PMR diagnosis Oct 2020 with initial prednisone 20 mg. Tapered to now 11 mg. Thin onion skin with easy bruising and bleeding with minor scrapes. I have a very healthy diet of low carbohydrates, high protein and exercise daily. Will this improve with continued slow taper and are there dietary suggestions to improve skin health? I take no other medications with the exception of a multi vitamin.
Suggestions to decrease bruising and toughen skin... - PMRGCAuk
Suggestions to decrease bruising and toughen skin condition while on prednisone?
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Twadds
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You’re doing the right things but this is a side effect of steroids and will improve as the dose drops. Are you also well hydrated? The main thing is protection of the skin to avoid wounds and keeping it elastic with good moisturisation. It’s a pain!
I don't know about improving as dose drops. I never had the bruising before pred. Nor did I have it when on initial higher doses. Started when I'd been at a low dose for some time. Much worse since I had a flare, somewhat higher dose for a while, although not nearly as high as initially, and now back to a low dose. I get them on my arms nearly all the time now, since reducing the dose again. Only on 3 mg. Old age?
I expect your going back up hasn’t helped has it? I’m sure ageing doesn’t help!
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Moisturise, moisturise, moisturise aeems the mantra. And avoiding soaps/foaming cleansing products, all they do is strip the natural oils from the skin and dry it out.
Don't think there is much diet-wise to be done to be honest.
Just arrived here via FAQ's where I typed in thin skin and easy bruising. Having been on pred for over 5 months now, I realised that for the past few weeks, the slightest scrape or scratch causes an immediate purple bruise and bleeding, particularly on my hands and wrists whilst gardening. My skin feels very thin and veins are more visible than normal I have never experienced this before.
I have blood tests booked for next Tuesday to be followed by an appointment with the GP practices Pharmacist (didn't know they had one ??) I am assuming he/she is going to talk to me about managing PMR and possibly tapering, I have been on 12.5 mg. for about 6 weeks having started at 20mg. then dropping to 15mg
As this will be the first time I get to have a face to face conversation since being diagnosed with PMR, other than with the blood nurse, what are the questions I need to ask??
I will obviously mention the thin skin and bruising.
My family think I should ask for all of my blood test results since being diagnosed, problem is I am not sure I will understand them ??
Any advice will be very much appreciated.
Finally, being a man !! I am not used to using moisturiser, any suggestions as to what best to use please
Not a lot pharmacist can do about thin skin or bruising except prescribe emollient cream (you may be lucky!) …
See here for examples -5-top.co.uk/emollient-cream...
Request 1mg tablets be added to prescription you’ll need them once you get below 10mg …and are you on calcium/VitD supplement? If not, request.
Arnica -either gel/cream or tablets if you prefer-good for bruising
Ask for blood tests -and if you don’t understand any of them then ask here - in a new post preferably….
Thank you, will let you know how I get on
Not only not a lot the pharmacist can do about bruising - I would be seriously doubtful they know the first thing about PMR and how to taper successfully! I bet you will be told to taper the way patients taper for other uses of pred - I hope I'm wrong!!!
DL has said the rest for now - then once you have had your audience with the pharmacist, start a new thread and ask your questions. And we will do our best 
I do wish there was some magic way of stopping the skin problem. My legs are in a dreadful state and my arms are not much better!
My arms aren't too bad - though I wake with bruises on my arms that I assume are from contact with the bedside table!!! Lord knows what I do!
Me too! Where do these bruises come from. Sometimes look like ive be in a boxing ring!!!!
I get them from banging my legs with shopping bags! Enormous ones on my left thigh at present - I started using a different bag that I wear across my chest to stop it slipping off my shoulder and the bottom of the bag is level with those bruises! I hate wearing it like that - but seem to have no choice now - is it an aging thing? My mother wore her bag like that.
I would not wish to think it was an age thing, but I have started to do it as well. Partly as my shoulders hate bags on only one shoulder, slip off etc etc. Plus at least it is one bag that I know where it is! Blame it on not having enough hands and too much to manage - money, mask, shopping list, bags, where did I leave the car...You get the idea!
Well yeah!! Horrifying how heavy that bag can be - though the day before yesterday it was because I'd dropped an avocado in the top rather than getting out a separate shopping bag and then forgot about it as it had worked its way down to the bottom ...
What we do for treats......😉
We're worth it!
Better watch out for the cork with prosecco.....
Unlike certain cyclists, I know NEVER to point it in my own direction!!
👍
I thought it was bang on trend to wear it like that PMRpro! I’m being serious too. ☺️
No wonder I don't like it - never been bang on trend in my life!!!!
🤣
Trying to reach for the Prosecco???
The black guy who won the Giro stage yesterday hit himself in the eye with a prosecco cork - I know better!
Better than the arm of your own spectacles! Coming along nicely thanks 🐼😢
But he's had to withdraw from the Giro as he can't see well enough
Tell me about it! 🤣😂…..but not sure I’d want to be riding a bike at those speeds with both eyes, even if I could.
🚴🚳
Thank you. I’ll begin using a skin moisturizer. I hydrate reasonably well but can always do more!
It will be worth making sure that you don't expose your skin to the hot sun, too, Twadds. That's quite important...so it's full length trousers and long sleeves. I agree with Jinasc below, that Double Base Gel is very good. You can use it in the shower too. However, it has a very strong plunger so, if your wrists and hands are hurting, you might want to do as I do and get someone to decant it into a pot for you. x
Double Base Gel (you can get it on prescription) but I just buy mine).
Sadly I can’t say my skin problem has improved at a lower dose of Pred. Currently 6mg. If anything it’s got worse. I did buy some Dermatuff sleeves.
I bought 2 pairs of the sleeves but I wear them on my legs because I don’t want anything on my feet. You can buy socks. Even though it was very warm yesterday they felt comfortable and I felt so much safer from grandchildren, dogs and bulky items with corners !
Clumsiness is another side effect 🙁
I've been worse at lower doses. never had them at higher doses. Sigh.
Perhaps that’s because of the long term use ?
Probably -I still bruise easily -snd have been off Pred for over 5 years - plus with age skin is less resilient anyway.
Tell me about it! My extremely thin skin looks like crepe paper!!!
I get the mysterious bruising too... Grrrr. I'm on 7mg of Pred. I love sunbathing - what should I do? I slather myself in Aveeno and Dermol 200 often....
My vanity will not accept being pale ha ha
Spray tan ?
Oh no
Safer than the sun version ...
I've been taking collagen powder every morning - seems to help with the x!~'"y bruising ...
Hi Twadds,I would agree with all the advice so far. I do bruise easily and cuts and grazes take much longer to heal but on the whole, my skin is doing ok.
I work as hard at looking after my skin as I do the rest of my health. So:-
- I drink lots of water each day.
- I only bathe/shower with Dermal500 and no longer use anything on my skin that could irritate it (parabens, sulphates, etc) That also goes for shampoo and washing machine powder/liquid.
- I moisturise regularly..at least daily and sometimes twice or three times a day.... with a moisturiser that also nourishes the skin.
- I always wear sunscreen when going out on a sunny day but try and stay in the shade as much as possible.
Like with everything we're trying to achieve, nothing happens of its own accord and you have to put some effort in. We can all achieve some improvement even if we sometimes can't fully remediate the problem.
I hear a bovine collagen powder supplement is suppose to help your skin while on prednisone. I just ordered some to try.
That works for me!
Didn’t know that! I’ve been taking the marine collagen version as the bovine one really upset my tum. I still get bruises and little scrapes that take ages to heal. Would Vitamin C and Zinc help?
If you can tolerate fruits that are high in vitamin C and not just solely rely on vitamin C supplements, this would be your best bet for cellular repair.
Zinc is best if absorbed by food as too much of a zinc supplement can effect the balance of copper in your system. Meat, poultry, beans, nuts, whole grains, crab, lobster, fortified breakfast cereals, and dairy are good sources of zinc.
Hope this helps.
Thank you for that info - I do eat quite a few almonds and walnuts - but no dairy or meat. Love salmon, but not shelled fish. Do eat lots of oranges and clementines strawberries blueberries blackberries and plums melon and raspberries! Soya, Almond Milk and yogurt are plentiful too in my fridge. It’s a balancing act isn’t it! 🌸🌺
Yes, it is a balancing act. 😀
The doctor, who was treating all my skin gashes in the past, recommended vit A. My skin does not rip so easily and bruises less. There are arm protectors made of thin material for bikers. I use a back scratcher to pull stuff out of the dryer because, in reaching in, my arm with a bruise on the top of the opening as I reached in. We’ve covered some sharp things in the house with tape specifically that strike plate for the door latch the tends to stick out. Anything sharp in the house with covered with tape. I’ve actually ripped open my calf an open dishwasher door, a raised kneeler in church, a shoe box corner, in the store, poked my ankle- bled all over the store., the corner of an open car door etc.
Topical Vit A or dietary?
YOU SOUND LIKE ME!!
I await the humorous column you could write about this litany of damaged skin episodes. Impressive.
Dietary; I’m using the amount recommended by the Prednisone Pharmacist in her formulations. But I’m taking stuff separately because I prefer to do it that way.
Avoid needing a dose of Aspirin every day! Skin bruising occurred due to Pred but got worse once Aspirin was prescribed, and much worse once Clopidogrel joined in with all the fun. I’m off the anti-platelet medicine but still bruise and bleed quite easily.
Yes - I'm on Pradaxa as an anticoagulant. Keep forgetting to wait to take the morning dose until after having blood taken!!!!
Actually, that's interesting. I have had a bunch of (weather-related) headaches lately, and although I no longer have to overdose on aspirin to cure a headache I do take aspirin as my drug of choice. I shall have to observe if there is a connection between taking aspirin and getting more red splotches on my forearms.
I get the bruising even at lower doses but the worse problem is that everything I eat seems to puncture my tongue and I end up with great blood blisters which burst and leave a very sore spot.
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