I am 78 years old and have had PMR for 4 years and have had 10 flare ups. Having joined earlier this year and having read the many posts on reducing dosage of Prednisolone. I am at 20 mg and am now reducing by 10 0/0 only every 2+ weeks. Previously medics have had me reduce by much larger amounts on a weekly basis, probably causing my repeated flare ups. When flare ups occur I am unable to sleep on either side or on my back. I go to sleep initially due to tiredness but then wake up after about half an hour in a lot of pain. My skin has now become very delicate and frequently tears with only the slightest of impacts. Does any know that if I do eventually manage to reduce or even eliminate the need for the drug, will my skin recover or am I stuck with this problem for the rest of my life?
Skin Frailty: I am 78 years old and have had PMR... - PMRGCAuk
Skin Frailty
My goodness you’ve had a rough ride -thanks to doctors. Skin will improve a little when off Pred, but it gets thinner as we age anyway -so don’t expect miracles.
Just look after it as much as you can -moisturise, moisturise, moisturise-and wear light clothes to cover the places that it happens to most frequently -for me it was lower arms.
DoubleBase is a good cream, but there are others. Depending on how accommodating your GP is you may be able to get on prescription
Yes yoing yoing is not a good thing. I think you should look at the tapering plans in the Frequntly Asked Question section and take a look at DSNS and Dorset Lady's plan.
No more than 10% at a time is correct then use one of the plans once down to 10mg.
Before the plans came along, I used to choose a day to drop and then clear the decks for two or three days. In other words, did as little as possible. This helped me to lower the dose more easily.
I was advised to use Double Base Gel for my skin. My GP prescribed it.
Although I am in remission, I still use it and buy it at the chemists.
Hope fully your journey will now be smoother.
"Previously medics have had me reduce by much larger amounts on a weekly basis, probably causing my repeated flare ups"
No probably about it - they haven't taken the nature of the disease into account more understood the tapering process. Maybe they might "get it" better if they stopped using the words reducing and tapering and substituted the medical word for what it really is: titration. That means the slow adjustment of dose to find the right dose for this particular patient.
Changing the dose weekly with pred never allows long enough to know the new dose is still enough. And big changes compound that problem by missing the end point. They all did chemistry at school - they must understand that part of the technique.
As for your skin - it seems to depend - some people never have problems, others do find their skin improves with time. I have been on pred for a very long time and it is only in the last year or so that my skin has become thinned and delicate - especially on my shins which have bruised easily and that area has deteriorated. Some doctors say it won't recover, some patients say it does.
But you also have to remember that it is part of normal aging - my motherin'law had far worse skin than me and she didn't ever take pred. Moisturising seems to help and so does protecting delicate areas when doing anything where you might suffer damage.
Agree with everything you've said Pro. I definitely bruise more easily but the look and health of my skin has always seemed good....until I experienced the awful urticaria rash last Jan.
Since then I've been even more vigilant about looking after it:-
- washing/bathing only with Dermal500
- applying a good nourishing moisturiser (several times a day)
- eating a really healthy diet
- drinking lots of water regularly throughout the day
- always applying a high factor sun cream when appropriate.
I'm convinced all these relatively easy interventions are, if not actually preventing, at least slowing down that thinning/ageing process.
Which particular Dermal500 do you use? Is it the lotion? Am struggling a bit with psoriasis at the moment and thinking of giving this a try.
Yes, it's just the lotion in the green plastic bottle. I started using it after I developed bad urticaria. I definitely find it both cleansing and gentle and it seemed to help calm down the skin sensitivity.
Blacksley good afternoon.
Try taking a couple of paracetamol 500 mg an hour before going to sleep. That’s what my rheumatologist recommended for me. It does help.
For the back pain
Yulik 🌷
I think I had problems reducing due to my initial rheumatologist insisting I reduce at a ridiculous speed right at the beginning. He has caused me endless problems and pain. The trouble is I did not know any better and trusted him. My skin is incredibly thin and I am told it will not really improve sadly.
I'm absolutely positive that sets us up for failure later. I wish I knew why - there is no logic!
Mine has suffered due to high dose and blood thinners. Bad combination. I regularly cut, scrape or damage and bruise easily. I genuinely believe from what others have experienced that when reduced or no longer taking pred. this will improve gradually but it needs good circulation through sensible exercise and good eating to make sure skin is adequately nurtured. I have hopes.
Have you looked at my mobility exercises D2C? If you have full mobility and no cramping and no trapped lactic acid then try holding onto a sideboard and pushing your weight up on your toes. Repeat until you can't do more. twice a day and increase as they get stronger. As they get better you can do it one legged as that will double the effort.
I can sympathise, Blacksley. As with DL, it's my lower arms that suffer. Any little knock can break the skin.
Hi - I'm 75 and also about 4 years into PMR. Started at 30mgs pred and luckily my doctor more or less left the tapering process to me. With the help of advice on this forum I'm now at 2.5mgs pred and have not yet experienced a flare. The trick is clearly to go slow and I have found that quite long pauses seems to help - eg I stayed at 10mgs for about 3months before reducing further, then again at 5mgs.Best of luck!
I recently had 6 weeks of radiotherapy to my neck and face which to say the least did nothing for my skin. I was advised to use E45 liberally for a month and then when things were getting better I used Adex Gel, it is Doublebase with a anti inflamatory added. I find it is very good and use it where ever my skin is sore or dry.
I only found out several weeks ago from either Dorset lady or PMRpro, moisturise, moisturise, mosturise. It really does work. I now do it everyday without fail!
Either or both probably - apart from a few things (difference in age, and her having the brains for sure!) we could be the terrible twins 😂🤣…
👍
There are an awful lot of things you can do that I can't 
Probably best not go into that 😊 -just accept the compliment. How are feeling today?
Just had a very enjoyable trip to the ED - good bit of craic! Greeted in triage with "Haven't seen you for ages!" Soooooo embarrassing. Checked in, triaged, seen and boot fitted for the dodgy tendon and out in under 3/4 of an hour! Must have timed it well - the helicopter arrived with today's tourist who fell off a mountain or crashed their car just as I headed for the icecream shop!
Thought you’d been AWOL -hope the boot helps. -as much as the ice cream 😊
The difference when walking is amazing!
Good…
I put a scoop of collagen into my morning shake that already has collagen in it… double dosing! That and cod liver oil has helped my skin not thin as much as I expected. Sometimes skin is treated best from the inside out!
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