I'm thinking pred was doing more for me than easing PMR pain. After 8.5 years on pred I'd forgotten how I used to get random patches of rough itchy skin that were cured by hydrocortisone ointment and a particular skin cream (the cream not enough by itself). In fact using the hydrocortisone cream and gradually tapering off it onto regular skin cream made me (mistakenly) think I could taper prednisone the same way and gradually substitute in something else for the pred I was taking for PMR. Funny how I could have forgotten that. The otc hydrocortisone cream I've been using lately isn't doing a good enough job, although it helps. I had a prescription version back in the before times and never needed to use it for long.
Tempted to take a couple mg pred for a few days to see what happens. Going to be good and wait to ask the doctor when I go for my flu shot next month.
Do you think this is a reasonable ask? In myself, if you know what I mean, I've been feeling generally better, but that could be a result of PMR in remission, not coming off pred. Skin started acting up again once I got down to about 1 mg. In retrospect I now realise same thing happened when I flirted with zero in 2020, but I'm a slow learner and didn't put two and two together for ages.
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Sounds to me as if you need the prescription cream to calm down the flares while managing the eczema with a non-steroid cream between times. There is a range of emollient creams and some people do better with one than another - bit more trial and error!!!
I tried absolutely everything in the before times. Even consulted a naturopath. The only thing which really worked was something called Impruv, later available, but not conveniently, as Physiogel, after the original manufacturer was bought out. The naturopath suggested the ingredient which was helping was shea butter. You're right, I should just ask for stronger hydrocortisone ointment.
I'd definitely wait until talking to the GP, but I've had times when I've needed the hydrocortisone cream , pre steroids, and when it didn't clear it received a shirt course of oral steroids and a stronger cream , so they would probably be happy to agree with that anyway.I use Epaderm 2 in 1 which does help improve my skin and reduce the injuries and rashes. It was a godsend when I was on steroids every day,
You can use that as a make up remover and wash in the shower m although I've never used it in the shower myself.
I use a unisex unfragranced soap ( although it actually has a nice zesty scent from the ingredients) to keep my skin dermatitis, psoriasis and eczema patch free. I've got a number of friends with severe eczema or psoriasis whom I recommended it too who swear by it now too.
It's called Dudu Osun.
It's African Black Soap and uses all natural ingredients ( there is one version with fragrance but the original is the one we use).
It leaves you skin lovely and smooth with no irritation , as yet nobody has had an intolerance reaction from it.
It lathers up really well on a scrunchie even in hard water (my daughter lives in London and uses it).
African Black Soap products are generally recommended by people whom suffer with or treat chronic skin issues.
Dudu Osun cheap , about £1/ £1.50 a bar , you can get the brand on Amazon in most countries.
It can be used for hair too.
I actually grate it into a bottle and add water to make a shower wash that I can use on my hair.
I also have a black soap shampoo with Shea butter conditioner but that isn't available online , my friend gives it to me at Christmas from a little Black Hair Salon she uses.
Interested in trying new soap. What kind of skin is this good for? I've used Pears for a long time but I know it's full of chemicals, and whatever the dermatologist recommended to me was useless, very drying. I think my main problem is dry skin. Years ago I used to buy soap that was made in or near Chester (UK), but Nestle bought the company and discontinued the product. All the things I love seem over my lifetime to have been discontinued.
I've just checked Dudu Osun is available on Amazon Canada for CA$15 for three bars.
Normal Epaderm is available but it's a bit pricey at CA$39. You can get the Epaderm 2in 1 , it comes in an easy pump applicator bottle with a purple top from pharmacies and if you have skin problems diagnosed by your GP you could get it on a prescription which could reduce the cost.
Epaderm , unlike most emollient creams like E45 etc is not sticky and sinks in quickly.
When I do have patches of dry skin or dermatitis and the various skin spots I get I usually try to keep them dry and open to air or I waterproof them if I swim etc. with a cover of vaseline. This has worked for years.
I seldom need to use my hydrocortisone or other creams for more than a few days , and rarely need oral steroids since I started using daily moisturising with the Epaderm and drinking more fluids.
I remember Dudu Osun, Blearyeyed. You recommended it a couple of years ago and I got some for my eczema, now gone. Must have done the job, thank you! It did have a nice smell.
Interestingly similar patches have appeared on my legs since I have gone down to lower doses of pred (1mg alternate days). This has only been in the last 8-10 months and I have been on pred for 40+ years at varying doses. The doctors didn't seem very concerned and didn't recommend anything. I initially slathered on Nivea, but have now settled on the cheapest, simplest store-brand aqueous cream (Superdrug, UK) and it relieves things reasonably enough. Hope you find a solution. 🌻
It could be the simplest thing is the best. Some of the stuff I've bought recently I couldn't even bear to use long enough to see if it worked, one in particular smells like gasoline! No thank you. 😳
Btw my father was a GP and back in those days he noted that Nivea was particularly bad for causing skin reactions so I've never tried it although perhaps like everything else it's been reformulated. As a child I used to react to a number of things and maybe I'm just reverting.
To keep eczema at bay you need to avoid anything harsh on the skin, including soap. Use shower gels that contain moisturising cream instead and rinse well. Then use emollients to prevent the skin drying out during the day.
As you can see from the table, steroidal skin creams vary massively in strength or 'potency'. Only the weakest are available over-the-counter, and they've never worked for me. Once the eczema has come under control, the steroid cream can be progressively diluted (tapered) with emollient to prevent it bouncing back (rebound flares). I find adding a bit of antiseptic cream to the mix helps, too. I consider my eczema under control when I'm using roughly 20 parts emollient to one part antiseptic and one part steroid cream. It spreads really easily, so each patch of skin is receiving only a tiny dose of steroid.
A table showing the relative potency of steroid-based skin creams.
Thank you. Actually I don't know if it's eczema. All my pre-pred years with occasional and varying skin reactions from childhood, no medical person ever said the word eczema. Of course they never gave any other reason. I do have a diagnosis of sarcoidosis (mostly non-symptomatic, confirmed through biopsy of a lymph node), which could explain why prednisone basically eliminated this random recurring issue for nearly ten years, long enough for me to forget about it! Which is why I want to talk to the doctor about it, and why I'm wondering if a permanent dose of pred around 1.5-2 mg forever might not be such a bad idea. We'll see.
I found a regimen such as you describe very effective in pre-pred days, which is why I thought I understood the concept of slow tapering. Of course it's very different. There's no equivalent to skin cream to substitute in for pred when it comes to treating PMR, a realization I found very disappointing!
I suppose the PMR equivalent to diluting ever-less steroid cream with emollient is breaking up the prednisolone pills and taking ever-smaller crumbs.
To put things in context, the papers below suggest that the human body typically makes about 10mg of cortisol per day, and that this is equivalent to about 2.5mg/dy of prednisone/prednisolone in its anti-inflammatory action.
I can stop using steroid cream when I'm on prednisolone, but I have to restart the treatment when I taper below about 5mg/dy. Otherwise, I get a flare.
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