Steroid Atrophy

[gavinj]

Hi Dr.

I had a problem on the skin under my eyes ( the skin along my orbital rims, not the skin directly below the eyelid) and the dermatologist for one reason or another prescribed the cortisone advantan which contains 0.1% methylprednisolone aceponate. I used this for 17 days and then began to see problems such as veins, thin skin, symptoms associated with atrophy. even though the doctor wanted me to continue using it i stopped. I lived with this for a year (it is now just over one year), but today i went in to another dermatologist because i thought i had developed milia in this area, there were numerous clusters of tiny white dots that were very visible. The dermatologist took one look and asked if i had been using cortisone. he said the clusters were not in fact milia but were actually my sebacious glands showing through, since the skin was so thin. the doctor said there really is virtually no chance of my skin ever rethickening.

I would just like to know if in your opinion this is true, should i realistically just learn to live with this or is there anything, I mean ANYTHING that i can do?

also if this is relevant i am a 23 year old male.

Thank you for your help

[gavinj]

thank you for that response dr rockoff. just one more thing i wanted to enquire about. the doctor did say we could cauterise the sebacus glands but he was slightly hesitant because he was worried itcould cause redness. so we did a small test patch just as a tryout. what do you think about cauterising sebacuous glands?

thanks again dr!

[Alan Rockoff, MD]

I think you may need another opinion, in person, Gavin.  In the first place, methylprednisolone is a very weak steroid that would not be expected to cause atrophy.  Second, sebaceous glands are not a sign of atrophy.  Third, even when atrophy occurs, it is generally reversible.  I doubt that there is anything to do about your appearance, but I am far from convinced that what you have was caused by the steroid.  But I couldn't say that for sure without seeing you in person, so that's why you should consult with another doctor.

Best.

Dr. Rockoff