Chronic Desonide User needs advice to be "normal" again

[Nahor]

For many years since a teen I came down with some sort of rash to the face and treated it with Hydrocortisone daily probably once a day to the face. After some time, I learned this was bad and began to take other topical creams to keep my face at bay from different dermatologists. For years later I was administered Desonide and have always been using it once a day like a small dab on both cheeks and smear it in. I do not have the means to see a dermatologist as I have no insurance as I used to. I have been using Desonide in this manner for many years and after reading more and more about it I wanted to ween myself away from it. I recently read about a daily regimen of normal care for skin care and want to return to being a normal person not having to rely on the cream daily. When I sway from the cream for 5-7 days, my face inflames and from reading the forum I believe it is rosacea steroid induced. I am concerned that this topical cream could be what has caused an enlarged liver which I've had for years. But haven't been to a doctor to diagnose this.

My question is I have been using this new regimen for skin care, where I use Cetaphil in the AM and wash my face with it and apply a daily moisturizer from Neutrogena for Sensitive Skin and is Oil Free. Nightly b4 going to bed I use Ponds Cold Cream and tissue that off.

It's been a week and my face began with the redness in certain areas and dryness and almost leathery feel. I went back to using Desonide for the past two days instead of the Neutrogena moisturizer.

In the past I always used to use either Dove or Oil of Olay bar soaps to wash my face and thought that may of been too harsh, so tried the Cetaphil as the replacement.

So my whole long thread is asking, how do I ween myself off of Desonide, are there really any health concerns for using this for over 10-12 years. I always thought it wasnt as bad because i didn't use it as described 3 times a day. I only use it in the morning once.

Please someone help me return back to normal. I once went on a trip and forgot my Desonide and used petroleum jelly in its place which is ok for a few days, but towards the end of my trip, (a week), I was dying to get back to my cream.

I can always get a prescription written from a "friend" but paying $200-500 for a doc visit is a bit expensive as I stated no insurance...

Thanks in advance for any help anyone can give.

[Bhupinder Kaur, MD]

Hello,

Long-term corticosteroid use has been associated with local side effects (skin atrophy, contact dermatitis, striae, telangiectasia, and depigmentation.). You should consult a dermatologist and discuss about steroid induced rosacea so that you can slowly be weaned off this drug.

I hope it helps. Take care and regards.

[Nahor]

Thank you Dr. Kaur, are there long term adverse affects of using Desonide? Anything that could be effected already? I have not found any conclusive answers to the use of this topically once a day.

[Bhupinder Kaur, MD]

Hello,
It looks like steroid induced rosacea. Steroid induced rosacea or dermatitis is an adverse effect of using steroids. Some patients develop steroid-induced rosacea within weeks of applying a topical steroid; others may not experience it for years.

Using tacrolimus often resolves the itch, redness, and tenderness of steroid-induced rosacea but it should be taken after a dermatologist’s guidance. Avoiding rosacea triggers, such as caffeine, spicy foods, and alcohol, also may help clear the skin. If the symptoms persist then please consult a dermatologist. Also use of antibiotic creams, antihistaminics, sun screens helps but consultation of a dermatologist is required first.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.