Thin skin - prednisolone

[scottiemarg]

I have been on prednisolone for about 2 years starting at 15mg and am now down to 4mg per day. I have had the usual purple bruises just through brushing against things and also a couple of gashes when lightly knocking against a door frame. When I finally finish the steroids, I wondered if my skin will improve or is this permanent now?

[DorsetLady PMRGCAuk volunteer]

It will improve in time, but it still seems to be more sensitive than pre Pred, or maybe that’s just age!

Off Pred nearly two years!

[scottiemarg in reply to DorsetLady]

I suppose at 83 I shouldn't be too hopeful but I shall wait and see!!!

[PMRpro Ambassador]

It seems to depend - perhaps it depends on how fragile your skin was during pred. Mine is still pretty much like leather after 8 years on pred! I do bruise but it is more due to the anticoagulant therapy I'm on and also develop purpurae and petechiae, the tiny dark red spots but only in a few places rather than generally.

[scottiemarg in reply to PMRpro]

My skin was getting rather thin as I am elderly but it was only after the prednisolone that the horrible bruises appeared and the exaggerated response to a gentle knock. It will be interesting to see if there is any improvement but I'm not complaining - I am so lucky that I haven't suffered very badly and I do appreciate that.

[barbthy in reply to scottiemarg]

I know I hate the bruises - every little knock. I was kneeling on carpet to pin a quilt and now my legs are bruised

[Rusty8 in reply to scottiemarg]

Have the same problem was ok until started pred now as you said a gentle knock and you have bruises and the skin just peels away not nice but I don’t think we can do a lot about it have you heard if there is anything we can buy to rub in to help?

[scats in reply to Rusty8]

My father had this problem and tried all sorts of cream, nothing helped him. He fell against a door jam once and ended up in A&E so they could stich it back together!

[scottiemarg in reply to Rusty8]

I have seen some old posts where a cream called "Double Base" is mentioned. However, it doesn't seem to be available at present and apparently it was very expensive. I suppose the only other possibility would be an ordinary moisturiser which some have mentioned. - I have some E45 in the cupboard so I might try putting that on every day.

[PMRpro Ambassador in reply to scottiemarg]

Double base is still available - or do you mean you can't have it prescribed? That is a different matter.

boots.com/boots-pharmaceuti...

You can check which of your local Boots has it in stock.

I used to buy it from the pharmacy counter at Boots (though far be it for me to advertise the current owners). I think a few years ago I paid about £10 for a 500 ml dispenser which lasts for ages. But the tub is £3.59 for 500ml - hardly expensive. I suspect you may be thinking of the gels or washing products.

[scottiemarg in reply to PMRpro]

Thank you for that. I had seen it mentioned on an old post and i then looked on Amazon but it wasn't available so I had more or less given up on that idea. £3.59 certainly isn't expensive. I'll check out my local Boots. Thanks again!

[PMRpro Ambassador in reply to scottiemarg]

This is like the one I used to get from Boots - it is Diprobase rather than Doublebase but is the same stuff.

amazon.co.uk/Diprobase-Ecze...

The gel is expensive - and you have to specifically search Amazon for the cream.

[scottiemarg in reply to PMRpro]

I've just discovered that my husband has an emollient cream called Zerobase which he has on prescription, presumably because he is borderline diabetic and has to make sure his skin is OK. It seems awful that I didn't know this but he deals with all his prescriptions himself and I just let him get on with it!!! I wonder if this is similar to Diprobase?

[PMRpro Ambassador in reply to scottiemarg]

Zerobase ingredients:

Liquid Paraffin, White Soft Paraffin, Cetostearyl Alcohol, Macrogol Cetostearyl Ether, Sodium Dihydrogen Phosphate, Chlorocresol, Phosphoric Acid And Purified Water.

Diprobase ingredients:

white soft paraffin, cetostearyl alcohol, liquid paraffin, macrogol cetostearyl ether, chlorocresol, sodium dihydrogen phosphate, sodium hydroxide, phosphoric acid and purified water.

i.e. nearly the same but not quite - less in the zerobase.

[scottiemarg in reply to PMRpro]

Thank you so much for checking that for me. Looking at the Boots website I see that they have the Diprobase in a small size so I will give that a go. Many thanks for your help.

[DorsetLady PMRGCAuk volunteer in reply to scottiemarg]

Similar, my hubby used to get it on ‘script - he was also diabetic.

Arnica cream is also good for bruising. Any chemist and most supermarkets sell it.

[Hidden]

Oh gosh, I sure hope so!!!!!

I have exactly the same problem... bruises (and not from falling for Billy Joel!!! ) and gashes where I've barely grazed the skin! I look like I've been in a cat fight!

[scottiemarg in reply to Hidden]

Perhaps we should think about designing a suit of armour so that we protect ourselves from all this bruising etc.!!! I thought about this and then I realised that this would be over-compensating as it is mainly the arms and legs that get damaged and it would be difficult to attach the arm and leg armour without the rest of the suit (I'm not crazy honestly - but I think it helps!!!)

[PMRpro Ambassador in reply to scottiemarg]

Maybe football shin guards?

[scottiemarg in reply to PMRpro]

That's worth looking into!!! Could be quite a fashion accessory.

[polymy in reply to PMRpro]

Football shin guards are exactly what I wear out in the garden. My legs were like a battleground with knocking into my pots. Problem solved. Legs still stained from the previous bruising but my guards work well.

Liz

[Telian in reply to polymy]

I like that image polmy - reminds of my old Grandfather, he worked as a coalface miner and in retirement the r/arthritis took a real hold and to enable him to continue with his beloved gardening he wore his work knee pads, can see him now... he used to grumble to himself all the time, he was in that much pain, but he wouldn't stop..

[Pat9442]

Mine skin is awful. In the summer my arms are bruised from wrist to elbow and covered in cuts, grazes and also scars. I asked both my rheumy and dermatologist if it would improve (I have been off Pred for 7 months) and got a categorical ‘No’ from both. In fact they said it would probably get worse as I got older. Oh the joys of Pred!

[scottiemarg in reply to Pat9442]

Wow! They certainly were brutally honest!!! Perhaps it is inevitable as the skin ages - mine is pretty elderly already so I will just have to accept it. I'm just lucky the pain went away quite quickly and I'm grateful for that.

[joat]

I am rather elderly and have used Doublebase for the past two years and was given it on prescription - in a rather large plastic container! It has helped to a certain extent.

[HeronNS]

The skin cream I use is called Impruv and claims to restore the lamellar layer (or some such term, too lazy to go upstairs and look at the tube) of the skin. Have had none of the problems described on the forum.

[PMRJ]

Finally down to 3 mg after 3 years BUT, still the slightest bump/brush against something hard and my leg skin peels back and bleeds like a stuck pig! Yes, I too look like I've been in a big cat fight. Tegaderm Film is wound covering that helps

keep wound healing. Polysporin anti-bacteria ointment first, then Tegaderm.

Available Amazon.com. Used in hospital settings to protect 'wounds.' Good luck!

PMRJ

[Rimmy]

I suppose we are all different but hopefully at 'zero pred' yours will start to become more resilient again. I am still at 14.5mg after 18 months for GCA as well and I notice my skin has improved a bit under 16mg. Still as a gardener I have taken to wearing full on to the elbow 'gauntlet gloves' - the kind you wear when doing rose pruning and now have arms and hands that don't look like they've been 'chewed' by something - otherwise you'd think our plants were carnivorous !! I also notice the skin on my face has been much more sensitive and has little red circles/patches on my cheeks if I even rub them slightly with a face flannel - so I have now stopped that and have taken to plastering them with paw paw ointment (which is quite thick) - overnight - and they seem to have improved a little.

Best wishes

Rimmy

[Qubbie]

I'm only in for 3 months. If you look at me wrong I bruise. It's the prednisone for sure (I'm pretty thick skinned).

Can't imagine going through what you've been through for so long.

Any scrap bump or even shaving of legs create cuts. Going to have a series of scars due to this for sure

[Janicep]

I too bruise (blood spots) on contact with anything hard. I use long protective plastic sleeves when gardening and gloves and Epaderm ointment (not the cream, as I think the ointment stays on the skin better) and I slather lots of it onto my skin every day. Shin guards are a great idea.👍 I am taking aspirin also which seems to make skin worse but really I think it is to do with getting older. I am 69 now and I really do use heaps of skin care cream and I do think it is helping. I got a 500g tub which was not cheap in NZ but I think it’s good.

[Hidden]

Hi Scottiemarg

The only thing you can do to try to help is keep your skin well moisturised, my Mums skin was like tissue paper because of long time Prednisone she always wore long sleeves & trousers in the house when pottering about to try to prevent herself catching her arms or legs. She had a leg ulcer which would not heal, so anything that does not show signs of healing see you GP & get it looked at, then dressed by the Nurse.

Take Care

Mrs Nails 💅🏼

[Stella3]

I asked my Rheumatologist the same question and she said that the skin will recover. I have had the same thing even though I am now down to 6mg. Also I find the purple, then red bruises fade to brown...still wondering if that will completely disappear. I find that these things become less important when considering the early stages of PMR/GCA and all the fear etc. that went along with it.

[scottiemarg in reply to Stella3]

The experts do seem to have differing opinions regarding this point. However, as you say it is less important when considering the worry and pain experienced by many sufferers in the early stages. I suppose I was just curious to know if there would be an improvement but in my case I doubt it due to my age but it's not really a problem - just unsightly and I will have to try and walk through doors without knocking against the door frame in future!!!

[piglette in reply to scottiemarg]

I have been told it will not improve. I have yet to find out. I am covered in bruises and am still getting purpura which is really annoying.

[PMRpro Ambassador in reply to Stella3]

On the other hand, some doctors say no, it won't improve. It is yet another case of everyone is different and wait and see...

[Stella3]

Scottiemarg, I do understand how you feel. It is quite depressing seeing those marks. I felt really down when my hair started coming out (it has recently stopped), due to steroids or the shock of the illness according to the doctor. Each obstacle had to be overcome and vanity put on the back burner. (Easier said than done!). I am 73, so no spring chicken. But still like to look nice! Keep your chin up, we’re all in this together.

[Telian in reply to Stella3]

Good on you Stella, I'm with you whole heartedly on looking nice, whatever our age, I'll continue my 'beauty' regime as long as I am able, only moisturiser and mascara, I never go anywhere without my mascara as have fair eyelashes - I've told my family they must makes sure I'm wearing my mascara when my time comes!!!

[Jamie345 in reply to Stella3]

Hi stella3, I lost so much of my hair and it's still falling out but not as bad as I am tapering down now, and the condition of my hair is like one big fuzzy mop! Horrible, so I lashed out and got a hair piece, was costly! But exact same colour as my hair and designed by me sending 3 pictures of how my hair was originally and she copied it, I love it ! My friends and family also approve, it's given my confidence a big boost , hope I've not intruded by butting in

But hopfully someone will be as I was very depressed about my appearance plus having this awful desease and pain I feel a little better . Xx

[Stella3]

Hi Jamie, so glad you got yourself a hair piece and feel better. Your hair will stop falling out, probably fairly soon. Good luck!