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Side effects -- I haven't seen here
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Side effects -- I haven't seen here

Hi,  

I'm in week 20 of 24 of interferon/ribavirin tx for HepC type 3A, and doing pretty well:  undetectable viral load one month into treatment (down from 3.4 million units before treatment) and moderate neutropenia (<.9 ANC).  I've only taken 1 day off of work for symptoms & side effects so far since I started treatment in October 2010.  And I'm grateful it seems to be working. But my side effects are increasing:  mainly itchy skin and trouble with mucous membranes.  

I haven't seen anyone talk about my main side effect (which I've never had before in my life) on this list...To be blunt (it's kind of embarrassing):   hemorrhoids, slight tears in that area, and vaginal redness, soreness, itchiness etc.  This isn't herpes. The symptoms began at week 11 and have increased through week 20 (with 4 more weeks of treatment to go and then who knows how long for post tx healing) .   I've tried Preparation H, Vagisil (20% benzocaine), naftin (my husband's prescription ointment for fungal infections), zinc oxide (aka Desitin), cortisone cream 1% and 2%,  and staying very clean,  all with minimal relief.   The best so far has been a combination of the first 3 products I mentioned.

Has anyone had this problem as a side effect of HepC (or other) treatment?  What did you use for it?  Thanks for your thoughts/suggestions...
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14 Comments Post a Comment
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Avatar_f_tn
Like you, I didn't have these symptoms pop up until late in tx, and for me they came again once tx ended.  I used Monistat and Preperation H and they worked well.  Good luck.

Carol
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419309_tn?1326506891
There was some recent discussion about "anal pain" as a possible side effect, but as you bravely pointed out, both are rather sensitive subjects, so perhaps the lack of info is due to its embarrassment factor.  I'm sorry I don't have any useful answers, but I wonder, with your lowered ANC, that you might be more prone to infection (yeast, etc.), and it may be worthwhile to follow up with your ob/gyn, especially with open tears and such just to make sure to rule out any kind of infection.  Hoping you find some relief. ~eureka
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Avatar_m_tn
It's not unusual for these areas at the "edges" of things to be the driest. My rear end is not affected, but I constantly get "splits" at the corners of my eyes, mouth, anywhere the skin comes together and abruptly "changes direction".

The rear end is another of those areas that has lots of "thin skin". I'm not surprised it would be one of the first to dry out.

Like with all skin issues, keep it lubed up is about the best you can do. I'm not sure about the female parts, being a guy.

:-)

Robert
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Avatar_f_tn
Thanks much for your replies.  I've done more reading in the archives and found that a lot of people have had hemorrhoids and other dryness/itchiness in  surface mucosal membranes (like the eyes and mouth, as Robert mentioned) .  Of course my Dr says she's never heard of this side effect, but at least acknowledges that her other patients may have had more serious problems to report and left this one out... Anyway, I'll try your suggestions (hadn't thought of monistat), drink more water than I can imagine (that seems to help a little) and take comfort in the temporary nature of all things (including suffering).  

~fiver49

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Avatar_f_tn
Actually some of us have had this side effect, we just don't talk about this one much.  I had it but didn't talk about it a whole lot.  Drove me crazy to be honest and the doctor gave me steroid cream. Some controversy about steroids for people with Hep C but ask me if I gave a sh!t about that point in time because I scratched myself raw...I tend to say I should have had a whole lot more fun for the amount of time my hands spent in that area.  When treatment stopped, the problem stopped.  So seeing you are at Week 20 out of Week 24, I'd say hang in there....if it goes the way it went for me, it will get better soon.

I notice you have mild neutropenia, you say ANC of <.9.  Do you know what your exact ANC is? I've often wondered if that had anything to do with it as certain elements of my white counts took a hit but not necessarily my ANC, my lymphocytes and my CD4 count, which are two things that don't get looked at with any great scrutiny on treatment just yet, happened to be looked at because of the trial I was on.  So also wondering if your CBC shows your lymphocyte count, I'd be interested to know.  Doubtful you have a CD4 count, that's a very specific test for a very specific reason...but if you do, all the better.  Thanks.

Trish
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Avatar_f_tn
I had an extra bag that I carried to work with me everyday during treatment that contained all of the supplies I needed for help alleviate "side effects" of treatment.  In that bag was vagisil, monistat (the little tube that comes with the packet to be used on the external parts), anusol, Desitin and A&D Ointment.  I never knew from day to day what I might need to alleviate issues so I took them all with them.

I used several courses of monistat over the course of my 48 weeks of treatment because of issues in that area and I chose the one that was the 7 day course and then I would use the extra little tube for during the day if I needed it.  Inbetween times, I used a lot of Desitin or A&D ointment.

Treatment affected my skin...even the skin down there.  :)
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You being female excludes some of my experiences with the dread " riba rash " I too didn't experience any rash until week 10 or 11 of treatment . When it did appear it was sudden and quite debilitating . Starting with the small of my back and traveling north and south ending at my neckline and between the buttocks . I found that through the night I would scratch the reachable areas raw . The only thing that gave me relief is the use of Gold Bond Body Lotion ( green bottle / red cap ) Forewarned ! It will sting upon application , but this passes .                                   Mike
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Avatar_f_tn
Thanks all for your comments/answers.  Like you Meakea I have my first aid kit with me at all times, and need constant replenishment.  It's true, skin is skin -- and some areas are apparently more sensitive to the drying and other effects of these meds than others.

I've gotten some good ideas from you all, and will see how they pan out.  I also checked out this link from another skin rash/irritation thread (which I found by reading Mike's prev messages) that might be helpful to others as well:

http://www.medhelp.org/posts/Hepatitis-C/Skin-issues-on-tx/show/1461904
  
Best to all and thanks for helping to make this a lot less isolating as experience...
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374652_tn?1311302831
Generally, hemmerhoids  are just veins that carry blood to the anal area, These veings are more like arteries in that they do not have valves, anyway, when that blood pools there to long it tends to stay, and can create a kind of hemmoraghing (sp.), it takes about 10 days for the body to reabsorb the blood,but if you develop blood clots down there it may require excising the tissue and releasing the blood clots.
the best thing I've found for this situation is.... a lot of water, walking will help pump the blood back, swimming, a lot of water I used to drink one 8 oz glass an hour.  metamucil or equivalent, do not sit on toilet for long time at all.  if you cant go get up.  sometimes the tissue prolapses and it feels like you have to go, but its just the tissue.  Their are tons of nerves in the anal area ( when an animal in the wild wants to down its prey, thats what they go for) so it HURTS.
Pectin is also very good for this situation, make some apple sauce with whole apples (organic )
It can take a couple of months to get "things" healthy down there, but it can work, Also, take your time eating, take sits baths, the hot water can help with the circulation, but be careful of blood clots, if you have external or prolapsed hemmers go to a surgeon for an ecliptic excision.
the itching is part of the healing process i believe, but use soft wipes to clean the area to prevent any bacteria from causing the itching.
ice sometimes helps too,
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374652_tn?1311302831
Oh, hemorrhoids are hemorrhoid tissue that fills up with blood from the veins to cushion the area during bowel movement. and the veins are more like arteries w/o valves to get the blood their quickly and lots, but the blood may pool as well.  (clarification)
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Avatar_f_tn
Thank you for the recommendations and information. So, I've learned that what I have is not hemorrhoids, but just your average ordinary delicate skin getting torn up by the dehydration. (it was, strangely, not comforting to know this could be worse).  But you're right, water seems to be the first answer to nearly all things related to this treatment.  So, proceeding along:  tonight begins week 21 of 24.  can't wait.  thanks again. It really does help to not feel so isolated.
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Just wanted to add that candida is a quite common side effect for women.
I was on fluconazole (1 time release tablet per week) through almost the whole duration of tx and a couple of weeks after. Each time I went off it, the candida would return.

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Avatar_f_tn
Had the same side, my PCP suggested using Neosporin. It won't hurt the delicate skin in the nether regions. It worked wonders for me!
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412873_tn?1329178055
Since you brought it up....I didn't share much about it on the forum during my tx, but about 12 hours after my first dose of meds, I developed a condition I called "the wiggles".  I didn't have hemorrhoids, just a constant itching and irritation.  As the weeks went by, it was really difficult.

I was in a study with triple therapy for the first 12 weeks.  At the end of those 12 weeks, within about a day, the symptoms totally went away.  So it was definitely something in the Telaprevir.

Bottom line...no pun intended...our alimentary canal is a mucus membrane that goes from our mouth to our anus.  These drugs affect mucus membranes.  I suppose they follow no rules on where to hit us.  

I was very mindful of my diet, drank tons of water, used tucks, prepH and a cortisone prescription.  Tucks worked best, but honestly...nothing really helped all that well.  

Thank goodness you're nearing the end of tx.  I hope your problem goes away as quickly as mine did after stopping the Telaprevir.

Thanks for bring up a subject that is not often discussed.  

Good luck and congrats on getting thru this far.

Isobella

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