Is there no need of topical steroids withdrawal if I apply Dr. Fukaya’s lotion?

I received a question from a client of my hyaluronan lotion overseas. A TSA patient who is attending to the online shop in UK diverted it to me.
　　
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Thank you for yr kind reply. We are loyal people following Dr Fukaya's blog from XXX, regarding topical steroid withdrawal, addiction.
  
From the online shop, i noticed there is also mention that Dr Fukaya's skin lotion can even be used together with topical steroid? I m curious how this works, because mostly users are trying to stop/wean off steroid completely, resulting in redness, withdrawal symptoms, uncontrollable flares, causing extreme dryness to the skin.
   
But why / how can this skin lotion prevent the side effects of such strong steroid penetration effects? I mean if we continue to use steroid, then why should we be still using Dr Fukaya's lotion? Because steroid will suppress immune system and then there will not be any withdrawal redness etc. So what is the co-relation of these 2?

Can you please enlighten me on this point?

Many thanks in advance.
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I sent the following answer.
　　
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The topical steroids have two aspects. They are the immune suppression and the barrier dysfunction (epidermis damage).

My hyaluronic acid suppresses the latter. The mechanism is on the “Why it works?”
http://drfukaya.ocnk.net/page/4.

My hyaluronic acid doesn't suppress the former. The mechanism of TSA is considered as the latter. Please refer to my article “Paradoxical idea of systemic steroids use for withdrawal from topical steroids”
http://mototsugufukaya.blogspot.jp/2013/06/paradoxical-idea-of-systemic-steroids.html
The immune suppression only (systemic steroids) doesn’t cause addiction.
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Soon after that, the mediator herself asked related to the question.

“Doc, I have a question too. Do you think patients who are using TS don’t need withdrawal anymore if they use your hyaluronan lotion ? I mean, does the hyaluronan lotion only decrease the risk of TSA or completely overcome the development of TSA?”

I understood the meaning of the questions of the inquirer and the mediator.
It might be a stress for the patients in the middle of withdrawal from steroids to know there is an agent that decreases or removes the risk of TSA. It will sound a temptation to resume steroids.

But sorry to say, I also don’t know the answer to the question of the mediator yet.

It is certain that my hyaluronan lotion decreases the risk of TSA development of steroid users. Steroid users with hyaluronan lotion should develop less severe rebound even if it occurred. Theoretically the risk disappears completely by using it but I am not sure of it at present.

OK, I say, don’t resume steroids so easily. My hyaluronic acid lotion has only been out for several months so far and it's too early to say my lotion will cease the entire risk of Topical Steroids Addiction. So I would advise to continue TS withdrawal for now.

On the other hands, there must be such patients who are using TS now and can’t stop immediately for various reasons. Use my hyaluronic acid at the same time when you apply TS.

I recommend my hyaluronic acid to the patients also who are not using steroids or stand the hard rebound now. It will help your recovery.

As a conclusion:

1. Don’t change the present stance to TS by knowing the existence of my hyaluronic acid.

2. I would confidently recommend to use my hyaluronic acid lotion to all categories of patients.

3. If you're having financial difficulties (as some people are during TS withdrawal), don't strain yourself. My Hyaluronic acid lotion will be surely beneficial but not absolutely necessary to heal your skin.

That is the honest answer from me. Thank you.
 
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