear and return. Two people with similar steroid histories can have completely different recovery patterns.

When we treat stage charts as universal truth, they can unintentionally create pressure rather than reassurance.

A different perspective: waves, not stages

This idea of non-linear healing isn’t unique.

In the book 肌戒毒 2 (Skin Detox 2), Taiwanese dermatologist Dr. Song Feng-Yi (宋奉宜) describes steroid withdrawal reactions, including topical steroid withdrawal as cyclical rather than stage-based.

Drawing on years of clinical observation, he noted that flares tend to rise and fall over time, often gradually reducing in intensity, rather than progressing through fixed, predictable steps.

When skin has been exposed to long-term topical steroids, it adapts. Blood vessels constrict. Inflammatory signals are suppressed. Natural regulation changes.

When that suppression is removed, the body doesn’t rebalance in a straight line, it recalibrates.

That recalibration can look like:

·       Inflammation rising

·       Then settling

·       Then rising again

·       Often a little less intensely each time

Rather than fixed stages, it may be cycles, the body adjusting, stabilising and gradually finding its baseline again.

That perspective resonated deeply with me because it reflected what I experienced.

 

Different areas, different timelines

Another reason rigid TSW stages can feel misleading is that healing isn’t uniform across the body.

The face and hands are more exposed, often thinner-skinned and subject to constant environmental stress. In my own journey, these areas flared more visibly and felt slower to stabilise, but they did eventually settle.

Healing can happen at different speeds in different places.

That doesn’t mean you’re stuck.

 

A gentler way to measure progress

Instead of asking, “What stage of TSW am I in?”, I’ve found these questions more helpful:

·       Do flares settle more quickly than they used to?

·       Is my baseline tolerance slowly improving?

·       Can my skin settle without me feeling like I need to panic or change everything?

·       Do setbacks feel less overwhelming over time?

 These don’t give neat timelines.

 But they often give a more honest picture of topical steroid withdrawal recovery.

 You can find more lived-experience articles like this in the [Learn section].

Where external support can help

Healing itself has to come from within.

But that doesn’t mean you have to endure every flare without support.

During waves, the goal isn’t to “fix” the skin. It’s to reduce distress while the body does its work.

For many people, simple, non-irritating measures, like baths, can make a meaningful difference.

This is where my bath soak fits in.

Over the years, I’ve seen a wide range of experiences.

Some people have described noticeable improvements in comfort relatively quickly. Others have used it consistently as part of a simple routine and felt steadier, more gradual improvements over time.

There’s no single pattern, just as there’s no single TSW timeline.

If you’re exploring ways to support your skin more gently during this period, you might also find my experience with reducing heavy moisturisers helpful — I’ve written about that in [Moisturiser Withdrawal in TSW & Eczema].

Sometimes reducing discomfort even slightly can change how well someone copes mentally.

And that can make the whole process feel less overwhelming.

 

Disclaimer

I’ve lived with eczema for most of my life and later went through topical steroid withdrawal myself. This article reflects my personal experience and observations from supporting others navigating similar journeys. It is not medical advice and should not replace professional medical guidance. Everyone’s skin and healing process is individual.