My initial treatment plan for TSW

After reading through all the Facebook groups, ITSAN, and different commentary on Dr Rapaport and Dr Sato, I have decided to start with the following treatment plan:

  1. Cold turkey – no more steroids at all.
  2. NMT. This treatment plan looks to have the best evidence of fast recovery.
  3. Diet. I’m going to be alternating between various diets. More below.
  4. Exercise. Daily!

Cold turkey

I’ve looked into both the approaches of weening off and just stopping completely.

Weening off may seem to alleviate some symptoms but doesn’t show any evidence of faster healing.

Cold turkey seems to be the fastest path to recovery, and is the method recommended by both Dr Sato and Dr Rapaport so I’m inclined to go with them.

Even though the symptoms may be more severe, I’m ready for the hell.

NMT (No Moisturizing Treatment)

There seems to be two schools of thought within the TSW/TSA support groups. One group supports NMT in line with Dr Sato (popularised by the blog of a patient named Tokuko) and the other is all about salt baths, oils etc.

From what I can see, NMT makes more sense. It is the idea that reducing fluid intake and not applying topical moisturisers or even water allows the body to dry out the damaged skin quickly, shed it and regrow new skin underneath. This means no showering or bathing (or only a very quick 1 minute shower every 3-4 days) and only drinking 1L of fluid per day or less.

I like this approach – putting moisturizer on damaged skin has always felt uncomfortable for me. I always felt scabs should remain dry and fall off, rather than being treated. Therefore I’m going to at least start with NMT and see if my body responds like other patients have.


This is interesting because Dr Rapaport seems to believe diet has no bearing on your recovery. Dr Sato doesn’t say much about diet but does believe your fluid intake will have a bearing (less than 1L per day).

I have been very nutrition conscious and experimented a lot with diet over the last 5 years and read many books on the subject. I believe diet is absolutely going to have a role in fighting TSW.

I haven’t decided exactly what combination of diet I will be using, as it will all depend on how my body feels and reacts at each stage. Ideas I am considering are:

Raw foods diet – Have done this before, excellent for cleansing with the alkalinity and high fibre.

Fasting – Will definitely be incorporating fasting. Boosts HGH (needed for skin/wound repair) and amazing for cleansing.

Carnivore – I think this will be ideal in the mid stages. Carnivore diets have shown amazing results for healing and I think it will be perfect for TSW on NMT, because meat is dehydrating (great for the reduced fluid intake on NMT) but very high in nutrients and collagen.

Avoid all grains, sugars, gluten, dairy. These are inflammatory and in my experience provide no unique health benefits.


As I can’t shower I want to do regular exercise but avoid big sweaty sessions. I will be aiming to do 100 pushups per day, hopefully this keeps cortisol pumping and doesn’t get me all sweated up like I might during a long run.

That’s the plan I have in my head right now. Will keep you all updated as I go. In my mind I am hating that I have to go through this, I had so many plans for this year that have already been thrown to shit because of it, but as I’ve learned in the past, half of the battle with these things is mindset. Be STRONG AND KNOW YOU WILL WIN THE BATTLE! I’m ready.

One thought on “My initial treatment plan for TSW

  1. Jack says:

    Hey Bren,

    Thanks for writing up these posts and sharing them! I’m just starting strict NMT now. I’ve been off steroids and moisturisers for almost the entire year, but haven’t been strict with my liquid intake or bathing routine, and my skin hasn’t improved a whole lot.

    I’m looking at other lifestyle changes I can make to help myself get through NMT quicker, but also to make myself a healthier person (if I pick up a bunch of healthy habits during NMT and my skin gets better, I’ll be scared to let them go whether they had an impact or not ¯\_(ツ)_/¯).

    Your blog looks like it has a lot of handy tools and tips for getting through this. I just wanted to comment as a friendly stranger to say thanks and that you look like you’ve made a lot of progress – you’ve got this!

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