New Skin Science Frontier in Skin Microbiome

Topical Steroid Side Effects

Question 1: What is this new term I keep hearing of “Skin Microbiome” or “Skin Flora”?

Answer 1: Welcome to the new-age of skin science! This is going to be fun. We are at the doorstep of realizing that we’ve been mistakenly killing off our best allies that were designed to protect us all along. Technically speaking, the skin microbiome, also known as skin flora, is the family of trillions of bacteria, fungi, viruses, archaea and tiny arthropods that make your skin their home!

Question 2: So wait…bacteria is good?

Answer 2: Yes! We like to call them the “good, bad and ugly” for easy reference. They belong together and if we learn to respect that the bad bacteria can be eaten up by the good bacteria, then we will be mindful to stop using toxic anti-bacterial products and hand-sanitizers that supposedly kill 99.999999% of all bacteria. Sound familiar? That’s because our society has developed an obsessive compulsion to sterilizing our living environment which has, in turn, literally reduced our immune systems as a collective society.

Now we realize that our immune systems are actually made up of bacteria too! They are not all bad or ugly. They’ve been fighting for us all along, despite us.

Question 3: So do I or don’t I wash my hands?

Answer 3: Hey, hey, hey. Don’t go from one extreme to another, cowboys and cowgirls! This is where we all learn from our mistakes of the past and don’t fall for the pendulum swinging from one extreme to another.

We are smarter than that now. We are going to not take this new science for granted because we know that a more diverse flora of bacteria is actually helpful to resist the common dangerous ones that even the toughest of antibiotics no longer have any effect on them. So we are going to go back to the basics of washing with good old-fashioned bar soap without preservatives, and we will just slow down a bit, take a breath and exhale while we enjoy the lather. We minimize the “Skin Burden Threshold®” of chemicals and additives.

Question 4: What do scientists predict this new discovery to do for skin conditions?

Answer 4:  It’s kind of like this… We are happy dancing yet trying to hold down our expectations as we do more research simultaneously. The findings so far are incredible, and yet we feel the responsibility to guard the data from hijackers that will come along to exploit the science for profit’s sake. They need more time, data and research. 

Question 5: Is it true that our ancestors had a more diverse bacteria biome?

Answer 5: YES! Both internally and on their skin. They lived, hunted and played outdoors so they were exposed to a more diverse spectrum of inhabitants. That boosted their immune systems.

Question 6: So a more diverse biome will help me boost my immune system?

Answer 6: As the science of probiotics, prebiotics has shown in our gut systems, yes, our glorious skin biome, also reflects the same amazing potential. So we can actually consider the right bacteria/fungi/viruses to help rebalance the naughty ones from harming us. It’s that simple. The complicated part is identifying the ratios of each and locations on skin and body and statistically seeing where the cut-off point is on each of the “good, bad and ugly.”

Question 7: Is it true that babies born naturally through the mother’s birth canal actually have less incidence of eczema and allergies?

Answer 7: Yes! This is further proof that the baby is inoculated with a deep-tissue massage as it exits into the world through the mother’s bacterial passageway!

“Babies delivered by cesarean section (C section) acquire a microbiota that differs from that of vaginally delivered infants, and C-section delivery has been associated with increased risk for immune and metabolic disorders.”

So now it is becoming a common practice to gather cultures of a mother’s internal flora and apply to a baby that is born via Caesarean operation.  It’s still a relatively new science and the difficulties are obvious that nothing can truly compare with the voyage of a baby vs. an application of mother’s bacterial cultures collected quickly.

Question 8: How can I increase my skin microbiome naturally?

Answer 8: Go take a hike. Go play in the dirt. Go visit your uncle’s farm and help him tend the land for a few months! Stop being so metropolitan. Cancel your gym membership and do cross training in a park, a beach or mountain. Open your windows and shut off the air conditioner. Eat clean foods without preservatives, sugar, alcohol and dyes. Resist taking antibiotics unnecessarily for minor situations whenever possible and boost your body’s natural strength to fight off invaders.

Stop being obsessive and compulsive with household cleaning products and use baking soda and vinegar instead.  Go back and use simple ingredients on your skin and hair without preservatives.  Be a minimalist. Get rid of stuff, go outside, travel and explore different worlds, cultures, and cuisine.

Question 9: Would it help if I increase my gut biome as well?

Answer 9: Yes, since your immune systems are inter-related your ability to fend off the “bad and ugly” will be determined by both your gut and skin biomes to attract the good and mighty. So make friends with people from around the world and potluck your get-togethers with a variety of dishes from each “culture.”   See that word “culture” it also refers to the different species of bacteria so remember a different culture brings a different culture of bacteria and that’s really good news for your diversity training both biologically and socially speaking.

*My work is (almost) done here.

I hope you’ve enjoyed this preliminary journey exploring the side effects of a widely misunderstood drug and what you can do to offset potential side effects for your future health.

My next book, SKIN Confessions, focuses more on re-setting the immune systems with alternative, ancient and futuristic methodologies. It is intended to inspire you to discover so many other ways to take control of your health to explore your journey of healing.

Read sample chapters right here.

Let the healing begin…®

Emollient Solutions

Topical Steroid Side Effects

Question 1: Can an emollient moisturizer really help with eczema?

Answer 1: Yes – they have been found to help reduce flareups and increase complete remission and/or reduction of atopic dermatitis in high-risk infants. That’s pretty amazing and the best part…is they are considered to be generally safe to use.

“Parents and carers of children with eczema often underuse emollient therapy, essential to repairing and protecting the defective skin barrier in atopic eczema. Educational interventions delivered by specialist dermatology nursed in hospital setting shave been shown to improve emollient use and reduce symptoms of atopic eczema.”

Question 2: Any proof to back it up?

Answer 2: In 2008, a pilot study was conducted by Dr. Eric Simpson, who was funded by the National Institute of Health (NIH) and National Eczema Association (NEA).  The study included 22 babies at high-risk for atopic dermatitis. Parents applied an emollient cream at least once a day over their baby’s whole body, except diaper area and scalp. The result was that only 3 babies of the 22 developed atopic dermatitis within the follow-up period of 547 days. Similar studies of such high risk subjects would have probable results ranging from 30% – 50% towards the eventual development of atopic dermatitis. 

That pilot study has since inspired more international clinical trials both sponsored by companies with vested interests in promoting their own emollient use, as well as non-vested  academic researchers legitimately looking for alternative protocols for atopic dermatitis.

Once daily usage of an emollient showed considerable promise to prevent the atopic dermatitis according to the Barrier Enhancement for Eczema Prevention Study. BEEP was a multi-center, international, randomized controlled pilot study. This was announced at the annual meeting of the Society for Investigative Dermatology.

Question 3: Are emollients safe and are there any adverse side effects?

Answer 3: Of course, there are always exceptions to every product or medication and allergic reactions can occur from any particular ingredient. However, generally speaking, the consensus is moving towards using emollients as the first line of defense and prevention before prescribing the more risky alternative of topical steroids. We are moving in the right direction of reassessing the medical protocols of jumping too soon on the corticosteroid regimes.

“The results of this trial demonstrate that emollient therapy from birth represents a feasible, safe, and effective approach for atopic dermatitis prevention. If confirmed in larger trials, emollient therapy from birth would be a simple and low-cost intervention that could reduce the global burden of allergic diseases.”

Question 4: Isn’t ELAJ an emollient?

Answer 4: Yes – it has been called emollient, moisturizer, eczema therapy and the fancy word, emollience. But the basic premise of ELAJ products is that they are lipid rich and intensive, without water in the formulation. So it is not a light moisturizer.  The best results have been found when patients apply ELAJ 3-4 x during a flareup until it subsides within a week or two or less. Thereafter, apply once a day, preferably after bathing when body is still warm and dry. The absorption will be more higher.  A secondary touch up for the affected area if there is a tendency to itch at night. More information can be found at .

India’s Progressive Movement

Topical Steroid Side Effects

Question 1: Why was India experiencing a pandemic of topical steroid abuse?

Answer 1: This was due to a cultural obsession with lightening dark skin. This is a sad, social phenomenon that has to do with racial classification. The desire for lighter skin tones still has seriously dangerous and detrimental psychological ramifications among many Eastern, Mideastern and Asian cultures, not just India. Actors, models, singers, and the general public still deal with economic discrimination as well as social preferences in marriage proposals to lighter skin tones. 

There were also other factors for topical steroid misuse resulting from public ignorance, lack of information and medical negligence. Pharmacies were disregarding the manufacturer warnings while profitable sales increased each year. The market was saturated with prescriptions for steroid cocktails of antibiotics and anti-fungals that would be re-filled and shared among family and friends without any direct supervision from dermatologists.

Another factor was that there had been a shortage of dermatologists in ratio to the country’s population of over 1.35 billion. Most of the dermatologists are located in urban municipalities completely denying access to so many in the outlying populations.

Question 2: How did the consumers use the steroids to lighten their skin?

Answer 2: They mix topical steroid cremes that are known to thin skin with a bleach creme to lighten darker skin tones. That was the onset of an epidemic level of topical steroid addiction case studies. Since 2008, Dr. Koushik Lahiri and other doctors started seeing more and more patients that tried to alter a cosmetic issue, but unknowingly became far more injurious to their skin and endocrine systems with far-reaching consequences. 

It was not an eczema-induced prescription that caused the topical steroid addiction, but rather a cosmetic craze for lighter skin tone that triggered a topical steroid addiction epidemic!

Question 3: How and when did India ban the sale of topical steroids from being sold over-the-counter without a prescription?

Answer 3:  One of the first heroic voices in India lobbying for change was the world-renown dermatologist, Dr. Koushik Lahiri.  Since 2008 he has been a trailblazer documenting the detrimental history of corticosteroid abuse. Loaded with case studies, he pleaded to the Ministry of Health and Parliamentary House in India.  His personal mission was to rescind the law and ban OTC (over-the-counter) sales of any topical steroid without a prescription. In August of 2016, he finally succeeded with his original proposal to the Indian Association of Dermatologists called: Stop OTC Sale of Topical Corticosteroids without Prescription.

He has since been recognized by the International Society of Dermatology for his work on many fronts to protect public health and skin care and educating and encouraging international medical professionals to become more sensitive to the conditions. 

He also founded a countrywide initiative task force to study and publish the first multi-authored international compendium on the topic: A Treatise on Topical Corticosteroids in Dermatology: Use, Misuse and Abuse. This medical practitioner’s reference tool aims: “To fill up the lacuna and to contribute significantly to the dissemination of knowledge about the indication/contraindication, mechanism of action, ethical use, side-effects and various other facets related to topical corticosteroid.

Topical corticosteroids (TC) have greatly enhanced dermatologists’ ability to effectively treat several difficult dermatoses. The available range of formulations and potencies allows them to flexibly treat all groups of patients, different phases of disease, and different anatomic sites.

Improper/incomplete knowledge about topical corticosteroids’ mechanism of action, indications, classifications, and contraindications has produced a rapid rise in the incidence of improper use of these drugs, which could potentially bring disrepute to this entire group of amazing drugs.

Responsibility for disseminating proper knowledge regarding when, where, and how to use TC both to internists and patients primarily rests with dermatologists. In this regard, the benefits of rational and ethical use and the potential harm of overuse and misuse for non-medical, especially cosmetic purposes, should be clearly conveyed before prescribing TC.”

Question 4: Will hydrocortisone ever be taken off the over-the-counter market in the United States?

Answer 4: That is highly unlikely due to the powerful wing lobby of Big Pharma. What we can do is educate ourselves, our loved ones, and report Adverse Drug Reactions to the FDA and register at to become a better informed self-patient advocate!  The doctors in India have taken great strides in causing ripple effects in the east.

We, in the west, can learn if we choose to see the parallel universe of topical steroid addiction potential. Albeit, the original intentions of using corticosteroids were quite different, the results and consequences have the same endocrine disruption. This provides more valuable data that can be shared to document the clinical effects of addiction/withdrawal.

For more  information on Dr. Lahiri .

Facebook page:

Lahiri K, Coondoo A. Topical steroid damaged/dependent face (TSDF): An entity of cutaneous pharmacodependence. Indian J Dermatol

[serial online]

2016 [cited 2018 Nov 9];61:265-72. Available from:

Coondoo A., Lahiri K. (2018) Topical Steroid Damaged/Dependent Face (TSDF). In: Lahiri K. (eds) A Treatise on Topical Corticosteroids in Dermatology. Springer, Singapore://

ITSAN – International Topical Steroid Awareness Network

Topical Steroid Side Effects

Question 1: What is ITSAN?

Answer 1: ITSAN is a non-profit organization dedicated to spreading awareness about Red Skin Syndrome, also known as Topical Steroid Addiction or Topical Steroid Withdrawal. Their full name is International Topical Steroid Addiction Network. Also they have been known as Topical Steroid Awareness Network.

Their website is .

The youtube channel is linked here.

ITSAN Red Skin Syndrome Support has grown into a thriving world-wide online community where members share, comfort and encourage one another. ITSAN serves international populations as a resource for the individual, the caregiver, and the healthcare provider.

Question 2: How old is ITSAN and how did it get started? 

Answer 2: Again, we are amazed at how one individual’s experience and heartache can turn a question into a snowball movement and potentially a revolution in less than a decade. In 2009 a woman started the website from her own experience in Red Skin Syndrome and her personal topical steroid withdrawal experience into an international resource and safe zone for so many! Kelly Palace posted her photos as well as articles and white papers from Dr. Fukaya, Dr. Rapaport, and Dr. Kligman.

By 2012, Palace changed the website to and filed for non-profit status with Dr. Rapaport as a co-founder. Soon after, Dr. Rapaport left ITSAN while Palace continued as president until 2015.  Today ITSAN is a member in Good Standing of the Coalition of Skin Diseases since 2014. ITSAN is now hosting its own conference.

Question 3: How does ITSAN work to get the word out?

Answer 3: ITSAN advocates for the RSS community by:

1. Being a member of the Coalition of Skin Diseases

2. Member of the International Alliance of Dermatology Patient Organizations IADPO

3. Community outreach at the Eczema Expo by National Eczema Association NEA

4. Participating in the American Academy of Dermatology’s Inflammatory Skin Diseases/Itch Measures Work Group

5. Attending the AAD Annual Meeting and Scientific Sessions

6. Lobbying in Washington, D.C. With the Coalition of Skin Diseases at the Annual AAD Association Legislative Conference

7. Working toward creating a patient registry to further future research efforts

8. ITSAN has developed a survey to estimate Cortico-Steroid Exposure (CoStEx) that can help quantify Withdrawal & Recovery experience. The survey was developed by an MD and a PharmD. It is confidential and would help those suffering with TSA/W. Here is the link to that: ITSAN SURVEY.

9. They developed a brochure that can easily be printed that can be shared with your medical team or friends and family  ITSAN BROCHURE

10.  They produced a really cute cartoon whiteboard video that easily explains the whole deal with this crazy phenomenon  ITSAN CARTOON VIDEO

Question 4: What’s on the immediate agenda for ITSAN to do more?

Answer 4: To break it down in steps, they are :

Developing a member registry so that the growing Facebook support group will be transferred into a database of actual members.

Organizing a webinar series to help offer more support

Host one-day conferences.

Question 5: What’s holding ITSAN back from really getting the word out there?

Answer 5: Remember this is a volunteer organization of actual RSS sufferers that are barely getting their health and lives back from the tight grip of topical steroid withdrawal recovery.  The passion of getting the word out there is immeasurable from these warriors that sacrifice their own time and effort at their own expense. They are only limited by lack of funds. Many times the volunteers are relying on the $5, $10 and $50 donations from the ones that are already suffering with limited incomes due to the debilitating condition and not being able to work.

Question 6: What can I do to support

Answer 6: There is still so much to do to get the word out. It’s a two-part process. One important aspect is to work on a medical outreach program directly educating medical practitioners on topical steroid side effects.The second is public outreach directly to the eczema/psoriasis populations to help them be fully informed before, during and after the decision to use topical steroids.

Remember it was less than 10 years ago that one woman’s voice started this snowball movement, and today ITSAN is a lifeline for so many to make better-informed decisions about their health through support.

Imagine if your donation just happened to be the spark that helped someone avoid unnecessary suffering…

Patients Like Me

Topical Steroid Side Effects

Question 1: What is Patients Like Me all about?

Answer 1:  Go to Patients Like Me to discover a new online forum where over 600,000 patients with 2,800+ different health conditions share their medical history, symptoms, medications, and side effects. All in the hope that others will compare and learn about their particular condition or treatment, so they make better choices. As patients, we do not have access to see the true independent clinical research about medications and treatments. Now you can dig deeper into that important information. How many people took a certain brand-name or generic medication and found it useless? Were the side effects of a new drug too risky to deal with? What other options do you have? You just may find the answers there.

Question 2: Is that information going back to the drug manufacturers and pharmaceutical companies to know that some medications are good, bad or ugly?

Answer 2: YES! It did not start out that way. It really was just a forum for patients. But it grew so exponentially big, that it’s become even more powerful than just a consumer/patient forum.

NOW the big pharmaceutical companies are actually taking back the statistical information from the website and using it to re-strategize their own medical research and drug development!  This is a HUGE breakthrough for patients!

Question 3: Is the Food and Drug Administration paying attention to this online site as well?

Question 3: YES! Since 2016, the FDA is benefitting from direct patient-reported data and gaining powerful insights to drug efficacy and safety!  This is so exciting for everyone. It’s a win-win partnership for all.

As of 2015, over 110,000 adverse drug reactions were reported on that site alone. Because the FDA has always struggled with a huge gap in adverse drug reporting from doctors and patients, now this online forum is a safe place for patients to share their reactions.  The FDA has now taken this site seriously as a place to survey starting points on market reactions.

Question 4: Has there been any case where helped get a drug recalled or refuted?

Answer 4: YES! Because of the data generated about a lithium carbonate treatment for amyotrophic lateral sclerosis (ALS) the same disease that Professor Stephen Hawking died from in March 2018, they were able to refute results from an actual clinical trial!

Again…we are here happy dancing at this news that a patient-to-patient network was about to evaluate and provide more realistic results than a clinical trial! We think should qualify for a courtesy Nobel Peace Prize in Medicine for helping redistribute the power back to patients and their voices, rather than relying only on the frequently skewed clinical trials that have vested interests in more profitable results to benefit drug manufacturers.

We hope that this platform stays true to their original intent and does not sell out to the proverbial devil and the deep pockets that feeds the system. As of the writing of this book, we have not found any hint of that occurring. However, whenever data is shared, a higher level of vigilance is needed to make sure that power is not hijacked.

Question 5: Why didn’t anyone think of this long ago?

Question 5: Sometimes it takes a devastating heartbreak to drive a question into a movement into a revolution. In this case, it was two brothers, James and Benjamin Heywood, who were inspired to reach out and find more effective treatment for the ALS disease that their brother was diagnosed with at 29 years old. The two brothers just needed a resource to compare notes with other ALS patients, so they could decide what treatment option would be better. There were no other resources. That’s how was born.

In just one decade since their brother’s death, has grown to be a force to reckon with as a robust and legitimate resource information platform. We congratulate they Heywood family and the team at Patients Like Me for their noble mission and their accomplishments already made to the medical community of patients.

Question 6: How can benefit the eczema/psoriasis and other skin condition patients?

Answer 6: If more skin condition patients register online and deposit their health journeys and detailed topical steroid medication experiences, then the statistical database of pros and cons will grow. Once more data is accumulated, the public awareness will benefit, as well as medical practitioners to know if their protocols are working.

Question 7: Has anyone reported Topical Steroid Side Effects or Red Skin Syndrome on

Answer 7: YES, YES, YES!  As of this book publication date, there have been 68 patients that reported their own experiences with each topical steroid they used. In fact, the condition is listed as Red Skin Syndrome/Topical Steroid Withdrawal. There you have it folks! Where many medical practitioners have not acknowledged this condition, there is now an independent platform that does right there, and it is open for everyone to review. This is just a starting point to provide a safe place to deposit the long history of topical steroids and efficacy and potential side effects.

Question 8: Is there any way to create a poll or another type of survey within Patients Like Me?

Answer 8: YES! YES! YES! They have a large research division within their platform and can set up an independent survey by contacting the folks at Patients Like Me RESEARCH tab on their website. They can guide and initiate how they can help to administer this type of survey.  There are academic ways to do this or with an independent group to get this funded by grants as well. This is where it all comes together.  Dermatology students also have credence to work with Patients Like Me and their data to help with publishing papers and research activity.

Question 9: Is it really anonymous?

Answer 9: A patient or caretaker can create an anonymous profile on any computer and set up their health history and medications list(s). They can detail their experiences with each medication or treatment protocol. It is a brilliant concept to help share valuable information that would otherwise not be available to patients.If you’ve read this book thus far, you must know someone that has dealt with topical steroids on some level. Please forward this information to them and encourage them to share their experiences on Patients Like Me.

Question 5: Can we really make a difference just by inputting our individual health issues on a website?

Answer 5: Thank you for asking this magnificent question! That one question may be the key to saving humanity…no, seriously! There is a new platform online for patients and caretakers that could be the missing piece to the puzzle. It was created by two brothers who lost their other brother to Amyotrophic Lateral Sclerosis (ALS.) When they explored the medical options available for treatment and what, if any, side effects they had, they found a huge void and lack of available information. Just like topical steroids! They needed to compare medications their brother was given and how it fared with others that were a few stages ahead. What was the statistical average of survival and what were the side effects? The brothers intuitively knew that relying on the original clinical test of the pharmaceutical companies was not wise. After all, those companies had a vested interest in swaying information in their favor and, quite possibly, were not going to help them in trying to save their brother.

So they started a website called They created an online system where anyone – patients or caretakers – can share their true experiences with each drug, medical protocol and side effects with honest feedback from others that went through the same ordeals. WHAT A BRILLIANT CONCEPT, right?  Here at ELAJ headquarters, we constantly nag, nag, nag for anyone and everyone with any disease or medical ailment to register, even if anonymously from a random computer at a library or hospital to just DO IT! For the sake of humanity, DO IT! For the sake of clearing our collective conscience to help others in need, DO IT!

Imagine if 70% of patients with eczema or psoriasis input their information into that database? I can imagine the shivers of the pharmaceutical executives all the way through my computer keyboard as I’m writing this.  How else can we, patients and caretakers of those that are ill, gain control back from the dominant power of Big Pharma?  This could be the ONLY way to statistically get the data and leverage back in our favor.

In light of the latest concern about opioid drug addiction and abuse, imagine people sharing their stories. Cancer treatments and the recurrence ratios and hearing from people in similar cases describe their actual health journeys? This is why I think this could be one of the keys to saving humanity. It has become a beacon of light for so many people.

Here are some of the data points that are priceless and can help all of us. Can you see how this is so powerful? THIS is the game changer we’ve all been looking for all these years. If the FDA had stepped up their own game, the ADR Adverse Drug Reaction reporting system could have been this, but instead it’s a hidden web of sticky data that we do not have access to, which we should have had all along. Now, Patients Like Me is where we can go and get some answers. Obviously, it won’t work until it gains more traction and you, me and every grandma deposits our experiences and data into it. That’s when it will gain more significance. But at least now, there is hope. These are some examples of the types of information that can be

Topical Steroid Phobia

Topical Steroid Side Effects

Question 1: My doctor responded to my questions about topical steroid side effects with an answer that I, “suffer from topical steroid phobia,” is that possible?

Answer 1: We hope that gathering more comprehensive information to make an informed decision does not constitute ‘phobia.’ Our goal is to fill in the blanks of where the medical industry has not done due diligence in informing their patients properly. Until recently, many doctors minimized the potential risks and failed to communicate them to patients. This book intends to open the discussion wider to include more resources for further research for both patients and medical practitioners.

The worst possible scenario is to have an extreme pendulum effect. The pendulum swings from one extreme to another and they are on opposite spectrums. We humans have a tendency to run the other way if we sense danger as part of our flight or fight instinct. But we don’t have to run in the opposite direction. Corticosteroids can be effective when used carefully and with knowledge of side effects and a well-thought out plan with your medical practitioner(s).

Question 2: How can I balance my fear of side effects with the necessity of taking them carefully?

Answer 2: You’ve made it through this book this far, you are already well-informed and cautious. We are so proud of you. Now this is where good reasoning skills kicks in. You are aware of the side effects. You know what to look for and most importantly, you know that you can out-smart steroids by keeping your adrenals in check. It’s all about timing and quantity of application and potency. The general consensus is that 2 weeks is the demarcation point of giving your skin/adrenals a break. This allows you to keep trying to track and test where the original problem comes from and eliminate the cause – whether it be an allergic reaction from a skin irritant or an auto-immune response stemming from your gut or other systemic reaction.

You also have resources to check like and and online facebook chat groups that have veteran warriors that have been through the trenches of it all.

You also are now aware that alternatives to steroids like emollients can actually help bridge over the difficult flareup stages. The website offers variations of emollients and bath soak alternatives to bleach.

Question 3: There are other new drugs that I’ve been offered to participate in clinical trials and free medications. How do I decide to take them?

Answer 3: The same resources in Question 2 would apply here. Do your research. Some of them are identified as non-steroidal, yet have immune-suppression similarities. Again, those Facebook groups have folks that have already been down that road and can offer some help and more resources.

Question 4: This paranoia of topical steroids is all over the internet. How can I get through the noise?

Answer 4: Be your own patient advocate by keeping your health journal to document your journey. Everyone reacts differently. Everyone has a different health journey. So keep track of each medication, each reaction, each flareup with pictures that will help you document a better case to evaluate what is working for you. The overload on your memory is too much to rely upon when trying to decide if the next course of action is good or not. Once you arm yourself with a well-documented picture diary, you will be a better patient and your doctor will respect you more and consider your wishes more carefully.

By doing this, you prove you are a force to be reckoned with and any doctor will be more inclined to strategize better with you. Furthermore, a full team of doctors, nutritionists and alternative doctors will help bring more discussion and a cross-section of options. It may get overwhelming but remember, you are documenting everything carefully and that will carry you forward through the decisions that need to be made. You’ve got a phone to take pictures and keep a chronological history that matches your medications. That’s gold!

Fragrances Off-Limits

Topical Steroid Side Effects

Question 1: Are fragrances harmful? Why did my doctor tell me to not use anything with fragrances?

Answer 1: Let’s go back in time, shall we? When a deer in a forest wants to leave a text message for another deer to follow her around, she would spray trees with her scent, a musky flavor that was irresistible to another deer. Cavewoman wanted to attract a certain caveman, she would surround herself with beautifully scented flowers to confuse caveman that those scents belong to her. Caveman would either be attracted or repulsed by her and/or her scent. All of us have a distinct signature smell. That’s why your dog sprays and sniffs every other dog along his walking trail. Even fruits and flowers emit a scent that is basically a composition of plant hormone or pheromones. So scent has been in all of us and used as a sneaky seduction tactic by many species of animal, plant and, of course, us cavefolk.

Question 2: What makes scent? And by the way, you did not answer my first question here.

Answer 2: Okay, okay, I’m getting there. Scent is actually made from hormones. Why? Because you are attracted to that powerful pheromone. So every perfume maker from here to the old perfume district in Paris is going to try and seduce you by emulating the natural scents like a deer desperately following a musky odor or a cavewoman communicating her readiness to mate. 

But nowadays, it’s not cost-effective to crush a ton of roses to make 2 ounces of rosewater or your favorite and expensive eau de toilet. So they make perfumes, colognes, air fresheners, and all the additives to cosmetics and laundry detergents artificially. That is torture on our endocrine system. It has become a buffet of chemicals instead of natural fragrances that delight our senses. Now the senses are overloaded with foreign chemical compositions that make our endocrine and immune system ‘feel’ like they are being attacked.

In the book “The Secret of Scent” by Luca Turin, the author details how the same exact perfume from the same manufacturer no longer smells the same as it did 50+ years ago. That is because almost all of the manufacturers have no choice but to scale production to meet economic profits. Sorry. Perfume was good while it lasted. 

The idea of ‘wearing flowers’ came in the Victorian era when men wore boutonnieres and women wore corsages to offset body odor! Smart idea! Not far from the cavemen ideals, we have evolved with solutions over the years. However, now we have to find an alternative solution to the chemical warfare that is artificial fragrances. 

Question 3: Why is that synthetically made hormone fragrance is actually dangerous?

Answer 3: So when caveman wants to smell you, but instead he only smells roses, he is not getting the full picture of your health, your DNA, your bacterial composition. Let’s just say – it’s a tricky way around seduction, and more like deception. His natural immune system is looking for a certain combination of DNA, bacteria and hormone balance to match his own and make a more diverse and stronger spectrum of immune systems for his future 27 children. That’s what we call attraction. It really is a chemical reaction beyond basic flirting and good dance moves.

But the problem is that when you apply artificially made fragrances, they are made with synthetic hormones, like estrogen-mimicking compounds. Once your body absorbs them, the body has to readjust its own estrogen and other hormones because it can’t have too much of a good thing, right? That’s exactly what you’ve learned from this book by the parallel example of topical steroids being a synthetic hormone.

So your own hormones are going to slow down in production. Your endocrine system goes into snooze control and keeps hitting that button to go back to sleep. Meanwhile, you are enjoying that plug-in air freshener with the latest pumpkin, bourbon, cinnamon apple pie that are just basically a group of fake hormone molecules. But your body has to work around this influx of hormones coming in your nostrils and through your skin!

Again, it’s sensory overload on the your poor endocrine system. It’s so sad. And your future 27 children? You know your body is going to be flooded with those fragrant hormones in that uterine swimming pool of yours, right? For the first time in history, the umbilical cords of newborns are being tested to find dangerous levels of BPA – Bisphenol A, another dangerous synthetic estrogen faker! 

Question 4: So no fragrance, right?

Answer 4: Yes. No fragrance. Thank you. This is really important.

Question 5: Are you serious?

Answer 5: Okay…obviously I’m not done here. Did you know that perfumers, cosmetic or personal care product manufacturers do not have to disclose what’s in a fragrance? Sad, but true. Why? Because the fragrance lobby is HUGE and POWERFUL. So they decided that their “fragrance molecules” are their proprietary intellectual property. That is called a Trade Secret. Therefore they were able to play around that requirement of labeling what’s in your products.

So when a sneaky manufacturer wants to put something in their formulas that they do NOT want to list or alarm you with, they can just include that in the “fragrance” and no one can ask what’s in that and you are subjected to some serious potential toxins.


Good luck with that. So keep those plugin air fresheners, scented candles, laundry detergent going and go on with your daily routine of using personal care products loaded with fragrance.

Send my love to your liver though…

Gut Health Relationship

Topical Steroid Side Effects

Question 1: What does my GUT have to do with my skin?

Answer 1: Everything! Absolutely everything. We are in a symbiotic relationship with our gut microbiota. The gut microbiota helps balance metabolic and immunological tasks. The most common illnesses triggered by gut irregularities are inflammatory bowel disease, gastro-enteric infections, irritable bowel syndrome, obesity, cancer, liver disease, allergic and autoimmune diseases such as eczema and psoriasis.

Wait…what? Eczema and psoriasis because of gut problems? YES! That is correct. This is where it gets interesting. 

Question 2: So between my gut and skin, you’re telling me I should have more bacteria? 

Answer 2: YES! The more diverse your gut bacteria, the less allergies you’ll have, the more enzymes will digest everything like a magnificent garbage disposal! The wider spectrum of bacteria you have, the better your chances of, oh and get this…you’ll even smell more irresistible, increasing your chances to find a more compatible mate also with a diverse bacterium so that you can have 27 healthy children! Isn’t this amazing? So go play in dirt! Go to a farm and dig up some manure! While you’re at it let’s get some natural probiotics in our system the right way. 

Question 3: I’m so confused with this PROBIOTICS stuff – where do I start?

Answer 3: So if you’ve ever taken antibiotics – you are a murderer. Anti-Biotics are Anti-Bacterial, and they are designed to the living bacteria. The medical world is now waking up to being more careful to not prescribe antibiotics unless it is an urgent situation.  But now you need to go redeem yourself in front of your gut garden and replenish all that good bacteria you wiped out with antibiotics.

If you eat lots of clean fruits and veggies, congratulations that is prebiotics.  Those coat the lining of your intestines with powerful enzymes and fiber. But then you need to step it up and actually get the living bacteria into your system. How? With fermented foods such as non-sugared yogurt, miso soup, Korean Kimchi, sauerkraut, certain types of pickled veggies, and Kombucha teas.  My suggestion is to create a variety at every meal and keep exploring.

Question 4: How do I protect my gut flora?

Answer 4:  Oh, come on, you know this. Eat clean. Sleep well. Poop like a king… Rinse, Repeat. In between all that, play and exercise as if your life depended on it and then focus on even better eating habits. It really does come back to the basics. Be a minimalist with what you put on and in your body. You don’t need to be a high maintenance diva or metro-dude with a bathroom full of personal care products that sabotage your skin and gut flora.

Question 5: So now I have to protect my skin flora too?

Answer 5: Yes! Anything you apply to your skin gets absorbed into your blood stream in about 26 seconds. So did you think your skin was just about making you look good?

Wait till you hear all the heroic things skin really does in SKIN Confessions. You’ll think twice next time you pass by that body lotion store you love so much that smells like pink fruity-tutty bubblegum flavor. Those moisturizers are taking their toll on your skin and endocrine system. This is important because all those fragrances are actually synthetic hormones. Now that you’ve been reading this book, does that ring an alarm bell? What did we learn about synthetic hormones and how they cause chaos in our bodies?  Remember, our goal is to become a minimalist and not burden our skin’s threshold.

*On a personal note, this subject is near and dear to me. Poop science was ingrained in me as a little girl. Whenever I would come down with a fever, my father would inspect my breath and ask to see my poop. It was awful and embarrassing. The first thing he’d do was tell my mom to give me a suppository and make sure I’m pooping within the hour! Then rest, fluids and NO TYLENOL, NO MOTRIN, NO FEVER REDUCER! They encouraged my fever and made sure I sweated out the fever in one night. Essentially, they were ‘feeding the fever, starving the cold.’

Growing up in America, I didn’t understand why I didn’t have normal parents that coddled their children lovingly with a simple pill to reduce the aching, fever and cold/flu symptoms like I saw on TV commercials and The Brady Bunch. But then I grew up. Now I’ve come to realize my Circassian parents and grandparents were champions of ancient immune-boosting hacks from the Caucasus mountains of Southern Russia. Among those hacks was the invention of yogurt, the fermentation of milk over 3,500 years ago. Recent archeological evidence found in gravesites preserved in perma-frost revealed ancient tombs with a funeral feast that included fermented milk that turned into yogurt. So for the record, it was Circassian yogurt, not Greek Yogurt! 

These were among the simple basic tactics to keep everything flushing and moving along. The first step at the sign of any cold or flu symptom? Check your poop. There you will find the answers to the universe. No really. The answers to the universe are in our poop.

Our digestive history, our gut flora, our magnificent bacterial composition is EVERYTHING!  Scientists are now racing around the world collecting poop samples from indigenous tribes in remote areas. In their poop is some of the most diverse bacteria!  It’s called the HMP Human Microbiome Project. It is the largest collection of data right from the source…Isn’t this exciting? 

My book, SKIN Confessions, details so much more about this fascinating subject!

Anti-Bacterial Soaps

Topical Steroid Side Effects

Question 1: Are hand sanitizers safe? Shouldn’t I use anti-bacterial soaps?

Answer 1: Believe it or not, using a normal bar soap with lots of agitation and movement to lather for 45 seconds seems so counter-intuitive, but achieves almost the same results without killing your skin microbiome.

As a healthcare provider, there are different recommendations, and now hospitals are quickly making a U-Turn on the harsh chemicals because of the high-risk factor for their own employees. When nurses and medical practitioners develop skin/hand problems, it directly affects their bottom line because of the many worker’s compensation claims from absentee employees. Once their hands are compromised, they then become even more sensitized to the rubber and latex gloves, and they can’t do basic medical procedures. Add to that equation, the risk of their immune systems being jeopardized by going through the vicious cycle of topical steroids and another perfect storm is brewing.  

Question 2: What’s the big deal with my handy purse sanitizer that is so convenient?

Answer 2: They are made with at least 62% Alcohol or Triclosan – a very harsh chemical that the Food and Drug Association (FDA) issued a final ruling that these ingredients are not as safe as previously thought. They recommend regular bar soap with water and agitated scrubbing is just as good.

“Consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they are any better than plain soap and water,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research (CDER). “In fact, some data suggests that antibacterial ingredients may do more harm than good over the long-term.”

Question 3: What about public restrooms?

Answer 3: For those of you that are already sensitized by any eczema, Contact dermatitis, psoriasis or skin lesions, please consider carrying around a little Ziplock baggie with a small travel-size bar of soap like DOVE for sensitive skin. That seems to be the prevailing go-to for those with severely sensitive skin. Don’t trust public restrooms that opt for the cheapest possible anti-bacterial soaps.

Bleach Baths

Topical Steroid Side Effects

Question 1: Why did my doctor suggest I take BLEACH BATHS?

Answer 1: Probably because your skin looked like it was getting infected from deep scratching and open lesions. We have to forgive ourselves and our medical practitioners. They were trying their best with the information they had at that time. Medicine evolves.

Question 2: I thought all bacteria was the enemy and my job was to kill 99.9999% of bacteria – so what happened?

Answer 2:  The science of discovering GUT bacteria came along in the last 15 years and that changed everything in medicine. We now are trying to study our internal flora, our gut bacteria as an organ in of itself! And our skin microbiome as another organ. We are made with more bacteria than we have DNA cells! So yes, bacteria are a living part of us that we are at the doorstep of where quantum physics was upon discovery.

Question 3: Was bleach bad all along?

Question 3:  It may have served a purpose, however the current research does clearly project that protecting our diversity in microorganisms may be serve our overall health far more than trying to kill off the bacteria.

So let’s focus on the body’s amazing healing power instead of the sense of remorse that question brings now that the current science proves our skin microbiome needed to diversify instead of nuclear bomb it? Let’s stay positive and rejoice in the body’s natural healing ability and commit to detoxing and replenishing the good bacteria.

Question 4: What else can I soak in to gain some relief?

Answer 4: Mineral Salts like those of ELAJ Salteral that are loaded with Dead Sea Salts, Magnesium, Zinc, Epsom, Honey Powder, and Algae Powder. They have been incredible for helping those with full body flare-ups and itching spells. They also work as an exfoliation scrub onto skin that is not compromised, but rather those plaque areas from psoriasis and lichenified skin. ELAJ Salteral can be found at

Another alternative is Apple Cider Vinegar. The gentlest of all is adding colloidal oatmeal to a bath. Be careful with essential oils as they may be too harsh. You can experiment with the most minute concentrations, a little at a time, and test your tolerance level and benefit.