Bruising: I have been on long term steroids which... - PMRGCAuk

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Bruising

bowler profile image
32 Replies

I have been on long term steroids which has caused my skin to be very thin and papery and easily bruised [ I do use Diprobase ] however my skin is getting so much worse and even rubbing the Diprobase very carefully into my skin is causing bruising, mostly to my lower legs, also my legs and feet feel hot, more noticeable at night in bed.

Does anyone else have the same problem with thinning skin.?

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bowler
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32 Replies
Annodomini profile image
Annodomini

I've had it too, principally on my wrists and forearms. Even leaning on the edge of a table would bring up a bruise. However, I've been steadily and gradually tapering the pred dosage and am almost down to 4mg and find that I am not bruising nearly so easily, although my skin still looks like crepe paper. I still keep up with the moisturising regime because I certainly don't want to scratch my arms and make matters worse again. I hope you will find that there's an improvement as time goes on.

bowler profile image
bowler in reply toAnnodomini

Thank you for your reply, I am on 15 mgs pred at the moment doing a slow taper from 25mgs so the high dose isn't helping with the bruising, and like I said it's getting worse.

My problem is after 16 years of Pred, It's getting harder to get to a low dose. The last time I got to 10 mgs I had another flare, so once I get to 10mgs again I will stay on that for a longer time. I sometimes think my adrenal's have had it.

Annodomini profile image
Annodomini in reply tobowler

That's miserable, Bowler. I've only had 5 years of pred and started on 20. I think things improved at around 7mg, but you've such a long way to go. You have my sympathy and I am sorry i can't be more help. Is your GP any use?

bowler profile image
bowler in reply toAnnodomini

I was only 54 when diagnosed with GCA I'm now 71, I started on 60 mgs, pred and I'm afraid it's been a roller coaster ever since, I did get to 5 mgs [ maintenance dose ] for several years.

I attend Addenbrook's Rheumatology every 6 months. Our surgery is run by Locum's since our regular Dr's of 28 years retired, and the Locum's don't seem to have a clue.

I more or less manage myself, and know more about GCA than they do

SandraBanks profile image
SandraBanks in reply tobowler

I too go to Addenbrookes and my Ruemy doctor retired (possibly the same one) and was going to live in Scotland. Great doctor, expert in fact. Not at all pleased with new doctors - I thought the nurse new more than him. This site is fantastic for information.

bowler profile image
bowler in reply toSandraBanks

Hi

my above post should have read " OUR DR'S SURGERY" is run by Locum's not Addenbrook's

Sorry for the confusion.

piglette profile image
piglette

I have bruising problems and thin skin. When I have blood tests I turn down the plaster which would probably tear my skin off. When I go to the osteopath she leaves her finger prints as bruises on me!

bowler profile image
bowler in reply topiglette

I am exactly the same, with the tape they use after a blood test, I recently had some surgery on my face and it was agony getting the dressing off, and the bruise from that was worse than the surgery I had.

Annodomini profile image
Annodomini

Just realised that the tape I had over the site of a blood test yesterday hasn't left any mark which would not have been the case just a few months ago. I do have a bruise on the back of my hand and have no idea where it came from, so maybe not completely out of the woods yet.

piglette profile image
piglette in reply toAnnodomini

I am always getting bruises on the back of my hands, goodness knows where they come from. Also my legs look like I have been beaten up at some point. The bruises don't actually hurt normally they just look a bit horrific.

bowler profile image
bowler in reply topiglette

You can tell I'm right handed as most of my bruises are on my right hand and arm, I only have to reach in the cupboard for a saucepan and I get a bruise yet I don't feel that I have knocked it as I try to be so careful, My husband said I should wear long gloves, I do wear trousers most of the time and still get bruises on my legs, I probably need a suit of armour !!!

HeronNS profile image
HeronNS in reply tobowler

I get these purple marks on my forearms for no apparent reason. They appear, stay for a few days then fade. Never had anything like that before pred. A result of bashing into something unawares? But they don't look like normal bruises.

piglette profile image
piglette in reply toHeronNS

The purple marks are purpura, I get those too. Sometimes I look as if I have been in a fight with a wild cat. They seem to appear from nowhere and take about a fortnight to fade. I also get them on my legs occassionally. The vascular surgeon said it was caused by the pred.

HeronNS profile image
HeronNS in reply topiglette

Hopefully they won't be as common by the time summer and short sleeves arrive. :D

piglette profile image
piglette in reply toHeronNS

I hate to say this but mine seem worse in the summer, possibly because they are caused by knocks of some sort.

HeronNS profile image
HeronNS in reply topiglette

I am disappointed that this is happening now that my dose is quite low. Hate to think what is going on inside, unseen....

Megams profile image
Megams in reply topiglette

Hi Piglette -

Please describe these purple marks?

You may remember that I had my veins injected twice last year & the purple spider veins developed in abundance after the 2nd lot of treatment. Is this one in the same thing we are talking about??

piglette profile image
piglette in reply toMegams

No these are not spider veins, the best description I suppose are blood spots, a reddy purple colour, they can be quite small and sometimes much larger, just one by itself or several together. They tend to fade over a period of about two weeks or so.

Megams profile image
Megams in reply topiglette

Ah ha I know.

Tiny little bright red spots that appear out of no where.

What is happening here do you know?

piglette profile image
piglette in reply toMegams

They are not really bright red more purple red. All I know is that steroids can cause them! Mine tend to be more on my arms although I do also get them on my legs occassionally.

PMRpro profile image
PMRproAmbassador in reply toMegams

Petechiae or purpurae, depending on the size:

"A petechia, plural petechiae, is a small (1–2 mm) red or purple spot on the skin, caused by a minor bleed (from broken capillary blood vessels). Petechia refers to one of the three descriptive types of bleeding into the skin differentiated by size, the other two being purpura and ecchymosis."

Pred makes the capillaries fragile - and the slightest knock that wouldn't normally do anything noticeable makes them leak. The tiny ones are often due to something rough against the skin, the bigger ones scratching (for me anyway). I also note that once one has happened that area seems to remain fragile. This Mayo Clinic article shows how diverse the causes can be:

mayoclinic.org/symptoms/pet...

What I find astounding though is that mine aren't too bad at all now - even when my INR has shot up way above where it should be! You'd expect someone on an anticoagulant to have problems.

bowler profile image
bowler in reply toPMRpro

I was at Addenbrook's Dermatology yesterday [ not for my bruising ] for My Bowen's disease. The Dermy. noticed the skin on my arms, so I showed him my legs [ not a pretty site ! ] which are really bad, my skin especially on my legs is getting to the stage when even drying them with a soft towel almost takes the skin off and I'm left with large bruises that have become a bit painful/sore,

Dermy confirmed that it's due to long term use of steroids, and not much can be done for it and sent me off with a few samples of skin lotions/potions to try which was good of him, as like I said I was there for my Bowen's not my bruising.

I'm hoping that as I gradually reduce my Pred. dose [ I'm on 14 mgs. slow reduction ] it may get a bit better, No shorts for me this summer !

bunky52 profile image
bunky52 in reply toHeronNS

Me too. I am now going on 2 years since diagnosed. I am now on 3 mg pred...still bruising on arms ...takes nothing to bruise.

Suex2015 profile image
Suex2015 in reply topiglette

I'm like you Piglette, with unexplainable bruises on the back of my hands. Also get the on the inside of my knees where I sleep on my side with my knees together. But if that's the wise I've got to cope with then that'll do for me ☺️

HeronNS profile image
HeronNS in reply toSuex2015

I know what you mean. Things like purple marks or a round face are nothing compared with diabetes, glaucoma, necrosis of the hip joint or a number of other nasty side effects. Pred may be our friend but it is a two-faced, dangerous friend, the kind of which one says: with friends like that who needs enemies...?

Nap1 profile image
Nap1

Yes and my skin tears and peels and I bleed through. I take good care not to get infected. Arms are bad too. As pred is reduced it will get better. But not normal. Be careful. I wake up with bruises from my very expensive soft sheets. Good luck.

Charlie1boy profile image
Charlie1boy

Yes, it is the same as HeronNS describes for me. No pain, but the marks on my forearms don't look great, and I have no idea where they come from, unless I have been out pruning the roses!

Am down to 7.5mg now, but the bruise marks continue to come.

Good luck.

Rusty8 profile image
Rusty8

I have just taken a chunk out of leg and skin just peeled of was told because if steroids it is going to take a very long time to heel

Blow me two days after caught arm on door and that ripped skin back

I have cut myself down to 5mg and looking at going down further

I have lived with pain for years and no I don't like it but side effects are horribly

You don't know what to do for the best

Judigardener profile image
Judigardener

I think another thing to do would be to have a bath or shower and use Oilatum.

That way the warmed skin would absorb more moisturiser but you would not have to rub at all hard.If not Oilatuml then something similar like E45 products for showering or Neal's Yard stuff for babies.

mega profile image
mega

Yes, Bowler I too am afflicted with awful purple patches, on my arms and wrists mainly but extending up to my shoulders and onto my hands. They take weeks and weeks to disappear by which time I've acquired more, of course. The nurses always ask me if I'm on Warfarin, which I am, so that must add to the problem. My skin too is like tissue paper and used to 'concertina' at the least little knock - a Christmas cracker pulled a bit too enthusiastically on one occasion - which leaves a white scar when they heal. At least that hasn't happened for some months. I started on 40mgs of Pred nearly five years ago for GCA and after a couple of false starts am now on 5/4 regimen on a VERY slow reduction. I can see no improvement in my skin or the horrible bruising. I haven't worn a short or three quarter's sleeve top for nearly five years, even at home! Strangely enough, my feet are usually freezing in bed! That's easier to alleviate though, than overheating.

I am extremely conscious of my horrible arms and, even though I'm aware there are far worse things to endure, as a fellow sufferer I do sympathise with you. Any medic I have asked about it just shrugs and says there's nothing to be done.

Best wishes.

Mega

Rusty8 profile image
Rusty8

Yes I have only been on it 5months skin is so very thin knocked leg took a chunk out of it skin just peeled if now having to go docs twice a week for dressing

This is a good but horrible pill with side effects the sooner I can ween myself of the better

bowler profile image
bowler in reply toRusty8

How painful, I hope your leg soon heals, I only rubbed/patted my leg skin with a soft towel and I now have a 4x2 inch bruise, luckily the skin didn't break.

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