Working Paper Article Version 1 This version is not peer-reviewed

Could Strengthening the Gut and Skin Microbiome Help with the Adverse Effects after Stopping Long Term Topical Steroid Use?

Version 1 : Received: 7 September 2021 / Approved: 8 September 2021 / Online: 8 September 2021 (20:19:35 CEST)

How to cite: Wallen-Russell, C.; Gijsberts-Veens, A.; Wallen-Russell, S. Could Strengthening the Gut and Skin Microbiome Help with the Adverse Effects after Stopping Long Term Topical Steroid Use?. Preprints 2021, 2021090160 Wallen-Russell, C.; Gijsberts-Veens, A.; Wallen-Russell, S. Could Strengthening the Gut and Skin Microbiome Help with the Adverse Effects after Stopping Long Term Topical Steroid Use?. Preprints 2021, 2021090160

Abstract

We set up this preliminary study to evaluate one main question: could strengthening the microbiome have potential benefits for 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 promise. 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). Furthermore, the subsequent withdrawal the body experiences when coming off the drug 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 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 to improve their gut health and biodiversity. 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 a stagnation or regression in 11% and 4% respectively. We believe these results show enough promise to warrant expansion of this research to use a larger sample size, preferably 50+ participants, in future work. 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 more in-depth analysis of skin and gut microbiomes.

Keywords

topical steroid withdrawal; topical steroids; eczema; atopic dermatitis; skin microbiome; gut mi-crobiome; microbiome; biodiversity; skin allergy epidemic;

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