Topical corticosteroids are prescribed in 59 percent of atopic dermatitis office visits — and Briana Banos wants that number treated as a public health concern. The award-winning filmmaker and writer, who has lived with eczema her whole life, went through severe topical steroid withdrawal (TSW) after years of using the very treatments meant to manage her condition.

Banos has spent almost 12 years in the TSW community as a vocal patient advocate. She has made two documentaries, Preventable: Protecting Our Largest Organ and Still Preventable, which give voice to patients going through withdrawal. She spoke at the National Corticosteroid Stewardship Summit in Washington, DC, arguing for greater awareness of how steroid use is managed in dermatological care.

The treatment became the problem

Banos traces her advocacy back to a paradox in her own treatment history. "When I was little, I was diagnosed with eczema. It was very mild," she said. But even a mild condition shaped her self-perception. "Growing up, I was very acutely aware of my appearance and maybe how I was perceived in that way."

The turning point came not from the eczema itself but from the withdrawal that followed years of topical steroid use. "What ended up happening to me is I started going through topical steroid withdrawal," Banos said. "So the thing that was actually helping me hide the condition that I didn't want anybody to know I had made it so much worse. So then I couldn't hide it."

She refused to treat the experience as a private setback. "I'm not someone to just sit on my couch and wallow in pity for myself," she said. "I used it as fuel to try and educate other people to take a bit more agency in how they deal with their health and talk with health-care providers, and it's become a career."

Her philosophy is blunt: "You can have a million problems. But once you have a health problem, that's the only problem you have."

Resilience, reframed

Banos challenges the usual framing of resilience as a compliment. "People that are resilient or have had to build that resilience muscle, it's because they've gone through something really difficult that they probably didn't ask to go through," she said. "Going through this alone has made me a resilient person. It's taught me that whatever challenge comes my way, I can face that and get through it."

Her relationship with her own skin remains complicated. "I'm still very hyperaware of what I look like. I don't think that will ever change," she said. "A skin blemish or things like that still make me feel anxious in ways."

One encounter with a health care provider shifted her thinking permanently. "I remember working with one health care provider when I was on a drug and it was the best I had ever felt. And she was nitpicking this very little thing. And I found that so concerning and dangerous in a way, because I was trying to tell her how good I felt in my body, and she was still trying to tell me that it wasn't perfect," Banos recalled.

She now rejects the pursuit of perfection outright. "I do think that certain beauty standards almost are a bit of an illness. Having perfect skin, having perfect anything is just not attainable and it's not real," she said. "I don't need my skin to look perfect because at the end of the day, I could be hurting myself to try and do that."

Her advice to others with visible skin conditions: depersonalize the commentary. "Try not to take it too personally. I think people just at the end of the day, either they mean well, or they just get nervous and don't know what to say to you," she said. "It's not who you are, it's a part of you, but it is not your identity."

Art as decompression

Creativity has been central to how Banos copes. She has stepped back from dance but continues documentary work tied to advocacy, which she says "makes it feel very purposeful." She paints and has recently taken up pottery in a workshop. "Mentally it takes me out of thinking and ruminating and helps me be present," she said.

Dance, in particular, served an emotional function. "Being able to share and move the emotions that I'm feeling without having to say anything, I find it very cathartic," she said. "The arts in general are a super helpful way to decompress when you're thinking about your skin or anything that you're ruminating over."

What's next: a PhD

Banos's trajectory has scaled steadily: from a personal YouTube channel to two documentaries to commissioned documentary work with skin-care brands. In 2027, she begins a PhD using observational documentary to examine the psychosocial burden of topical steroid withdrawal.

"I'm hoping to create resources for both patients and health-care providers, medical students, things like that," she said. "It's like the next bigger step."

She admits the leap brings self-doubt. "I always feel like an imposter any time I'm stepping out of my comfort zone. But that's how you learn. That's how you grow," she said. "The only way you keep going forward is to jump in, you know, do it scared, do it scared."

If the PhD produces evidence-based resources for both patients and prescribers, Banos could move the conversation on topical steroid withdrawal from patient forums into medical education — the audience the 59-percent prescribing figure suggests she most needs to reach.