Pred causing thin skin. Bleeding gums?

[Cross-stitcher]

I have been on Pred for PMR for more than 2 years, now reduced to 2mg. For about the same length of time I have suffered with very thin skin which bruises or bleeds very easily, e.g from a rose thorn. For about the same period, my dentist and hygienist have commented on my bleeding gums. These are not apparent when I brush or floss my teeth, only when they do their "gum scores" with a sharp pointed implement. Could there be a connection to Pred? My dentist said he had never heard of it, but my hygienist thinks it could be related to my Pred dose. Should I be worried? I really don't want to lose any teeth as a result of Pred.

[Kendrew]

Hi there. Others with more knowledge will be along to advise you further but I can tell you that steroids do indeed cause the skin to become more fragile and therefore more easily bruised, wounded or damaged. It also often takes longer to heal so it's important to take care of your skin. This can include the tissue around your gums also.I always moisturise my body skin every day with a gentle nourishing body moisturiser like Aveeno and I brush my teeth regularly but more gently to try and avoid problems. The brushing also stimulates blood flow to the gums helping to keep them healthy.

I would like to respectfully suggest that your dentist read up on the connection between corticosteroids and teeth as pred most certainly can lead to the loss of bone that supports teeth in some cases. This can cause some problems if not addressed and if you're on biphosphonates also then it's really important that they're up to speed on the possible complications to look out for! These complications are rare but your dentist should really know about them.

[Hidden in reply to Kendrew]

I agree that it's unlikely that Pred is causing Cross-stitcher her gum issues. However, I do believe that Pred does in fact cause thin skin. Since being on Pred, 2 yrs in Dec I have now got very thin skin on my arms and legs. The slightest of knock rips the skin and causes a flap which I have to gently put back in place. I bruise very easily too. It's very important to maintain good dental health and have regular check ups due to the biphosponates that many of us have to take do to osteoporosis.

[PMRpro Ambassador in reply to Hidden]

juniperpublishers.com/adoh/...

"Corticosteroids therapy interrelates to enhanced potential for clinical manifestation of alterations of taste sensation, periodontitis, gingivitis, ulceration, candidiasis, tooth decay, xerostomia. Authors have established that the prolonged use of corticosteroids is in direct ratio to elevated rate of incidence and progression of inflammatory disorders of the supporting periodontal apparatus."

The primary cause of bleeding gums is periodontal disease ...

[SnazzyD]

Snap for me. My dentist was not surprised at all so I’m not sure why yours was. I had the same issue and my gums receded a little and I also had sensitised dentine. Pred makes the skin and the little blood vessels fragile so bruising and bleeding is common. Trying to avoid damage is the main action and keeping the skin supple with a cream that suits you. I had to avoid the anti hard skin types containing urea until my skin recovered a bit more later on down the line. My skin took months after Pred to recover but it isn’t 100% still but then I’m 4.5 years older now.

[yogabonnie in reply to SnazzyD]

I am so happy to hear your skin recovered at all.. ! I thought maybe mine was just done for. !

[Alchemy8 in reply to yogabonnie]

Me too!! Congratulations Snazzy D!

[Hidden]

Exactly Snazzy, skin, gum health and everything else goes South as we age...hate, hate the aging process. But, like the old saying 'better than the alternative'

[cycli]

I am shocked at the speed with which my previously tough skin has become thin and fragile. Like all replies here I now bruise easily and skin flaps pull off easily. Healing takes longer and I.ve only been on pred since June 13th for GCA and PMR. Hoping to reduce from 40 soon. I've not had any teeth or gum problems to date but with this disease I wouldn't be at all surprised if I should experience some down this unpleasant road.

[herdysheep]

I caught a brief snatch of discussion on the radio recently about a possible link between the menopause and problem gums. If one thing doesn't get you, another will, it seems............

[PMRpro Ambassador]

juniperpublishers.com/adoh/...

"Corticosteroids therapy interrelates to enhanced potential for clinical manifestation of alterations of taste sensation, periodontitis, gingivitis, ulceration, candidiasis, tooth decay, xerostomia. Authors have established that the prolonged use of corticosteroids is in direct ratio to elevated rate of incidence and progression of inflammatory disorders of the supporting periodontal apparatus."

Good mouth hygiene is essential - and even more so if you happen to be on bisphosphonates. Periodontal disease is a primary cause of loss of teeth as we age. And pred predisposes to increased bacterial infection in gingivitis.

[Rottsuzi]

Hi , have you tried using a mouthwash ? I like dr organics tea tree it’s a antiseptic so keeps your gums clean . Holland Barrett sell it .

[Alchemy8 in reply to Rottsuzi]

I use Neem mouthwash by Theraneem Naturals from Baldwins the Herbalist. And Neem toothpaste.

[Rottsuzi in reply to Alchemy8]

Hi I was using neem powder in my smoothie it’s supposed to be very good for you but then someone said it might not work with having a autoimmune disease,I’m not sure 🤷‍♀️

[Alchemy8 in reply to Rottsuzi]

You are right but it seems to be linked to tablets and oil? I found this which backs up your concern. I am checking it out elsewhere but meanwhile found this: verywellhealth.com/the-bene...

[TheMoaningViolet]

Hi, I had persistent bleeding gums on one side (before PMR) and my excellent hygienist recommended that after I use my electric brush, I also brush around the gum margins with a soft brush (the best one I know comes from Sensodine) to get under the gum line, which worked. She also recommended the use of interdental brushes and regular flossing (I do this every evening). She was against the use of mouthwashes, but suggested rubbing on some toothpaste around my teeth in the evening after brushing (to give my teeth a boost of fluoride). I tend not to do this.

I also don't eat sugar and try to see a hygienist regularly. So far this regiment is working for me.

What I am trying to say longwindedly is that I have not noticed that Prednisolone had any effect on the health of my gums so far.

[yogabonnie in reply to TheMoaningViolet]

did she say why she was against mouthwash. I use something called ACT and it has fluoride and no alcohol.

[TheMoaningViolet in reply to yogabonnie]

Apparently, it kills off all the mouth flora which is there for a reason. As I hated the taste of mouthwash anyway I didn't investigate further.

[AyJayBass in reply to TheMoaningViolet]

I have similar advice from the hygienist at my dentists; using TePe brushes certainly helps prevent bleeding of the gums.

[Hidden]

Lucky you managing to get off Pred. How long in total were you taking it. I take it you've no problems with aches and pains since stopping. It seems men get away with it better than women.

[yogabonnie]

You are off Prednisone and the PMR symptoms are gone? how long were you on? What a nice thing to hear that your skin and gums returned to normal..scars and all. !

[Hidden]

Thin bruised skin is a constant for me. My teeth have always been a problem, ( have only about half my teeth) so I have cleanings often. The best thing has been getting a post- op toothbrush from the hygienist. It’s much softer than any I can buy and helps a lot with brushing thoroughly at the gum line.

[Hidden]

Wow ! that is heck of a long time to be on Pred. That's what we women do, we nurture our men. I'm in the same boat as your wife. My husband is type 1 diabetic with Chronic Kidney Disease, Macular degeneration and now he's just been told he needs two new hips. 'In sickness and health' and all that !! Got to say when I was first diagnosed with PMR, leading on to get GCA he was brilliant at looking after me. Once the Pred kicked in that was my lot haha.

[wizofoz]

Just a quick note to let you know I also have problems with my skin. I have been on daily prednisone for 4 years. Just recently, i had a burning sensation on my left hand, under my knuckles. the next day it was an open sore. It seemed to be getting infected, so I put anti biotic ointment on it with a band aid. I am happy to report that it is almost healed.

so just another challenge of living with a chronic disease.

Also I have read that steroids will cause problems with your teeth-. It amazes me how little some medical professionals know. I think you should enlighten your dentist or find another one!-God bless!

[Janstr]

My dentist & hygienist both said there is a link to pred. Advice was to use an electric toothbrush & hold on each tooth at the tip, then both sides at the gum. Also, as well as floss, use the little inter dental brushes.

[ling]

Could you share what the other two autoimmune disorders were?

Thank you

[Karenjaninaz]

I never had any gum bleeding since being on pred. I credit that to taking Vit D- about 2000iu daily. What did happen was a long term dental implant came loose and had to be removed recently. The dentist said my bone is good and no infection but I have an imperfect bite.