Listed as below are the summary of Dr. Sato’s instruction, which is also explained in his book.
I translated this to English, so many people can understand the summary of his instructions.
1. Stop Using Steroid
There are some ways to stop using steroid.
1: Stop using steroid and moisturizing cream at the same time.
After average 7 days stopping using steroid, a peak of symptoms of withdrawal will happen.
2: Stop using steroid gradually
Gradually decrease umber of times using steroid, area, and amount. When you are having social life, you can stop areas which are covered by clothing. After recovering those areas, you can stop using steroid for your face and neck.
*If you are taking also pills of steroid for a short time (within 2 ~ 3 months), you can stop taking pills at first. Otherwise(taking pills over 2 ~ 3 months), you should stop using steroid cream at first.
*Also if you have asthma or cataract, you should use steroid only when crisis of life situation.
You can ask to your doctor not to use steroid after cataract surgery.
2. Stop Using Protopic and Neoral(Immune antibiotic agent)
Protopic was started to use for atopic dermatitis because steroid couldn’t perfectly cure atopic dermatitis symptoms, so you need to stop using them as well. If you are using Protopic, it takes time for you to improve back your natural skin functions, and this cannot also cure symptoms. In addition, the possibility which can cause lymphatic malignancy was reported when it developed, but it was released without enough investigation.
3. Stop Using Anything For Moisture Retention
Depending on moisture retention creams is the abnormal condition which skins are adopted to the situation skin has more than enough moisture.
A normal surface of skin is little dry, and you need to get back to it.
For obtain above, my doctor said me to follow as below.
1: Stop using moisturizing retention cream and lotion
2: Stop using or stop spraying beauty wash and acid water
3: Stop covering skins by gauze, bandage and so on
It has a moisturizing effect, which case the delay of cure.
4: Stop swiping off exudate
Exudate will cover your skin and it will be scab, and new skin under scab will be created.
If you swipe off exudate, your skin is always wet and causes delay of cure.
5: Not to take water too much
When skin obtain and keep a lot of water, it tends to be fragile.
Drinking a lot of water after dinner cause that upper body keeps more water and upper body such as face tends to be fragile.
Skin needs to get dry at first when you stop steroid, so need to be careful how much you take a drink in a day, especially at night.
6: Stop being bed for all day
Being inside of blanket is also cause of moisturizing effect, which delays your cure.
7: Stop having long time bath or many times bath
It increase the time when moisture is on skin, and causes moisturizing effect.
8: Stop making up and using sun-cream
These also cause a moisturizing effect.
4. Do not think the root cause of atopic dermatitis is an allergy
The root cause of atopic dermatitis is not IgE allergy. There are many cases that atopic dermatitis can recover without decreasing of value of IgE. These such as nourishment and ticks are not the problem.
5. Spend a regular life
Cells inside human body have a biological clock, and body will have unfunctionality if it goes insane.
Eat well, Sleep well, and Work well.
6. No limitation of nourishment
Balance of protein, fat, carbohydrate, vitamin, and mineral are important. Anything like Italian, French, American or Japanese are okay. When you have a lot of exudate or desquamation, you should to take protein more than normal.
7. Limitation of water ingestion
Many people ingest a lot of water for detoxing or some reasons. However, when you stop using steroid and moisturizing cream, you need to be careful how much water you ingest in a day. If you take a lot of water, the amount of exudate will increase, edema will increase, which cause that skin becomes fragile and a delay of cure. Of cause, it should be adjusted, for example, in summer you will get more wet, you should take water more then, in winter you will not have a lot of sweat, so you need to reduce the water ingestion amount, and also after drinking soup it is also need to be thought. Thing is need to think about amount of water in and out in a day.
8. Physical therapy
Your heart and lung function should be improved to recover skin. After rhagades are recovered, you should start to walking or running. But don’t push yourself too much.
9. Know the process of skin recovery
It is difficult and we don’t want to watch the symptoms when it is really bad, but you need to watch and observe to check how your skin is becoming, dry? wet? or red? and normal color?
– The process of skin condition is: erosion with exudate -> wet edema erythema -> dry scab and chap -> desquamation -> normal
– The process of skin color is: cherry red -> dull red -> bark -> white -> normal
10. Reduce your physical and mental stress
There are many patients whose symptoms become bad by some stresses.
Be careful for too much exercise also.
11. Do not depressed
Do something fun to temporarily forget your symptoms.
12. having Limited bathing
It has already reported that reducing bacteria on skin by antiseptic and antibiotic doesn’t make any improvements on atopic dermatitis sympyoms. Do not wash too hard and try to keep natural oils on skins. If you have strong itching sensation, you should not take any shower. If not, you can reduce the bacteria on skin by few minutes showering, which is recommended. But again, not to take shower or bath many times in a day and not frequently.
13. Properly using antihistamine medicine and anti-allergic medicine
There are two types of anti-itch medicine, both has antihistamine effect, and some of anti-allergic inducing drowsiness. Those effect are different by individuals. The portion of itching sensation from atopic dermatitis is small and those medicine doesn’t perfectly stop your itching sensation.
It is better to take some of them which doesn’t induce drowsiness in the morning, and which does induce drowsiness in the evening. If you cannot sleep because of itching sensation, you can also take sleeping-inducing drug. It is better to sleep even if you scratch your skins. However, when you take sleeping-inducing drug, you tend to lose your consciousness, but without your consciousness you scratch harder than usual. In that case, you need to think whether you really should take sleeping-instruction drug or not.
14. Protection of skin
You shouldn’t protect any erosions or crabs. Do not moisturize your skin, and it is better to cover your skin by a grainy gauze to protect your exudate. And let your gauze be until it will get off by itself.
15. Fever and bacteria virus infection
The most of the reason of fever when you stop using steroid, is bacteria infection and Kaposi’s varicelliform eruption. Basically you should handle them by taking anti-virus medicine.
16. Protect your skin from cleanser
My doctor suggest that the amount of cleanser for clothing we should use is 70-80% of the amount which is normally suggested, to clean enough your clothing. If you use them too much, it remains on your clothing and affect on your symptoms.
17. cutting your nails
When you scratch your skin with your long nail, you will have deep scar or scar line. If you cut your nail, those scar will be eased.
18. Surrounding people should not say “Don’t scratch”
It is impossible to stand for itching sensation when you stop steroid. If surroundings like family say like “Don’t scratch, you get worse because you scratch.”, this is really stressful and they don’t understand this diseases. It is impossible to stand for scratch. However, you don’t have to regret that you scratched. By scratching, your skin getting stronger and stronger, and your natural skin function will come back.
19. Supplement and chinese herb
If you are taking a regular nourishment in a good balance, you don’t have to take any supplement or Chinese herb. Supplement and Chinese herb doesn’t help your skin recovery and their impurity can be a problem.
For example, caffeine of coffee or green tee and alcohol makes you to tend to create histamine which induce itching sensation. If you, however, can relax by taking them, it can also reducing itching sensation. You will know only after taking them. Smoking delays your recovery, so it seems not good.