Finally went to the doctor(s)

[goat]

Damaged penis pt.3.Well I finally went to the doctor(s).A dermatologist and my urologist.I told the derm. about the Lotrisone and he said two weeks         would not do any harm.But the nyastatin/triamcinolone that I used had thinned the skin on the left side of my penis.I used it only for three day intervals 6 times over three and a half months.He said it could have possibly permanantly thinned the skin.He said also it is much weaker than the lotrisone but can still have the same side effects.I went to my urologist who prescribed the nyastatin/triamcinolone.He said I see some skin change but dont worry about.The derm. really did not say there was anything to do for thin skin.you say atrophy is temporary,is there a chance of the skin thickness returning even after 6 months.Is there any treatment for strenghthing thin skin.I am only 30.How will this skin stand the test of time.The skin has never torn but it does get abrasions very easy.I only used 1/3 of a 30g tube.Why would urologist have prescribed something that would do this?he even gave me 3 refills.He is also a friend of the family.Help

[Alan Rockoff, MD]

As the dermatologist said, Lotrisone has a stronger steroid than triamcinolone.  Whilie it is in theory true that thriamcinolone can thin the skin, 1) 6 times over 3 months wouldn't do it, and 2) atrophy is reversible.

It seems that the dermatologist is interpreting some whiteness as atrophy, while the urologist is interpreting it just as color change.  Abrasions can happen on any thickness of skin; atrophy would result in skin breakdown, which you say is not happening.

Lots of people use triamcinolone or the equivalent on the penis, and nothing happens to them.

There is, in any case, nothing to be done for atrophy but wait, even if you have atrophy, which I believe you do not.  If you need added reassurance, show the white patch to another dermatologist.

But my advice is to keep the skin lubricated to avoid or minimize abrasions, and just leave it alone otherwise.  You'll be fine if you give yourself  a chance.

Best.

Dr. Rockoff

Dr. Rockoff

[goat]

When I look at the whole left side of my penis I see thinner looking skin     .If I twist my penis I see small wrinkles on the whole side.It looks more transparent than the other side.Could atrophy reverse after 6 months.How will atrophy last throughout my life if it is permanant.It is painful and gets abrasions even with proper lubrication.This is the whole left side and bottom of my penis.The rash was on my scrotum and my penis laid over that.

[goat]

I USED THE NYSTATIN/TRIAMCINOLONE 6 TIMES,FOR THREE DAY PERIODS OVER 3 MONTHS.NOT FOR WEEKS AT A TIME.i WOULD NOT EVEN LEAVE IT ON THROUGH THE NIGHT.bUT IT STILL THINNED THE SKIN MY DERM.SAYS.NOT EVEN HALF 1/3 OF A TUBE.I AM VERY DEPRESSED.wIL IT RETURN AFTER 6 MONTHS BEING THIN.

[Alan Rockoff, MD]

Yes, it will return.  Atrophy (skin thinning) returns even after you inject cortisone into the skin.

As we discussed, you need to deal with your depression, which I believe is more significant than the skin thinning issue.

Dr. Rockoff

[goat]

I really appreciate you answering all my questions.You know this has crushed me emotionally.I went to another derm. and he said the same thing about the skin being thin.He also said that the skin at the base of the penis was very thin and the veins were in jeopardy.He says my sex life may be jeopardized.He gave lidocaine to use for pain.He did not say anything about the skin returning after so long a time.You gave me assurance it will.I hope it is true.Why would the other derm. tell me it was permanant.

[goat]

How long could it take.I am desperate.

[Alan Rockoff, MD]

You know, in all my years, I have never seen thinning of the skin anywhere on the body which put "the veins in jeopardy."  

If your sex life were at risk, then the skin would have broken down while you were using the cream, not now after it's been healing.  The same is true for skin breakdown of any sort--if it were going to happen, it would already have happened.

I really think you should get another opinion, just so you don't work yourself into more of a tizzy than you already have.

Go to another city if you want.  But get somebody else to look at it.  That's my advice.

Dr. Rockoff

[goat]

maybe a trip to Mass. would be a good idea.You be the judge.

[goat]

I think the skin was thinning as I was using the cream but I did nit realize.I was obbessed with this stupid rash.If the skin was slowly thinning over a period of time and I did not realize,will it still return.

[Alan Rockoff, MD]

Yes.

I must ask you to stop posting these questions and to stop calling my office, as I will no longer respond.

Dr. Rockoff