Thin, fragile skin

[janedivney]

I thought it might be helpful to post this for those of us with very thin, easily damaged skin. It’s one of the many hazards of long-term, high dose steroid use, including inhalers. Of course, if it weren’t for steroids I wouldn’t be here, so I’m glad they’re available.

After decades of steroid use my skin is very fragile, so I keep a first aid kit at home and also in the car, with wound spray, steri-strips, padded dressings etc, for repairs on the go!

You can get plasters & dressings for fragile or sensitive skin. Boots do them, and a company called Allevyn. Just google. Inevitably, they’re more expensive 🙄 I buy my own steri-strips too, and use disposable tweezers. The quicker you can repair a wound and get it covered, the better it will heal, with less chance of infection.

Also, Zoff do adhesive removal wipes quite cheaply, you gently wipe around the plaster or dressing & then it peels off more easily.

Of course, I use an emollient cream to shower with, and a good moisturiser.

I used to be able to get some of these things on prescription, but alas no more.

[peege]

Great post thank you. It's horrible isn't it but par for the course. I have Steristrips stashed everywhere too all ready to go. I only get the 6mm ones because I find the 3mm ones don't hold. Boots copy are useless however Tescos 6mm copy are great & save a bit of cash.

Do you know know if internal skins are thinned as well? I only ask because when checking results on NHS app I noticed 'thinning of gall bladder walls' on my medical records after a recent scan. P×

Edit: I forgot to mention that I bought tubigrip for arm protection, I wore double when being active. They're great, inexpensive protection and pop in the washing machine.

[janedivney in reply to peege]

Actually yes, Tesco dressings are good. I tend to buy online but my sister gave me some Tesco “swim” plasters and they’re excellent. I agree the 6mm steri-strips are best, and easier to handle too. Too scary to think about internal organ coverings but I know from bitter experience that my healing is very poor. We’re both falling apart! 😆

[Chip_y2kuk]

I have an ouch pouch and a herbal first aid kit ... the ouch pouch has plasters and first aid cleaning wipes a few small gauze pads etc

The herbal first aid kit I have:

Pine resin salve (for cuts, scrapes, pain relief (for sore muscles cuts etc) it's antibacterial and because it's a salve (with organic waxes) it forms a layer so don't often need a plaster.... it also encourages healing

Bruise balm which has arnica ans camomile to help heal bumps ans bruises

Dandelion salve .. fantastic moisturiser and also has tea tree (which is antiseptic)

Soothing balm .. good for colds/hayfever (has catmint in it which has a decent menthol content)

The pine resin gets the most use followed by the bruise balm

[fraid in reply to Chip_y2kuk]

Am very allergic to Tea Tree oil, so was my horse, made us quite ill! Need to be careful what is actually in these products. Best thing to stop bruising I have found is an ice pack but don't bother for the little ones. Does just make you feel and look old though when you're covered in bruises and people ask what happened to you. 😕

[Chip_y2kuk in reply to fraid]

I do bruise really easy... the stuff in my herbal first aid kit is hand made in small batches by a nearby apothecary and does indeed have an ingredients list on the back as well as usage instructions

[janedivney in reply to fraid]

Funny you should mention tea tree because I don’t get on with that either. I don’t have an allergy, but it’s strong stuff and even the smell is too much for me

[Lysistrata Administrator Community Ambassador in reply to Chip_y2kuk]

As fraid has mentioned, for those reading be careful with herbal stuff in case it sets off your asthma - triggers vary!

[janedivney in reply to Chip_y2kuk]

You’ve got a good kit there! I haven’t tried pine resin, I use calendula balm from the Weleda range, and also arnica which as everyone knows is brilliant for bruises.

[Chip_y2kuk in reply to janedivney]

Thank you

[Wheezycat in reply to Chip_y2kuk]

I have tried pine salve - it made me itch and gave me a rash.

[fraid]

Just replied to same problem post! Was though told that inhaler steroid that gets Into system is minimal, maybe depends on which you use? 🤔

[Chip_y2kuk in reply to fraid]

It depends on how much you use and how reactive you are to them..m I've been told the same but my adrenal glands disagree

[OMGWT in reply to Chip_y2kuk]

my cortico inhaler 🫁has side effects I’m sure many do but when I finally got a doctor to lower the dose ( budesonide/ formoterol to 80, it helped a lot .ive tried so many inhalers ( non cortico also) and it’s the only one that worked effectively.it definitely helped me systematically but so are the side effects.

U called it reactive I’m definitely sensitive so much I didn’t do so well on the pill form ( maybe the antibiotic made the effects worse)? I believe the test I had done for NAFLD is most likely accurate because other meds filters or affects by the liver I have to lower dose of everything.

So that might be another factor is your health issues.( this is despite trying to live as healthy as possible).😑

[Chip_y2kuk in reply to OMGWT]

Budesonide im very reactive too when I had a cortisol test my starting (9am baseline) was 52 and they said it should be nearly 650, I think it was but either way it should have been decent triple digits and I was only just double.

I've since been switched to high doses of becloemthasone and now push 250-300...still lower than it should be but to be expected on high dose inhaled steroids.

[OMGWT in reply to Chip_y2kuk]

Labs and medical facilities differ here and even with “ competition “.So my understanding is cortisol blood 🩸 for you was low and it should have been higher? Do you get high BP with the higher dose ?

I guess I misunderstood the cortico and cortisol connection.i will do some research.i dont think mine was ever high maybe not even before the medication.💊

[Chip_y2kuk in reply to OMGWT]

So cortisol is the bodies natural steroid and is involved in a stupidly varying array of things including blood pressure, blood sugar, inflammation, controlling the release/trigger of other hormones .. and when we take corticosteroids (or any other steroids) your adrenal glands don't need to make as much cortisol and so slow down .... over time they can stop/become lazy ... which can be a problem

My blood pressure is always ok/a little low.... my heart rate however normally causes me issues with doctors.... its pretty consistently 100+ Bpm and there are various theories on it from medication to airway inefficiency being assisted/aided by an increased heart rate.... it was actually higher before treatment(186bpm) so I'm going with the last theory as the most plausible

[OMGWT in reply to Chip_y2kuk]

My issue is I had symptoms of “ adrenal insufficiency “ before starting inhaler.so I just thought that’s why it helped so much system wise.to this day doctors keep saying allergies, asthma blah blah 😒 and so many other symptoms…maybe it’s both..it helped with blood pressure,blood sugar and gastro.even weight gain. many doctors didn’t listen and were surprised and said it should do the opposite

Many of my problems with higher heart rate and BP came mainly after the wrong treatment for something else.” Infusions “ nearly ended me. I wa sin ICU when they took out the cortico I went into a coma. I don’t think that was the intention of the test they did. seemed to be permanent damage.i will keep this in mindAnd thanks for sharing because I understand people are different and many reasons why they even take cortico.

[Chip_y2kuk in reply to OMGWT]

Interesting you say that but.. before medication I used to feel faint of an evening and even passed out in occasion I was initially investigated for AI as once I started on cortico steroids it stopped, even though the treatment wasn't enough to solve my breathing problems

However I would also say a folic deficiency over a long period of time can cause AI symptoms (weakness, tiredness, forgetfulness/brain fog, heart rate/blood pressure problems) .... and I've recently discovered that chronic inflamation can deplete folic levels ..... im currently being treated for a folic deficiency too.

So it may be worth your folic levels being checked?

[beech in reply to fraid]

I chatted to my asthma nurse about this only a couple of weeks ago, hoping there might be an alternative steroid contain8ng inhaler of similar efficacy I could change to.

But sadly the quantity in mine is small, but I react very easily to it - my skin on my forearms and shins is very fragile, and I bruise badly all over my body at light knocks 🤷‍♀️ so all I can do is moisturise, shield my skin and be careful 🙄

[janedivney in reply to beech]

I agree, if we need to take steroids it's down to us to protect our skin. As you say, that’s all we can do. I’ve learned to be really, even obsessively, careful. I wear trousers and long-sleeved tops all year round, partly for this reason but also because I’m self-conscious about my poor skin!

[janedivney in reply to fraid]

I think the truth is more likely to be that the steroid component is minimal compared with the alternative of oral prednisone! But yes, obviously the problem is worse with a max dose of a high steroid inhaler. My adrenal glands packed up years ago and I’m on replacement therapy.

[Oldandgray]

my skin in my mouth is very thin and fragile. My dentist has had some serious problems when he has had to use stitches.

[janedivney in reply to Oldandgray]

That sounds really painful, you poor lady 😕

[GintyFerguson]

Yup...gardening is particularly hazardous! My skin will break if it touches a twig! I usually just run it under a tap, dry with tissue, put the skin back, apply steri strip and cover with a mepore sterile dressing . I form it into a pouch so it doesn't touch the wound!

[janedivney in reply to GintyFerguson]

That’s interesting… I find if I press the dressing firmly onto the steri-strips and cover it with a thick pad, the pressure helps stop the bleeding, especially on shins. Then I just leave it. Whatever works for each of us!

[TwoPuffsAl]

Great post Jane, all very familiar to me. A couple of tips I’ve picked up over the years are to initially press and hold the injured flap with clean gauze wetted with cold water. This helps stop the edge of the flap folding underneath itself. Also on the first two nights after an injury I will top the the dressing with bandage to avoid damage while sleeping.

[janedivney in reply to TwoPuffsAl]

Thanks, Al, that’s a good tip about the wet gauze because the flap shrinks so quickly.

[TwoPuffsAl in reply to janedivney]

interestingly I’ve had two quite nasty cuts, one in a London tube station and one while playing badminton where in both cases the first aid boxes did not contain steri strips. On the badminton one it was ok because I had my first aid kit in the car but on the tube station it meant finding a chemist and buying them and the other necessary supplies. The tube first aiders told me they weren’t allowed to stock them.

[janedivney in reply to TwoPuffsAl]

Crazy isn’t it 🙄

[janedivney]

Thanks everyone for all your comments and tips!

Another tip is to use OpSite waterproof dressings. So for a shin or forearm skin flap I use: wound wash, steri-strips, a folded piece of gauze cut to size, then an OpSite on top. The OpSite stays in place for up to 7days with normal showering, though I wouldn’t soak it. Of course if I think the wound is exuding, or the skin around it looks inflamed, I change it.

What larks we have, living with severe asthma 🙄😂