There has been a huuuuuge influx of new members to all of our social media sites (the biggest now having 18,000 members) since Tyler’s story went viral. We used to get a lot of questions anyway, but with this coinciding with Dr Aron reopening to new registrations we’ve been inundated with them! I agree, the process can be confusing, so I thought I’d write a little guide from my own experience to help newbies get to grips with what they may come across when starting treatment. For those wondering how to get access to the treatment in the first place, click here and make sure you’ve requested to join the group.
Firstly, this is not a cure.
This is a long term management treatment with the aim of helping patients return to a good quality of life. There is no cure for eczema, but this is the closest thing to one that I’ve ever come across. There will of course be ups and downs, but as Dr Aron says, it’s a marathon, not a sprint 
Get familiar with the main pillars of Dr Aron’s treatment.
So basically…
- Deal with the staph: in eczema patients, staph is rampant. Before you start treatment, more than 90% of you will have been colonised by staphylococcus aureus, or staph (according to National Eczema Association https://nationaleczema.org/eczema/related-conditions/infections/staph). Staph is a nasty little bacteria that can live on normal skin with no issues, but on skin with a damaged barrier, its exotoxins produce inflammation which induces itching… which makes it spread and produces more exotoxins which induce itching, which makes it spread and produces more exotoxins which induce itching, et voila! The itch-scratch cycle.
- Prevent rebound: contrary to conventional treatments, which use short bursts of strong steroid and antibiotics followed by an abrupt stop, more often than not resulting in eczema rebound (where after stopping steroids or antibiotics it feels as though the eczema comes back with a vengeance), Dr Aron’s method uses weak medication over a long period of time, gently reducing the amount you use. The heavy dilution makes this a million times easier (your first taper from 5x to 4x would be a 20% drop rather than the 50% drop you would have if tapering neat steroids from 2x to 1x a day).
- Keep moisturised (but not too moisturised!): moisturisation helps to repair the skin barrier (which in eczema patients struggles to produce its own moisture.) However, too much – and especially the use of oils – could help the staph bacteria thrive.
- Keep it simple: this treatment is effective because it’s so simple. Simplicity also makes it easy to comply with, so no excuses!
It’s as easy as that! If you’d like a more comprehensive explanation as to why this treatment uses both antibiotic AND steroid, click here (again, you’ll have to be a member of the group to see it).
Remember, everyone’s different.
We all have different severities, different triggers, and different compounds. Therefore, although there are a huge number of so-called ‘overnight miracles’, not everyone will see dramatic change in the first few days, or even the first few weeks. Similarly, in the long term not everyone will be able to taper down at the same rate. Try not to compare yourself or get disheartened, with enough perseverance everyone seems to get there in the end! This isn’t a one-size-fits-all potion so anything can be tweaked by Dr Aron until it’s right for the individual – although he normally gets it right first time! Just make sure you’re following his every instruction and keeping him up to date and he will guide you through any difficulties to clear skin.
Things might get flaky.
And that’s ok. At the beginning of treatment, lots of patients experience dryness and tightness of the skin. Don’t panic, this will shed to reveal the beautiful skin underneath. Try and hold out from applying extra moisturiser, especially if you’re starting out using 5 emollient-based compound applications a day. Speak to Dr Aron if this goes on for more than a few weeks.
Itchy red bumps can also be common at the beginning (Dr Aron will usually recommend calamine to dry these out) and staph boils pop up for a few, for which he may ask you to go on a round of oral antibiotics to get rid of a particularly bad infection. Don’t worry, it’s not a setback, you just need to make sure it’s taken care of properly.
Do not just stop.
Do not! One of the key elements that make this treatment work compared to conventional methods is the slow, gentle taper. For this reason, you should keep treating areas that were affected by eczema even if they have been completely cleared up by the cream; you just gradually taper down so you use the compound on these areas less and less frequently. If some areas are doing better than others, you can taper them down separately (my body is a patchwork of application frequencies!).
Ask for tips and tricks.
Having done this for so long, Dr Aron (and indeed, his support group) has a wealth of tricks to boost tricky areas into healing. Favourites include calamine lotion before the compound, cling film wrapping and a short burst of neat steroid for really tough spots. You’ll learn so much from the group alone, but it’s always best to check with Dr Aron before adding another variable to your regimen. Which brings me to my next point…
Reduce the number of variables.
If something isn’t working, it’s hard to determine what it is if there are 8 different regimens you’re using for your skin at one time. The sheer simplicity of this treatment means that pinpointing triggers becomes very easy, so try not to complicate it. If you’ve already been keeping a certain diet before starting treatment, sure, keep it constant, but don’t start taking 14 new supplements, slathering yourself in oil at night and introducing new foods in the first month of treatment. In terms of other creams and oils, it’s really best that the only thing that goes on your skin is what Dr Aron has prescribed or the treatment could be compromised (especially as oils – yes, even coconut oil – can allow staph bacteria to thrive). Dr Aron recommends Dove bar soap (unless you have known allergies) for the same reason – keeping it simple.
It takes a while to get stable.
People tend to yo-yo in the beginning. Most see great progress in the first few weeks, and then they hit what is known as ‘The Calamine Period’, during which time it is very likely that Dr Aron will advise calamine lotion to dry out any sign of flare. It can lead people to believe the regimen is not working for them, when in reality it’s a time in which the staph probably just has one last fight in it, your skin barrier is not yet repaired enough to defend itself on its own, and triggers are still mostly unidentified. Your skin becomes more stable in time, and flares typically get smaller and further apart (think opposite of labour contractions).
Staph travels.
When you begin the Aron Regimen, you’re now using a topical antibiotic, which is obviously localised compared to oral antibiotics. Many people experience eczema popping up in completely new areas in the beginning stages of the AR, which was explained to me as being the result of staph ‘escaping’ the topical antibiotic; going to pastures soon to be redder, if you will. This is nothing to worry about, just add the newly affected areas to your normal cream routine and taper as you would the rest of your body.
Do not undertreat.
The eczema community is plagued by steroid phobia in ways that other skin conditions’ support networks don’t seem to experience. I agree, steroids are piled onto eczema patients inefficiently and I think many people have suffered from the over-prescription of stronger and stronger steroids and then felt the wrath of rebound after following instructions to stop abruptly or use ‘weekend breaks’. However, this is, I believe, the right way to use steroids. It effectively minimises the amount of steroid needed over time whilst also maintaining clear skin, sometimes to the point that people (both children and adults of all severities) achieve remission. Not many treatments can boast that.
Due to steroid worries or full-on phobias, there is a tendency to drop apps before the skin is ready, or to treat with fewer apps than Dr Aron told you to start on in the first place. He’s a dermatologist, he’s been using this method with great success for decades (and as far as I know, no adverse side effects have cropped up), so trust him. If he has to, he would rather over-treat for a short while to kick the inflammation and colonisation before reducing the apps significantly than flick between on/off with steadily stronger medication for an indefinite period of time, as is the way of conventional treatment. The best thing you can do for yourself/your child is follow his instructions as closely as possible. Remember, the mix is SOOO diluted that you’re not using as much as you think.
Triggers get easier.
I read time and time again “I want to start my daughter on the Aron Regimen but I want to work out her triggers first”. If your child’s skin is locked into the itch-scratch cycle by staph colonisation, it seems illogical that simply eliminating dairy out of her diet will magically heal up her skin, even if dairy is her true trigger. You need to deal with the staph. In addition, when the skin is red and angry all the time, how do you know if something has definitely made it worse?! For severe cases, constant, all-over redness makes it almost impossible to pinpoint things. Allergy tests will only tell you so much (i.e. they won’t bring up specific intolerances), and please don’t believe any ‘muscle-testing’ kinesiology bull your homeopath tries to flog to you (on second thoughts, just don’t hire a homeopath).
But it gets easier. As soon as the skin is clear, it’s becomes blatantly obvious when a trigger affects it. Alarmingly obvious, at times. Stuff that you used to expose yourself to every day, and stuff that you’d expose yourself to once in a blue moon. As I said, everyone’s progress is different so maybe it will take you a few months to get to the stage where you can pinpoint new triggers, but when you do, boy does ticking stuff off the list feel good! Identifying these means you’ll have more control, which means your healing progresses exponentially. As time into treatment goes on and the immune system is no longer in a state of hyper-reactivity in its unwelcome attempts to ‘protect’ you, many patients find that they are no longer sensitive to their triggers at all. Things they once thought were allergies turned out to be false positives, and only the true allergies remain (sorry, Dr Aron’s good but he’s not that good!).
Pigmentation does come back.
Lots of people cite loss of pigmentation as due to using steroids, but Dr Aron believes it is actually due to the inflammation. This would fit with the fact that my worst experiences of hypo- and hyper-pigmentation came during a time when I hadn’t touched steroids in 3-4 years. I’ve been using steroids for a year now, and have no pigmentation issues other than the fact that my eyes are darker just due to being Portuguese-Italian; I had that years before I ever had eczema. If I have a big flare, however, I can get a bit of hypo- or hyper-pigmentation, but nothing like the old days, and it’s usually gone in a matter of weeks (the first batch took a couple of months).
It takes time, but the differences in pigment do fade once the skin is given a chance to heal without being constantly inflamed.
Choose your flares wisely.
I won’t lie; as an adult, and there are situations where I can’t possibly avoid my known triggers. Situations such as wearing makeup to a client meeting so they don’t arrive at the conclusion that I’m in some way slack and won’t be able to perform at my job (a discussion for another time, on another forum), or at your fourth-cousin-twice-removed’s third wedding where you need prosecco to get you through the next 6 hours of pretending to know everyone’s names and care about their mundane interests. Situations like that.
I’m fully aware that sometimes I put my skin in the firing line when it comes to triggers, but I accept that it may set me back a little, I prepare for it, deal with it and move on. I could live like a nun but then I wouldn’t be able to go out and actually enjoy my new-found quality of life, so what’s the point?
Now I’m not saying go out and roll in the grass and throw your kids in the pool and pack your dinners with E-numbers, but just to be prepared for a flare if do find yourself in a position where you cannot avoid being exposed to a trigger. It doesn’t mean the AR isn’t working for you – but you obviously can’t expect it to work at its best if the triggers are coming thick and fast. So wherever possible, stay away from your triggers, and mentally prepare yourself for the times that you can’t. It’s ok!
Do not share your mix with others not on the regimen.
No, this isn’t so that Dr Aron can get more patients and therefore more money. Lord knows, the man has too many patients (what he really needs are doctors on board willing to take the baton!), which is why he has to take periodic breaks from new registrations to concentrate on existing patients.
I know it’s heart-breaking when you see a plea from a patient or mum about how much suffering they’re dealing with, and when you have an almost magical cream in your hands that helped you so dramatically it’s difficult to hold back from spilling the beans on the ratio of your compound. But please, stop and think. This mix is tailored specifically to you/your child, based on age, weight, severity and medical history. There is a real skill in devising this mix, as shown when Dr Aron sometimes has to tweak it for people. As an admin of a 12,000-strong Dr Aron support group, I see people’s mix details thrown out left, right and centre, so please trust me when I say they really are all different – even if someone guesses the ratio, how will they know the potency to use? How will they know how many applications a day to use?! There are too many factors.
This treatment is intended for the long term, and at the start you do use a high dosage (between 3-6 times a day). Being unmonitored and unknowingly using a mix that’s too strong for you in the long term could risk damage from the steroid (yes, your doctor may have prescribed it to you neat but he/she probably didn’t expect you to use it for months to years without a break). If you go the other way and use a mix that’s too weak for you in the long term, logic would suggest that you risk antibiotic resistance.
You’re not paying Dr Aron for his compound, you’re paying him for his decades of knowledge and close monitoring over the course of your treatment. With this expertise on board, he will make sure you are safe for the months and years to come.
Please do not share your compound details or attempt a DIY mix without Dr Aron’s input (mixing the separate components yourself according to Dr Aron’s tailored prescription is of course fine if you’re trying to save on compounding costs!). We say this to keep you/your child safe.
Don’t panic about not being in remission.
Focus on the small steps first. This is a long term management treatment, and there’s no rush to ‘finish’. Some people do taper down incredibly quickly and go into remission in under 6 months, but you should be aware that these cases are rare. Some people will remain spot-treating or using the cream once or twice a week for the foreseeable future (often without the antibiotic element), and that’s fine. Dr Aron deems this (and in fact, more than this) to be a safe amount. I would be quite happy to use that amount for the rest of my existence if my quality of life remained this high.
By my amateur calculations, in using the compound every other day, my legs get less than HALF a neat steroid application a WEEK. And they’re clear. They’re so clear that I can’t wait until England has its annual two days of sun so I can wear my shortest short-shorts.
One of the UK’s longest-standing patients, who appeared on This Morning Breakfast Show in an awful state when she was just 13, is now 22 and still using the cream twice a day. While this may sound like a lot and is certainly slower progress than the vast majority of patients (she says her main struggle is with allergies), it’s also a fantastic case study for long term usage – she has seen no side effects, no dependency and no resistance.
So don’t focus on getting off steroids. Focus on getting your life back and when you do, enjoy every minute.
Best of luck, everyone! xxx
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