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Reversal of Corticosteroid Damage?

For about a year, on and off, I was prescribed various anti-fungal and hydro-cortisone ointment and creams by my doctor, and later my dermatologist to deal with itching on my scrotum and at the base of my penis shaft (where it meets the scrotum). No treatments seemed to help, so I eventually gave up on all prescription, about a year later and hoped the issue would resolve itself. It has now been a year since I gave up on doctors, and nearly two years since my problem began (august of 2009), and I find that my scrotal skin is hypersensitive. Just wearing pants causes me to experience itching and soreness. I don't know if its normal because i can't really remember how the skin used to look, but there is a "shinyness" about the skin, particularly where the penis hangs over the scrotum. In addition, the fordyce spots in this area are extra pronounced. I did a bit of my own internet research, having given up on my doc, and came across some unsettling information about steroid induced skin atrophy. I am in a panic that the cortisone treatments have permanently damaged my skin. Is this likely? I notice no striae, which i've read indicate atrophy, but the skin does seem to have lost some of its colour, and is, as i mentioned before, "shinyer"than before. Is soreness and itching a symptom of atrophy? Will the atrophy be resolved over time on its own? (I am only 20 yrs old.) In my panic I have searched the web for methods of reversing atrophy, and have come across a great deal of information about a product called "Tretinoin," which apparently helps to reverse skin atrophy. Is it advisable to use this or something similar on an area so sensitive as the scrotum? Obviously I will return to my dermatologist in person to ask, but I was hoping to get some insight from you. This condition is severely depressing as it is always on my mind.  
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Avatar universal
Corticosteroid/cortisone creams have indeed been reported to cause problems to so many people. I was prescribed a Hydrocortisone by my dermatologist for this hypo-pigmentation on my penis. But after doing some research I realized it's not safe for a long-term use. I only used it for a week and immediately discontinued after knowing that it could cause skin atrophy. Hydrocortisone applied on other areas but your genitals might not be as dangerous as if you apply it on your penis, because penis skin is a lot thinner than the rest of the body.

There is another post on this forum by a guy who's gonna sue a derm in California for prescribing him Hydrocortisone without informing him that applying it on your penis might result in serious consequences (he described the exact same conditions that you're experiencing). You might want to search and take a look at it.  

All the best!!
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Avatar universal
That's the last thing i wanted to hear :(
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Avatar universal
I really would like to hear a doctors opinion, this is getting me so down. An expert opinion would help me think more clearly.
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Avatar universal
I'm sorry, didn't mean to get you down... I'm very sure there are treatments available for your condition, you'd just have to see a dermatologist right away (please visit a good one this time). Meanwhile maybe Dr. Bhupinder has something to say...Dr?

Keep your chin up! ;)
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563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Using on and off corticosetroids is less likely to cause steroid induced atrophy skin. It is only after using topical steroids for a long time that this side effect results. However in your case from the symptoms that you have described i.e thin, red and shiny skin, this possibility cannot be denied. But on the positive note, since you used it off and on it should be mild and reversible.

I don’t suggest the use of tretinoin without a medical supervision as it may cause more harm than good. Instead, you can apply some calamine lotion at the rash as it will help in soothing the skin. If the symptoms are severe then it will be best to consult a dermatologist.

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 doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.







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3 Comments
Not true - I got steroid atrophy after using a cream for 7 days!
Not true. The redness started as a small round bright red spot on each testicle in a couple of days and I didn't realize what was going on. By day five the redness spread and I was in serious discomfort, but didn't realize it was atrophy that was taking place and that the damage was already permanent. I called the doctor but he was not in, but I spoke to a second one on the phone who was completely incompetent and kept telling me he wasn't concerned.
That was 2005. Fast forward to 2021 and nothing has improved. The damage was permanent.
Avatar universal
Hi Jimmy

I have the same skin problem as yours. Is your problem solved now.
If it is, please let me know the treatement you have followed
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Avatar universal
Hi Jimmy,
I too was prescribed a steroid/anti-fungal cream. I was told to apply it to the foreskin and glans of my penis and it caused skin atrophy. Please let me know if anything has worked for you. Hope yours is better. I'm praying that I'll find a solution or time will heal it.
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2134929 tn?1338260664
I'm so sorry to hear this my friend.  I don't wish to further depress you, but this is indeed permanent.  I am living proof.  I was prescribed Lotrisone (containing the potent steroid betamethasone dipropionate) for a rash on my nuts and I got serious burns that sent me to the emergency room.  I used the Lotrisone for 10 days.  When I complained to one of the doctors of bright red testicles and burning he told me he was not concerned, that I could keep on using it for the 2 weeks I had been told to use it.  My gut told me otherwise, but there was something about a doctor telling me not to worry that made me think maybe I was overreacting and let my guard down.  Anyway, by the time I spoke to him it was already too late because I've read that Lotrisone can do irreversible damage in as little as three days.  That was in 2006 and I'm no better.  My scrotal skin looked so bad today (six years later), like thin crepe paper.  Very red.  Just totally mutilated.  Now I've been having strange electrical shock like sensations in my groin area and testicles when I have sex (sometimes when I'm not).  I had some particularly serious pain for two days the other days.  The right testicle hurt terribly, as well as the area between the testicles and the body and this pain went all the way up to the groin area on my right side.  The doctor thought it might be a hernia, but that came back negative.  I have a strange feeling it has something to do with the nerve damage I'm sure I got back in 2006 when I got burned.  If the skin was damaged so severely, I can only image the thin veins and capillaries contained within did as well.  I am beyond shocked that these doctors continue to prescribe these powerful steroids to people without a care in the world and they just dismiss anyone who tells them this stuff is not safe. It's feels like a conspiracy from some movie. I'm in a nightmare I will never be able to wake up from.  And I can't ever kick this depression because of this.  My whole life has been affected.  It's like I had a life and suddenly I hit a brick wall.
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2134929 tn?1338260664
Not to mention that I suffer from Vitiligo, hair loss and have a messed up knee as well.  I guess the stupid doctors (and the pharmacist) who did this to me didn't think I was being punished enough.
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Avatar universal
Why is it that NO doctors talk about the rebound effect that happens after applying topical steroids to the skin, especially the groin area. The groin absorbs 30-40% of the steroid, much much more than other parts of the body.

LET ME BE CLEAR ABOUT THIS.

ANY Doctor who prescribes lotrisone for a guy to apply to his penis for a fungal infection has NO clue what risk they are taking with that persons life. IT IS NOT WORTH IT.

So Doctors, if you are really out to ruin peoples lives then keep telling your patients to apply a steroid to their penis, because that's all you are doing.



  
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Avatar universal
NEVER NEVER EVER USED STEROIDS FOR ANYTHING IT WILL RUIN YOUR LIFE FOREVER........ I know from personal experience i suffered for almost 10 years numerous ailments with no cure or diagnosis in sight. it all started after using cortisone creams and nebulizers both contain very powerfull and dangerous steroids . this class of drugs should be banned the side effects outweigh the conditions they are meant to cure.
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Avatar universal
Hi Jimmy.

I am so sorry for your situation.  I would really like to hear about possible solutions to your problem.  I have had a spider bite on my ankle for the last 5 years and have seen 20-25 doctors of all specialties.  The treatment of choice from all dermatologists has been topical cortisone ointments with strengths ranging from the strongest to the weakest, depending on the doctor.  While on the cortisone my problem seemed to improve dramatically, at least on the surface.  But once I try to stop, it comes back with a vengeance, so clearly the cortisone was a temporary fix.  The result has been redness, irritation, inflammation and swelling of the whole area and veins nearby.  Most often it becomes a superficial opened wound which burns, hurts, and is hypersensitive to everything in life including bandages, socks, pants, creams, and medicines.  So I understand your issue and it's horrible.  I have been working with many people nutritionally to build my immune system, strengthen my skin, and try and protect the area.  Prutect, a prescription cream, has been somewhat helpful at times.  So has soaks with 1/2 whole milk and 1/2 water and ice cubes (might be difficult for you, sorry.)  But I am still struggling and often miserable and depressed, living my life from the feet up.  It's affecting every area of my life.  I hope someone with good knowledge responds to us to help us.

SpiderwomanFromNJ
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Avatar universal
Hi Jimmy.  I hope your problem is resolved by now or that you will  see this next entry of mine.  I wanted to thank you and all the people who responded in this conversation.  It gave me clarity to investigate and realize that my problem at this point is what is called in Wikipedia Steroid Atrophy.  Cortical steroids for 5 years for a spider bite has significantly damaged my skin in its deepest layers.  It may sound strange but I actually was thrilled to finally have a diagnosis for my never ending problem. It has taken me 5 years to figure it out. It allowed me to figure out what needs to happen next, and why all my efforts were not working.  It was because I continued to follow Dr's directions and use the cortisone the whole 5 years.  Most things I read said that at my level, it is permanent damage.  But I am dismissing that since I have some tools that I expect will help me recover, maybe even completely.  Nutrition is huge.  I went on line to see what foods support healthy skin and collagen production and you can be sure I will be bombarding myself with them daily.  I also eat Sunrider International whole foods.  You get them on line and they do an amazing job supporting the body in its tasks, including creating healthy skin.  I am seeing a chiropractor now who has modern equipment to promote healing, i.e. a cold laser, electronic acupuncture, and a machine to decrease inflammation, plus lots of other things.  And I will continue with my ice milk soaks to decrease inflammation and help skin.  I am also looking to see what can be used as a skin mask directly on the area to replace some of the collagen, fat, and elastin that has been depleted by the steroids, i.e. smashed avocado, yogurt. And of course I have discontinued the steroid ointment.  I hope this information is helpful to you and others.  Best of luck to all of us in this situation.
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Avatar universal
Try Prumyx cream - it is a non-steroid and the only thing that has helped this problem. 3 weeks 3 times a day (talk to your doctor). It helps lock in moisture which leads healing.
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Avatar universal
To all who are suffering, I wonder is some of the problems can improve by following a paleo protocol diet that will improve your immune system and therefore help your body heal itself?
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Avatar universal
why
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Avatar universal
I used flutivate steroid which is a strong steoroid cream on my upper penis shaft skin because I got belanitis,. I  applied it on the lower half of my penis shaft. I had it on for two weeks. My skin broke down and is now thinner and have lots of striae as well due to healed scars. Every time I mastrubate I feel pain and the area becomes reddish. Doctors have confirmed atrophy from steroid and there is nothing they can do. My life is hell, I have lost all hope about finding a cure my only strategy is getting rid of the skin. I´m trying to search and find a plstic surgeon who can cut off the damaged skin. I dont know if it´s possible?

I guess my life is over
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Avatar universal
Hi Jimmy, how are you now?. Did you get better or found a way to recover?
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Avatar universal
Hi Jimmy,
I am 40 and have the same problem. I got Steroid induced skin thinning (dermal atrophy) because I use trimovate to treat psoriasis in that area for a week although I was using it before on and off and now the skin of my penis is reddish and much thinner.

My scrotum is the same.

Anyone of you has found a solution or got better?. Any hopes on how to sort this out?.

I found out that aloe Vera could help, anyone know anythings about this?.

Thanks for the updates on this
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Avatar universal
Hi mate,
I am 40 and have the same problem. I got Steroid induced skin thinning (dermal atrophy) because I use trimovate to treat psoriasis in that area for a week although I was using it before on and off and now the skin of my penis is reddish and much thinner.

My scrotum is the same.

Anyone of you has found a solution or got better?. Any hopes on how to sort this out?.

I found out that aloe Vera could help, anyone know anythings about this?.

Thanks for the updates on this
Helpful - 0
Avatar universal
Hi Caliman,
I am 40 and have the same problem. I got Steroid induced skin thinning (dermal atrophy) because I use trimovate to treat psoriasis in that area for a week although I was using it before on and off and now the skin of my penis is reddish and much thinner.

My scrotum is the same.

Anyone of you has found a solution or got better?. Any hopes on how to sort this out?.

I found out that aloe Vera could help, anyone know anythings about this?.

Thanks for the updates on this
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Avatar universal
there is no solution...surgery is the only solution...the steroid thinning is not reversible..i have had this for 5 years. Any doctor saying it´s reversible is lying. I´m trying to read everything about surgery now so the skin can be removed...i will probably look like a freak after but i want the pain to go away
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Avatar universal
http://www.researchgate.net/publication/232089692_Treatment_of_steroid_atrophy_with_topical_tretinoin_in_the_hairless_mouse_A_histologic_biochemical_and_immunochemical_analysis
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Avatar universal
Hello,
I have same problem, betamethasone dipropionate steroid used on scrotum leaves real mess (red skin and skin atrophy). I am doing long research and yes, tretinoin can help but it can be really bad in terms of pain (iw will burn your skin). But there is a little hope, vitamin D3:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1510095/

Calcitriol used topically ("Silkis" for example) can reverse skin atrophy, there are studies about this (link) and yes, probably without burning effect of retinoids. Keep in mind that this is Vitamin D3 and will affect calcium, so check your calcium before use :

http://www.drugs.com/mtm/calcitriol-topical.html

I am really envy that it can help, i am currently recovering psychically from from devastation of steroid, but i will probably try this cure, after doxycycline teraphy for red scrotum. Really it is only one that i have in my mind after really long search, after copper peptides, retinoids, alpha hydroxy acids (Amlactin) - i do not try theese and i dont think they will work.
And one more thing, if you try any of these solution please post them in this thread (this is most updated one) so we can help eachother guys.

regards,
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