271: Cold Laser Therapy for Topical Steroid Withdrawal w/ Jing Rui YeoBrought to you by Quell

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Have you ever heard of cold laser therapy (or the CAP laser) and how it can help with skin issues? Contrary to what most people think, it’s actually not a laser! It is called Cold Atmospheric Plasma (CAP), and it is a type of ionized gas. My guest today delves into how it can help!

Today's guest is Jing Rui Yeo, long-term TSW (topical steroid withdrawal) warrior and co-owner of Skin Solace Aesthetic Clinic. Through her advocacy for TSW, she helped to bring CAP treatments to the UK. Her passion is in alleviating the physical and mental struggles of those going through chronic skin conditions, particularly Topical Steroid Withdrawal.

Have you ever suffered from TSW? Let me know in the comments if you've tried the CAP Laser and if it worked for you!

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

In this episode:

  • What is cold laser therapy + how can it help those with Topical Steroid Withdrawal?
  • What does a CAP Treatment look and feel like?
  • Length of treatments (and what else to expect)
  • Who is NOT a great candidate for a CAP Treatment?
  • The reason TSW warriors flake after receiving a CAP Treatment

Quotes

“It has regenerative properties to the skin. It is used in various skin conditions such as eczema, topical steroid withdrawal, and can help with acne as well.”  [03:41]

“The wetter the wound, the more zappy it feels, but generally, from the neck and down, people actually find it quite comfortable.” [09:52]

Links

Find Jing online here and here

Follow Jing on Instagram | Follow Skin Solace Aesthetic Clinic on Instagram

Healthy Skin Show ep. 132: What is Topical Steroid Withdrawal? w/ Kathryn Tullos

Healthy Skin Show ep. 200: Getting Emotional + Mental Support For TSW w/ Jing Rui Yeo

Healthy Skin Show ep. 225: Topical Steroid Withdrawal (TSW)- Is It Just A Waiting Game? w/ Dr. Julie Greenberg

Cold Atmospheric Plasma Ameliorates Skin Diseases Involving Reactive Oxygen/Nitrogen Species-Mediated Functions (Frontiers in Immunology, 2022)

 

271: Cold Laser Therapy for Topical Steroid Withdrawal w/ Jing Rui Yeo FULL TRANSCRIPT

Jennifer Fugo: Hi, Jing. Thank you so much for being back here at The Healthy Skin Show. It's great to have you back.

Jing Rui Yeo: No, thank you for having me. It's so nice to chat with you again. It's been a long time. One year. It's flown by.

Jennifer: I know. It has been about a year since you were on the show. As many of you guys might remember, Jing has an extensive personal history and experience dealing with topical steroid withdrawal, and the reason that we're having this conversation today is because it was this beautiful thing that happened because you and many of the listeners might recall Louise King, who was also on The Healthy Skin Show, probably a year before you were on the show. You two met and this beautiful thing came out of your friendship that we want to talk about today because I do think it's a worthwhile resource for people who are in the UK as well as in Europe, to potentially have access to what you two are doing right now, and so, basically, long story short, you both opened a clinic called the Skin Solace Aesthetic Clinic, and you're utilizing this really cool technology that I think formally was only available if you went and traveled to Singapore, correct?

Jing: That's right. It was only available in Singapore and Thailand before this, and Lou, she came over to Singapore to do treatment and that's where we met and we decided that, hey, why not bring it over to the UK and people in the UK, Europe, and even people in the US can benefit from it.

Jennifer: It's a lot closer. It's a lot easier to travel to the UK. For those of you wondering why would you use this particular device and let's talk a little bit about it. You and I were trying to discuss how to talk about this interesting treatment, so to speak, for TSW to help with skin issues, and not only are you on this end of bringing it to people and help providing them this option, but you've done this yourself. This type of… I think you said before… Online, it's been described as a laser, but it's not really a laser.

It's actually a cold atmospheric plasma that is very confusing and people are like, “I don't get what plasma is.” So can you talk a little bit in layman's terms, and again, for all of you listening, Jing is not a medical professional or a science expert, so she's not going to dive deep into all of the logistics and ins and outs of science. There are some papers that we're going to link up in the show notes. If you're more interested in understanding it, you can dive into those, but Jing, what exactly is this cold atmospheric plasma device that you guys are using in your clinic?

Jing: So cold atmospheric plasma is basically an ionized gas. There are three states of matter that are really known in science. The solid, liquid and gas and plasma is actually the fourth state of matter, which is an ionized gas. When gas passes through a very high heat, it ionizes and then it becomes this blue substance that looks like lightning or basically is lightning. Dr. Chanchai, who is the person who created this machine, he has managed to put plasma through a machine and allow it to contact the skin without damaging it, and it has regenerative properties to the skin. It is used in various skin conditions such as eczema, topical steroid withdrawal, you can help with acne as well. Seborrheic dermatitis is also one of the conditions that you can treat.

Different machines have different powers, so for example, some other plasma machines can treat diabetic chronic wounds, huge diabetic ulcers that prevent the need for amputation, for example. Some of these machines are very powerful and because it is still quite new in the medical field, it is not very widely known. That being said, despite it being new, it's actually been researched for decades, and as we know in the medical field, it just takes a really long time for new technology to be approved by, let's say government sources, or in a mass commercial way. Yeah, I think it's an up and coming technology that is slowly gaining traction.

Jennifer: And funny enough, Jing and I were talking before the show that when she said, “Oh, it's plasma. I don't know if you're familiar with that,” my father had developed a surgical device using plasma. I actually am ironically very well versed in plasma, but only because of my dad's research and his patents and all sorts of things that he had done years ago. It is very interesting and for anyone listening, plasma does not burn the skin. There's no burning involved. I think that's a really important point because my dad's device was being used inside the eyeball. If you're able to use plasma inside the eyeball, I just want to throw that out there. He was able to do that. That's one of the interesting things about why you're not burning the skin. I think that's an important point to mention. So Jing, can you tell us what are some of the benefits of using this type of device?

Jing: Firstly, there are no side effects. That is the number one benefit, which is that unlike taking medication, there's always some side effect that affects some other part of your body or on your skin itself. This technology has been used for over a decade on the skin, and so far, no side effects have been reported. That's number one. Number two is that it regenerates your skin. It helps with anti-aging. If you have any open wound that are taking really long to heal, it speeds up that process, and hence, it helps with topical steroid withdrawal, which is basically your skin's huge wound. Another thing is it can kill bacterial and fungal infections. This is including infections that are persistent and even MRSA.

Jennifer: So MRSA.

Jing: Even infections that are resistant to drugs. The last thing is that it helps with micro-exfoliating, so people with hardened skin, elephant skin, if they have this thickened skin layer over their skin, it helps with exfoliating that in a very gentle way such that it doesn't harm it. You can even go over open wounds without hurting it. Yeah, these are the main benefits of cold atmospheric plasma treatment.

Jennifer: And Jing, with this device, are there certain areas of the skin that you cannot go over? Maybe around the eyes or the genital area or the palms of the hands? I just don't know. Are there certain areas that you can treat versus others that you generally avoid?

Jing: So far, we have treated almost every skin area. We do go over the eyelids, around the ears, on the top lip where it's also more sensitive. Yeah, we can also go on the palms, the soles, even your genitals. However, in our clinic we do not really treat the genitals just for hygiene purposes.

Jennifer: Okay. Now, you've done this yourself and I'm sure that someone who is dealing with… For example, you're predominantly focusing your clinic around folks that are going through TSW, correct? Topical steroid withdrawal.

Jing: Yeah. That's right.

Jennifer: Okay. For someone who's going through TSW, there's always the question about… “I don't want my skin to get worse,” and you may have wounds in areas and areas that won't close. As someone who's never done this before, I imagine they're afraid that it could hurt, so what is the experience when you get this type of device used on your skin? What does it feel like?

Jing: Oh, so I would say in your first few sessions, especially on the face, it can feel quite sensitive. I remember my first time doing it, it was quite warm. So the machine is like a pen and the probe bit of the pen, there is plasma emitting out of it, so when it touches the skin, the plasma touches the skin, there's a sound. Very electrical-like sound, and there's a zappy feeling. A heat and zapping feeling. On the face, it can be quite sensitive and people can feel a little bit like, “Oh, I'm not really liking this sensation.”

On open and oozing wounds, it can be quite painful depending on how deep the wound is and how wet it is. The wetter the wound, the more zappy it feels, but generally, from the neck and down, people actually find it quite comfortable. It's only the face with lots of nerve endings, thinner skin, you can feel quite uncomfortable, but the neck and down, you feel like, “Oh, it's actually quite like a massage.” It's nice and warm. The therapist will do it slowly, calming and it almost feels like it's helping you sooth an itch. It's a very unique experience that I can't really totally describe, and as people get used to the sensation, they quite like it on the face eventually. It becomes a relaxing experience for our patients to go through the treatment. I think they enjoy it.

Jennifer: Okay. How long is a session? Does it take an hour to do your whole body or are there some individuals who only get maybe a certain area done? How long does it take to do a session or a treatment?

Jing: Yeah, we go by how large the area needs to be treated and also how severe your condition is. For example, for the face, it's usually about 15 minutes. The neck and above, like around this area, is for another 15 minutes. We add up these treatment areas and in total, that's your treatment time. Let's say a rather large person needs a full body treatment, that's usually an hour 45, and that's the longest we go at a time for now, and if you just want to do your face, it's just 15 minutes. It really depends on where you want to get treated and basically how tall or small you are.

Jennifer: Sure. Is there an age where you don't do it for children? Is this adults only or is this type of device safe on all ages?

Jing: It is actually safe for even young children. However, with treating topical steroid withdrawal, we find that young children could be scared of the sound that it emits, and secondly, it is more difficult for them to stay still for an hour and do the treatment, and lastly, because the treatment increases your skin's regeneration, you will have increased flaking and you might also have increased itch, and with children, it's really difficult to control their itch or manage their itch. For that reason, we only treat people above 16. We have accepted a few cases who are under 16, but with parental consent. It is safe, but we have chosen not to treat anyone younger than 16 at the moment.

Jennifer: When you do these types of treatments with this amazing plasma, which is really cool, you had said… So a possible post treatment issue could be increased flaking, increased itch. What does it look like? Do you feel like your skin is a bit more irritated for about 24 hours and then it dies down? How long usually between treatments… I imagine most people don't just do one treatment. You it's better to do a series. What has been your experience with that?

Jing: I am speaking just for topical steroid withdrawal cases. For other conditions, it might be different. What the treatment does is it speeds up your skin cells' regeneration rate. How the skin naturally heals or regenerates is by flaking. The reason why we flake is because the skin cells are proliferating at different rates and these different rates make the flakes go up and down and they're uneven and the unevenness causes the flaking. I'm sorry, I forgot your question.

Jennifer: Oh no. Just basically what happens after you have the procedure. You have maybe some increased flaking and itching, but how long does it last for? Do you want treatment every month? What does it look like for somebody after their first treatment?

Jing: Treatment starts at a weekly rate. They come in for treatment every week and after a period of time when their skin is improved enough or stable enough, they move down to once every 10 days, and then after they're stable at once every 10 days, they go down to once every two weeks, then three weeks and so on and so forth until they come in for maintenance every month, and once their skin gets to the good stage for about six months, then they can be independent of treatment. That is the entire treatment process. How long this whole process takes depends on how severe the condition is. Someone who is a lot more severe may need six months of weekly treatment before moving down to 10 days, and someone who is milder may just need three months and then move down to 10 days.

It also depends on various flare factors. For example, if someone who has lots of flare factors in the environment, they constantly flare and we are constantly putting out the fire, then of course, the treatment is also prolonged. Whereas someone who might have really good management, low stress, sleeping well, their treatment time is also shortened. It varies from person to person. Generally, two to three days after treatment, the patient might feel like a lot more itchy.

That's because you are increasing your regeneration. There's a lot more flaking and dryness and you might also feel a lot more tired. That's because your body's expending a lot of energy to produce lots of skin flakes basically, and so, you might also feel a lot more hungry because again, it's using lots of energy, and after the third day of treatment, you might see your flaking reduce and your wounds start closing up, tightening up. Maybe if you are in early stages of treatment, by the sixth or seventh day, you feel like, “Oh wait, I need a top up for my treatment again.”

As your skin becomes stronger and more resilient and you go down to maybe 10 days or two weeks, you'll find that, “Oh wait, even if I scratch my skin, it doesn't tear as much. I'm no longer reacting to as many flare factors as I used to. For example, maybe I used to get period flares every month. Now I don't get them as often or as regularly,” and eventually, your flaking will also reduce in size and amount. The thickness of your skin will start to return, and so, your skin will just keep improving as you go along.

Jennifer: Okay. Did you find this treatment… When you went through it, did you find it to be help… What was your experience just personally? Obviously, you must have found it to be very positive because you wouldn't be doing this. You and Louise wouldn't have started a business in the middle of a pandemic. Nonetheless, you two ladies are bold and brave to have done that. You wouldn't have brought this to the UK. The first in the UK and in… I guess we could say the European continent. You wouldn't have done this if you didn't really believe in it, and I did remember when Louise had gone to Singapore to have her treatments done, I watched over the many months. She was there for what? Three months? I think, doing the treatments.

Jing: Yeah, I think three or four months. Yeah.

Jennifer: But I watched her. It was interesting to see the transition of her skin drastically improve over that course of time. Just in your own experience personally, having used this as part of your path or journey to helping support your body through TSW, do you feel like it was an integral part of your process?

Jing: Yeah, for sure. Just to give some background, I have been in TSW for 11 years now. Before I found this treatment, I was in TSW for about eight years, and at the point when I found this treatment, I could barely move in comfort. My legs were swollen, I barely had any hair, I had this thickened skin all over my body and I was addicted to moisturizers. I couldn't live without applying moisturizers every one or two hours. That was how bad my condition was at eight years of withdrawal, and within one and a half year, I was functional, I was doing a part-time job, I was working towards building this business.

I could go out and do my daily activities without any problems. I would say it is the thing that helped me to heal, and of course, in the eight years before this, I had tried every single thing possible. That being said, I am a very severe case, so that is why many things did not work for me, but yeah, this has basically changed my life. Without it, I wouldn't be where I am today. Not just business wise and being in the UK, but just living my life as a normal, fully functioning human being. I don't think that would be possible.

Jennifer: I don't know if this is available in the US. I don't know to be honest with you, but hopefully, at some point, maybe either some dermatologists that are TSW educated or someone will also bring this type of device to the US and make it more accessible to people because it sounds like it can be so powerfully helpful for people who are really struggling. I wanted to make sure that everybody knows where you're located. You guys are in… I hope I'm saying this right… Andover, Hampshire, which is about an hour outside of London, is that correct?

Jing: Yeah, that's right. Andover, Hampshire.

Jennifer: If someone wants to come to your clinic, should they contact you first? Is that the best way to get in touch? Do you evaluate the case or can people just book an appointment with your clinic?

Jing: At the moment, we have closed our information sessions. We used to have a link on our website to book online. We are working towards a system where it's a waiting list at the moment. I'm pretty sure in the next one month or so, we will have this system set up where you can put your name on the waiting list, give us all your information about your conditions, send pictures, and then we'll contact you when we are ready to schedule you in or book you in for information session.

Jennifer: It sounds like too, whenever… We don't know when this episode's going to be released, so my recommendation would be if it's something you're interested in, go to the website regardless and see where they're at in the process, and they may be in a different place at that time. If you're listening to this, I just want to make sure not to… Anyone to think like, “Oh, a month from now,” but who knows when that could be. I would suggest if this is something that you're interested in, go check out their clinic website. That's going to be really important. If you're also interested, you never know, this could be a great opportunity too, for other practitioners and doctors and things to maybe also reach out to you. I think this is a really promising potential option for people who are really struggling.

I'm so excited and honored not only to know both of you, you and Louise, but I just want to say here on the show, I'm so in awe of your tenacity. I just want to say that I'm so in awe of your tenacity and your stick-to-it-iveness to do this. You believed in it so much and you made this a reality and you're bringing this option to people to help them with this condition that unfortunately, you can suffer greatly as a result of going through it. I just feel so lucky to know the both of you and to be able to share what you're doing here with everyone. Jing, if everyone wants to get in touch with you, what is the best website for them to find your clinic?

Jing: That would be www.skinsolaceclinic… Wait, let me check. Yeah. Okay.

Jennifer: skinsolaceclinic.co.uk.

Jing: Yes. I just had a brain fart. Yeah-

Jennifer: Good ahead.

Jing: That would be www.skinsolaceclinic.co.uk.

Jennifer: Perfect. Perfect. Everyone, you'll want to go check out skinsolaceclinic.co.uk and you can also connect with Jing and Louise on Instagram. Both are there and they have a ton of information that they're always sharing and they are just wonderful people. Jing, thank you so much for joining us today. I really deeply appreciate it and I'm sure you guys will be back on the show.

Jing: Yeah, very sure.

Jennifer: You're two of my favorite people and you are just… Yes, yes, absolutely, and thank you so much for sharing this with everyone.

Jing: No, thank you for having us and inviting me on the show, and I just want to say that you're always an inspiration for me because you're such a superwoman, basically having a podcast, running your own practice and you have so many different branches to your business. I just really wanted to express that I really admire you as well and really look up to you and somehow, hopefully, we get to collaborate or send people to each other and help our patients even better.

Jennifer: Yes, absolutely. We all work together to help people on their journeys and I think that's a beautiful thing.

Jing: For sure.

“It has regenerative properties to the skin. It is used in various skin conditions such as eczema, topical steroid withdrawal, and can help with acne as well."