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For many people who have been struggling with eczema for years, using topical steroids on a regular basis has become a part of life. What you may not know is that trying to stop steroids after years of use can lead to Topical Steroid Withdrawal (TSW) which as of publishing is not an official diagnosis.
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My guest today is Hahn Byol Chang, whose goal is to spread awareness about topical steroid withdrawal (TSW) and how to prevent others from suffering in the future. He is 14 months TSW and 8 months NMT (No Moisture Therapy).
Join us as we talk his personal journey with NMT and TSW (Topical Steroid Withdrawal).
Have you heard of No Moisture Therapy before? Tell me about it in the comments!
In this episode:
- Hahn's skin journey until he ended up with TSW
- How did he feel when he realized he had TSW?
- What is No Moisture Therapy (NMT)?
- How does Hahn stay positive?
Quotes
“I was tired of spending hours a day showering, moisturizing, applying all these steroids.” [1:31]
“To just stop all moisturization in one day, it was a lot on my body. I got super, super dry. That also made it hard for me to sleep.” [11:38]
Links
Comprehensive Guide to No Moisture Therapy (NMT)
191: Personal Journey with No Moisture Therapy + Topical Steroid Withdrawal w/ Hahn Byol Chang FULL TRANSCRIPT
Jennifer: Thank you so much, Hahn, for being here. I really appreciate it.
Hahn Byol: Yeah. Of course. Thank you for having me.
Jennifer: Yeah. So I wanted to kick things off with you sharing your story because I think that for people to really understand where you are now, they need to know what came a little bit before that. So what were you struggling with before you ended up in topical steroid withdrawal land? What exactly was going on with your skin before that?
Hahn Byol: So I have a family history of not so great skin, mostly on my dad's side of the family. And when I was a kid, I had Kawasaki Disease, and I'm glad we're able to figure that out. But shortly after that I developed what was diagnosed as eczema. So from my childhood to basically last year, I was on and off using steroid creams and ointments topically to mitigate those eczema symptoms. It wasn't really until this past year that I finally really looked into it and questioned what was going on because I had heard that there were people that were able to cure their eczema through means of dieting, exercise, what have you.
Hahn Byol: So I wanted to explore those methods because I was tired of spending hours a day showering, moisturizing, applying all these steroids. It was just like, there's no way I have to do this for the rest of my life. And at the same time, this year I started to notice that the current strength dosage was not working anymore. So the eczema, I would apply steroids topically, but nothing was happening. That's basically how I got to the TSW journey, which started last September.
Jennifer: When you ended up unfortunately in this state of TSW, what was that experience like for you in this moment of realizing that this wasn't just an eczema anymore? This is something entirely different.
Hahn Byol: I felt really disappointed. I felt like betrayed almost because I had seen doctor after doctor after doctor. I mean, tens of dermatologists, and I liked to believe that I can trust doctors. That they have their best interest is for me to have good health. It's basically just that I didn't how much I didn't know. So that was not only just the beginning of my journey of finding out more about my skin and human skin and how we can treat these issues that we develop, but also just worldly matters. I need to question everything that I was taught as a child as I was conditioned. Why do we do what we do? So it's really been a humbling experience. But at the same time, it did start from a dark place. Yeah.
Jennifer: Yeah. So the way I found you, and I think it's fair and would be interesting to the listeners to know. The way I found you was basically I was on TikTok, and I stumbled across the video that you had put up about what your day was like being not just in the state of TSW but going through this process called No Moisture Therapy. I've had some clients that are interested in considering this who realized, where we're like, “You know what, maybe this isn't just eczema anymore. Maybe a flip the switch, excuse me, has been flipped. We've got some additional issues going on that require attention.”
Jennifer: So for those who are not familiar with this whole… By the way, it's not something to consider lightly, and I think dive into lightly. It can really positively impact your life, but it is a big deal. So for those of you who might not know, it's No Moisture Therapy Method. You might see it written online NMT for short, and it was actually this protocol I suppose you would call it was developed by Dr. Kenji Sato in Japan. The whole idea that if you do it very strictly, that you should see substantial improvement in three months turnaround time.
Jennifer: Now I would say that that might not be realistic for everyone. Everybody's different on a case-by-case basis. But I would love to know how did you stumble across the idea of No Moisture Therapy, and what made you decide to give it a try?
Hahn Byol: So first, I just want to definitely say that this is of course, as you said, my journey, and I don't want anyone to think that my journey's going to be like anyone else's because this therapy, this treatment, protocol specifically is very… It's based on the individual. But to answer your question, so I started off with the celery juice cleanse. The crazy celery juice cleanse. That lead me into a diet of whole foods, plant-based, and I also tried veganism. Then I tried keto. Basically my whole first six months of TSW was me just trying a whole bunch of stuff. Looking back on it, I could've probably slowed down a little bit because I was doing way too many things at once.
Hahn Byol: But from the beginning, I was always part of Facebook groups and just online forums. NMT was one of the methods of treatment that was always talked about, but people didn't really promote it that much. I was always curious about it, and for whatever reason, I didn't really look into it until about the six month mark because that was when I was realizing that… So I had gotten really bad, and then I started to get good again about three months. Then I started to get bad again. Towards the six month mark, I was like, “Okay. Let me do some research again.”
Hahn Byol: So NMT came to my lap once again, and I just researched the heck out of it. To me, I really trust my intuition. I really go with the gut feeling, and to me, this was just that. It was nothing is required for you to purchase. It's just read this protocol and do your best to follow it. That's basically it. In time, you'll heal and that's it. No funky medicine or special foods or anything. Just do you.
Hahn Byol: It's really, really been an arduous journey, and it's been a really humbling experience. Yeah, just to answer your question, that's how I got… Yeah.
Jennifer: I would say too, we were saying before we even started recording that it's not… So for those of you if you haven't yet looked this up, if this is something they are interested in looking it up, you can easily find photos of what people look like as well because it is something where you may not be able to go to work. Some people will acknowledge they look pretty awful going through this process. So you had to really want to do this. It also is very strict in some of the things in this protocol. Like really strict.
Jennifer: So the whole concept of No Moisture Therapy is that essentially you're not applying moisturizers, and you're not consuming an excess amount of fluids, et cetera and showering and bathing. You're really limiting the amount of moisture that your body on multiple fronts is exposed to. You have to go through the complete avoidance of steroids, and typically there's also the recommendation to avoid any products with licorice in them. Licorice is an adaptogen that can help stimulate the adrenal glands because the whole idea here is that…
Jennifer: You guys know, we've talked about this a lot. And if you're not familiar with TSW, I encourage you to go back and listen to some of our other episodes on it. Just so you can better familiarize yourself. But that the adrenal glands have trouble realizing they've got to put out cortisol because you've been applying cortisol through topical steroids. So they're like, “Well, somebody else took over my job. I'm just going to peace out.”
Jennifer: So this whole process of TSW to some degree, which some of you probably heard in Dr. Heather Zwickey's discussion on this, is the body reorienting itself. The immune system reorienting itself, and it takes time. And it can be very uncomfortable.
Jennifer: So Hahn, in the process of going, “Yeah, I think I want to do this,” what has it been like doing No Moisture Therapy? What's your regular day like? Maybe some things that people who haven't gone through this don't realize if they're just reading about it online.
Hahn Byol: Yeah. I'd love to share. And again, what I go through is definitely going to be different than others. I would have to say this experience has been probably the most tolling on my physical and mental health. Simply put, I've never experienced something so hard in my life as NMT. I do plan to show what I did go through with pictures and all through whatever platform I choose to to really show what I went through. But basically in the first month, and I guess I can just reiterate that the 90 days is what everyone is always looking out for. That's the initial, “Let me get through these 90 days and then see if I want to continue with this or not.” But those 90 days are rough, man.
Hahn Byol: So when I first started, you have to realize that I was moisturizing every single day for I don't even remember how far back, probably elementary, middle school days. To just stop all moisturization in one day, it was a lot on my body. I got super, super dry. That also made it hard for me to sleep. It made it hard for me to think, to eat. In the beginning, it was especially rough on my neck and behind my knees. Around the three-four month mark, before the 90 days hit, I thought I was getting better, but your skin, it can turnaround in a night, in a week. Basically I was exercising. I was following the protocol. I was doing great. I was getting better. My skin was clearing up from being super dry, and then all of a sudden I couldn't extend my legs and my entire front of my neck was just scabs.
Hahn Byol: With TSW, it's the itch that's the hardest to endure. With no moisture, the whole idea is it's okay to scratch because when you scratch and then you blame yourself, it's like you have to realize we don't even have anything out there to mitigate this itch. We don't even know why we get itchy. I do know about some theories.
Hahn Byol: I would constantly scratch, not just the skin but the scabs. You scratch the scabs, then you bleed, and then they form again. And then a couple hours later, you scratch them off again. I'm not intending too, but that's just how itchy it gets.
Hahn Byol: So my neck scabbed up. I was in a constant state of pain there, and also I couldn't extend my legs. So I basically just couldn't walk from about the two and a half month mark to about the four-month mark.
Jennifer: Oh my goodness.
Hahn Byol: Yeah. So I was basically sitting in a chair. I had a rolly chair. It's kind of funny. I was just in a rolling chair back and forth for that whole time in my parents apartment. But also my arms too eventually. So it was really hard to do things by myself. So I'm really grateful that I had my girlfriend and my parents to help me because realistically speaking, Jen, I couldn't even go to the bathroom myself. That was a real issue. I'm so grateful that I have these people in my life to help me go when I need to go. But that was a serious issue too.
Hahn Byol: But it just gets better with time. There's just so much I guess that I experienced. But basically the way that I went about my days in those earlier stages was just doing whatever I could. Just getting out of bed for me was good enough for some days. I was getting fed a lot because I couldn't extend my arms. I couldn't bend them forward in too much. So they're kind of fixed at these 90 degree angles. So it's hard to eat. So I had to get fed sometimes.
Jennifer: The things we take for granted.
Hahn Byol: Yeah. It's quite amazing.
Jennifer: Can I ask, if you were to talk to somebody who realizes that they're in the midst of TSW, so they've had a lot of exposure to topical steroids and maybe other forms of steroids. They're in this boat and they're considering this. Is there anything that you wish if you could go back now and tell yourself something at the beginning, is there anything that you would say to that person? Because obviously everybody's journey is different, and I think everyone has the right to choose their own journey. So we're not going to tell you guys whether to or not to do this. That's not fair. It's your journey. But what do you wish you could've told yourself if you could go back to the beginning before you started? What would you say?
Hahn Byol: For specifically NMT, right?
Jennifer: Yes.
Hahn Byol: I would say, “Hahn, take your time.” With TSW, everyone just wants to get out of it. I get it. I so get that. We don't want to be in this state. Nobody wants to be in this state, but with NMT especially, you have to realize that the people that are saying that they're healing in three months or in less time. A lot of those cases, they're coming from Dr. Sato in Japan. They're being monitored. Let me rephrase that. I don't know that a lot of them are, but I do know that the patients that are being seen my Dr. Sato are being monitored 24/7. They're being taken care of by nurses and doctors all the time. So that's much different than me at home in New Jersey with my parents just trying to do this thing.
Hahn Byol: So the biggest misconception with NMT I think is that people think you're just not allowed to drink water, but that's not the case. The case is, as you mentioned before, which is that you want to restrict it as much as you can. So I made the mistake in the very beginning of really going to… I used to drink two to four liters of water a day easily. In one day, I just went down to one liter max but also taking into account the water content in food. That's a no-no. That's a no-no. So especially because you're not going to be monitored by a doctor at all times unless you're going to see Dr. Sato.
Hahn Byol: I would say just ease into it. You'll get there in time. Really it just takes time.
Jennifer: Yeah. It does. I think the other thing too to keep in mind is that regardless of where you are in your journey and what choice one makes, whether they do No Moisture Therapy or they soldier through TSW in the various ways. I work with a lot of clients who also employ on their team someone that is a TCM dermatologist. I've talked to Dr. Olivia Friedman, some of you might remember, about this. So having some other people on your team can also be helpful to make sure that from a nutrient perspective you're okay. If you feel like you're not doing well, seek medical attention. Because like you're saying, it's hard for you to know if say your protein is too low or your salt gets too low or too high or whatever. We just want to make sure that everyone is doing things in a safe way and have a discussion with your doctor. They might not agree with you, but ask them to still support you in the process and make sure you're doing all right.
Jennifer: I wanted to ask you too because for those of you who are going through this, TSW, or even if you're just in a bad place with your rashes right now, I know when you're on a bunch of different social media platforms. But just especially have come to love and appreciate the videos you shared on TikTok. The one thing that I was saying to you before we started was just I actually have so much gratitude for the level of positivity given your circumstance because you show some videos where it's just physically, you can see your skin is just… It's not where you want it to be, and you look like you're in a lot of pain. Thank God for your mother and your father and all of these people in your life who are helping you. But you're positive, and sometimes you just come on and you say something like, “I just want to remind you that I love you. I wish you a good day.”
Jennifer: How do you stay positive when you're in a lot of pain and when physically you might feel very limited as you go through your journey, whatever it may be with your skin?
Hahn Byol: That's a great question. It's something that I continue to struggle with on a daily basis. I definitely want to say that with the level of positivity I do bring with the social media, I do constantly struggle with the itching and the pain. Your mind is so powerful, and the thoughts that you have and the words that you speak, they really make a difference. They really impact not only yourself but those people around you. It's easy to complain. It's easy to be negative. But it's hard to stay positive in the midst of adversity and struggle and anguish.
Hahn Byol: I think the biggest thing for me is I have these support systems in my life who help to remind me, “Hey, Hahn, that itch, it's passing. It's passing right now, and you know what, you got through it last time. You're going to get through it this time. Remember when you were just itchy but then you were fine, you're getting through it right now.” It's just that reminder of, “Hahn, you've already been through so much.”
Hahn Byol: The greatest gift I have from doing NMT is that even though I continue to cycle through these flare ups and whatnot, every cycle is shorter and my skin is getting stronger and stronger by the day. Never say never, but I will refuse to be unable to walk again. Even if someone blows off my legs, I'll get new legs. I refuse to accept that. So that as well as accepting my situation. I'm not going to be in denial and pretend like this isn't my situation of being in TSW and being hurt and being in pain. Let me accept it and just go through my day and just do what I can because I think everyone deserves to live their best life. And whatever you get to do in a day is what you get to do. I'm just grateful to be alive right now.
Jennifer: That's so powerful when so much online, we see a lot of the compare and despair.
Hahn Byol: Yeah.
Jennifer: She gets to do this or he's doing that. That's not fair. But you're right, focusing on the small things that we get to do, that we get to experience to be fully present to what's in front of you, that's a really powerful reminder.
Hahn Byol: Yeah.
Jennifer: Really is. Wow. Out of curiosity because I know that you've got a… We'll share the link because it's a little tricky for me to say because if you're listening to this, you're not going… You're going to go, “Where am I supposed to go to connect with Hahn?” But he has a link, we'll put it in the show notes, of all the different social media platforms and some of the different things that he supports or is sharing with the world and trying to get awareness out within this… For those of you know, it's a Linktree link, but you guys who don't know what that is, don't worry. I'll put the link in the show notes for you so it's easy to find.
Jennifer: Is there any final words that you would love to share with someone if they're like, “Is NMT right for me?” What would you say to someone who's thinking about it?
Hahn Byol: I would say do as much research as you can. Not just with this but with anything that you're about to partake in, especially with your body. Do as much research as you can, and give it a shot. Ultimately what it came down to for me was I have nothing to lose. I have nothing to lose. So I was like, “All right, 90 days, let's see what happens.” After those 90 days were over, I couldn't walk. But I noticed that my skin was getting stronger. So I continued. Here I am eight months later.
Jennifer: Wow. Well, I think that those are wise words, and I actually very much appreciate the fact that you have repeated reminders to people too that this is your journey and maybe not theirs. That's an important thing too because for those of you listening, you know that it's not for me to decide what's best for you. You're the CEO of your health, and you've got to make decisions for yourself that are the right decisions for you. Whether it's medication or it's supplements or it's food or it's a combination of all the above or something else, that is entirely personal and it's ultimately up to you. And I think it's incredibly important to always ask questions and go in with your eyes wide open instead of just looking at before and after photos because there's a lot of before and after photos that people don't share that don't show positive results, and we don't see those. So do your research.
Jennifer: And I think too if you're looking for someone who can offer some light and you just are really curious to check out more of what's going on behind the scenes, especially someone who's going through NMT, I would really encourage each and every one of you to connect with Hahn because he is… Like I said, I don't follow a ton of people on TikTok. I really only follow people that I'm interested in following, and I find your… I've never personally been through TSW. I have clients who are going through it. I've obviously never been through NMT. I've seen photos of it. So it was really inspiring and eye-opening to see what you go through. And I deeply appreciate your vulnerability and your generosity in sharing your journey with everyone, not just here, but everything else that you do because stories are really what connect us. And they're just so incredibly powerful. I'm really appreciative, Hahn, that you took the time today to join us.
Hahn Byol: And thank you, Jen, for constantly spreading awareness. It is so important what you're doing, and I really appreciate that. Thank you.
Jennifer: Well, thank you so much. Like I said, everyone, we'll have all the links and everything in the show notes. All right, thanks everyone.
