Side effects treatment - please take a look. Thanks! :)

Hi everybody,

Would anyone be so kind to give me his/her opinion on how to heal the side effects of corticosteroids?

By doctors recommendation I used a topical corticosteroid triderm (bethamethasone dipropionate) to relieve a redness of skin that appeared occasionally on my inner  prepuce (some sort of irritation apparently cause all STD tests came negative), but unfortunately i have got side effects from using it. I do not get an occasional redness on the prepuce anymore but now I've got swelling(edema), telangiectasias and redness which doesn't subside and is exactly on the places where I applied the cream. I felt an incredibly hot sensation when the side effects first appeared (immediately after the last application of the cream), but now I don't feel anything there.

Essentially, I went to numerous doctors in my country, but unfortunately they just don't know what to recommend to me for treatment. By an online doctor's advice I've tried using the following treatment on my prepuce for six months:
-talcum (baby powder) application to the the affected area in the morning
-panthenol cream in the evening
-vaseline before bed and leave it to stay at night
and I haven't experienced any improvement.

Is there any medication with which side effects (swelling(edema), telangiectasia, redness) from corticosteroids can be cured or at least minimized?

Thanks in advance for an advice and thanks for reading all of this!

[Faithpill]

Can someone please advise me on this...doctor...anybody? help...:(

[Bhupinder Kaur, MD]

Hello,
I can understand your concern for these symptoms, but increased thinning and fragility of skin, skin rosacea, atrophy and tachyphylaxis are frequent side effects of topical steroids. For these side effects, wait and watch is the treatment available as it may take ample of time to get better. There is no topical treatment as such which can counter these side effects. I am afraid to say but significant thinning of the skin and other skin changes that occur because of steroids or cortisone-related medication, generally does not reverse significantly.

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.

[Faithpill]

First of all I want to thank you so much for your response! :)

I will send to you a somewhat detailed description of my symptoms related to corticosteroid side effects in a post I'll be posting here tomorrow. It might provide you with valuable details about these side effects firsthand. In the meantime, as you've been so kind to help me on this would you please help me with another issue I am having:

Before I was recommended to use corticosteroids I was first recommended by a doctor to use baking soda (sodium bicarbonate) mixed with water (20 grams of baking soda in one liter of water), and after 4 weeks of pouring this once daily over my prepuce (and consequently the rest of genitalia) a pinkish oval appeared on my scrotum which started to widen and spread towards my legs. Where it spread the skin there became very very itchy - I scratched it till it bleed. When it had reached the legs a couple of days latter it stopped spreading (it is only on my scrotum, none of it is on legs or penis), but also caused some glands from the sides of the scrotum to start constantly secreting some sticky yellow liquid (sebum?).

My skin on the scrotum is now pink and itches almost none at all, but it is also somewhat thin and constantly wet because the glands from the sides of the legs work non-stop at secreting this yellow liquid, which also promotes excesive sweating.

I recently started regularly using baby talcum powder on the sides of my groin to dry the ongoing excretion of this yellow liquid and sweat, and i am also applying vaseline mixed with panthenol on my scrotum. I always wore cotton underwear and I do so now. I don't know if this will help much, but it is the best I can think off my head right now. The baby talcum powder helps somewhat, but doesn't seem to stop completely the excessive secretions of this yellowish liquid, or sweat.

When I say my skin itches almost none at all, i mean it does sometimes itch, but I think it is because of the wetness. The itch isn't severe at all (just like a regular itch) and after i scratch it, the itch is gone and doesn't return until I become very wet there again.

Is there any way for me to see what exactly is this yellow sticky secretion and what happened to my skin there? I read somewhere that baking soda can cause the sebaceous glands to start overworking.

Thanks

[nnn1357]

... can dry out your skin even more, so it's not the best option for treating dermatitis of any kind
You should check with your physician if natural remedies such as salt water bath, washing with chamomile tea etc. would work.
Also natural oils such as calendula, St. John's Wort, almond, and/or Common evening primrose oil could provide some relief (I see in your profile that you're from the region of former Yugoslavia so the local names are nevenovo ulje (zapravo ne ulje nego macerat), kantarionovo ulje, bademovo ulje i ulje nocurka).
Finally, check with your doctor if dermatological products for babies (baths, and ointments) might help (Mustela line is very good), because what you describe is possibly a very strong allergic reaction so washing with regular soaps might aggravate the condition.

[Bhupinder Kaur, MD]

Hello,
One of the possibilities that is coming to my mind because of the symptoms that you have recently added is intertrigo. An intertrigo is an inflammation (rash) of the body folds. It most commonly occurs due to bacterial,viral or fungal infection. An intertrigo usually appears red and raw-looking, and may also itch, ooze, and be sore.

Please keep the area clean and apply some topical antiseptics. Also wear loose-fitting cotton clothing and use an antibacterial soap or mild soap like dove. Avoid any kind of cosmetics. Topical zinc oxide cream like Sudocrem, Desitin are very helpful(apply with a paper towel and not directly with hands). For the itching please take some over the counter antihistaminic like Benadryl or Claritin. In case the symptoms persist then antifungals may be needed. Consult a dermatologist in that case.

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.

[Faithpill]

Thank you all so much for your advice! :)))) It's a good feeling to feel that things are moving in a positive direction - towards knowledge and consequent healing. :) Concerning the sticky scrotum I mentioned in my previous post:
To nnn1357:
-My physicians are baffled with these reactions I have and they don't know much about herbal remedies.
-To me it is important not to "damage" my skin any further by any treatment. I hope that none of these herbal remedies are in any way irritating to the skin. Do you know would it be a good idea to use most of these oils on a daily basis (i.e.calendula macerat in the morning, St. John's Wort's in the afternoon, almond oil in the evening and common evening primrose oil overnight), that is, would it be beneficial to the skin to use them all daily or will this just clog the pores? Should I try just one or two at a time? By the way, thanks for the local names, I'm from Serbia so this helped in finding out what these plants are. :)
-Do you happen to know where I could locally obtain Mustela line products and is there any product from this line that you would recommend for my condition?
-Finally, I am interested to know more about what kind of allergic reaction do you think this is? I haven't used any soaps down there for a while, but the condition is the same. Any ideas are most welcome. :)
I can't describe how happy I am that someone finally gave me an answer with a potential treatment options concerning this condition. It really made my eyes weep with tears of joy. God bless you!!! :)

To Dr. Bhupinder Kaur, MD:
-What would be the best way(s) to find out if this condition is due to bacterial,viral or fungal infection(symptoms are persisting)?
-I am not using any soap on my scrotum - just tap water. In this way I can easily remove this yellow liquid and sweat (at least for a while) without irritation that soaps would cause. Is this also a good option or is it really recommended to use antibacterial soaps or mild soaps like dove?
-Do you recommend to avoid cosmetics for this area (groin) or cosmetics in general(whole body) for the time being?
-I will consider using topical zinc oxide creams you mentioned.
-I don't have that much itching, just regular itch due to moist buildup - it happens only when i get really wet down there and is tolerable - for me the moist is a bigger problem than itching right now.
Thanks again for your answer - I see by your answers to various posts on these forums that you are such a kind and caring soul who devotes her time and energy selflessly to helping others relieve their suffering although you have no obligation to do so. God bless you!!! :)

[Faithpill]

As promised here is the post about side effects in more detail:
Of the side effects you mentioned I am not sure if I have increased thinning of skin. To me, by touching the prepuce area during an erection, it seems that the corticosteroid drug made the underlying tissue form some sort of hard "bubble like thing" beneath the prepuce and that "bubble" is what pushed the veins and capillaries to the surface and of course stretched the skin a bit, so it may look somewhat thin because of the fact it is stretched, but I don't have stretch marks as such. The skin itself might be thinner, but I am not sure of it.

As for fragility of skin I don't think I have it, but after some time has passed I think the aforementioned stretching of the skin(due to underlying edema) and normal dryness of skin made the skin crack on one spot only. I think if somehow the swelling were to go away I wouldn't have any problems with this. If I apply some vaseline I don't have a problem with this at all for a period of time.

As for skin rosacea, as far as I can figure I looks to me like I have redness beneath my skin rather than that the skin itself is red(I may be wrong with this), and this redness hasn't changed color (turned purple) at all so it is not blood caught up in there. I am not sure if it completely disappears on finger pressure and I don't know how would one call this condition.

Atrophy is what puzzles me the most because I don't know what corticosteroid atrophy represents. If it is an indentation as I read some other unfortunate people call it (they got it from kenalog injections), I don't have it, just the opposite - an edema. Please advise me on this as it is most confusing to me whether this edema is considered corticosteroid atrophy or is this due to tachyphylaxis or something third entirely. Tachyphylaxis might be the case because of edema (dilatation).

Would you be so kind to ask other doctors on this forums if they also know something about these symptoms(if they are available to you, of course), because I don't know how to ask them (there is no send message option on their profiles), and it doesn't hurt to have more opinions. :))

Wish you and your family all the best :)))
Cheers

[nnn1357]

Well, if you're from Serbia, I could give you my two cents in a language closer to you (I'm from Croatia), but I'll keep it in English so that other visitors to the forum may possibly benefit from it--though please, I am not a medical professional, I speak only from personal experience, and urge you and all others to cross-check my findings with their physicians.
The herbal remedies I mentioned are very traditional, in the sense that they are not some far-out new-age thing, but are a staple of regional medicine (the Balkans).
You can finds these in most pharmacies, not only those specialized in herbal remedies.
First: why your conditions seems to be a possible allergy? Your skin is clearly reacting to something, either in your diet, the medicine/hygienic solutions you applied, your environment, your clothes etc. The goal is to make the skin react in a normal way, rather than so drastically.
Bathing the inflicted parts in mild chamomile tea might, over time, reduce the inflammation (maybe twice per day). A salt water bath might also help, depending on how sensitive your skin is.
As for oils, do start with only one of them first, and even try them on a neutral patch of skin (e.g. inside of a wrist) before applying them on the inflicted area--I emphasize, these are used even in treating babies so they are very safe but in your case I advise extra caution.
Primrose oil (nocurak) has been extremely effective in treating eczema, skin inflammation etc. -- it is administered both locally and orally, so do check with your physician before taking it orally.
Calendula macerate (nevenov macerat) would be a more conservative choice, since calendula is used often in treating diaper rash, but again, try it on your wrist for a day or two, because any herb can cause an allergy too.
St. John's Wort's macerate (kantarionovo "ulje") is advised for almost any skin condition, but especially sunburns. One precaution in using it, though: it reacts to direct sunlight, so apply it ONLY in the evening and wash it off in the morning, just to be extra safe.
Finally, almond oil, is the milder and least medicinal of the four--but in your case might be helpful--I don't think one can even be allergic to it, but please, once again, check with your doctor.
Do start with only one oil, and maybe even only once a day (in the evening), and give it some time. Important to know: treatment with these oils should not hurt, not even the least, so if it does STOP using them. All these oils effectively reduce inflammation and should offer you relief.
My family and I have used these for eczema, seborrhea, contact dermatitis, neurodermatitis... you name it, but I only vouch for them with my personal experience. If you can, buy only oils from organically grown herbs, and from attested manufacturers.    
As for Mustela products, they are found in most pharmacies, under baby cosmetics--this is a French firm, and is highly acclaimed for its line of products for babies and children with skin conditions (and these are very stubborn indeed). Follow this link and see if anything sounds that it might help.
Finally, in my opinion talcum powder and vaseline cannot help--one dries out the skin, the other practically seals it off, and if you indeed have a strong allergy then the air is your best friend. So if at all possible, maximize the time you spend with the inflicted area exposed to air. I understand that in your case this might be somewhat of a problem, but...
Also, check your diet--some foods feed the allergy, or a skin condition, but it's again tricky to determine what is triggering your particular symptoms. Once a body finds an outlet, all negative aspects of our lifestyles tend to worsen a condition or ailment.
I hope at least some of this will help and wish you good luck and patience.  

[Faithpill]

First of all, I am sorry for my late reply and...thank you so much!!! :)) Your help is immensely appreciated (I cannot describe with words how much)! By seeing how much effort you've put in helping me - a complete stranger to you - speaks volumes of your kindness and altruism. :)

You can rest easy - I will definitely cross-check everything. I've been burned too many times to forget that. ;) As Sophocles wrote in his Antigone: "There is no greater evil than a man's failure to consult and to consider." I hold these words as true as no other truth out there.

You are right - this does seem like a reaction to something either caused by some bacteria, fungi etc. or something else in my environment. I will recheck everything one thing at a time, although the process will be tricky: my skin for bacteria, fungi and viruses; my diet, my clothes, hygienic solutions, water I drink and bathe in, etc. Once I have a clear vision what I am up against it will be easier to focus my efforts on overcoming it.

It is indeed a wise and a good idea to test on a neutral patch of skin before applying the oils on the inflicted area. I will recheck with my physician what I should use first from the list of oils you kindly provided.

Since you mentioned organically grown herbs, and attested manufacturers, I can throw something I know into the mix. It should be helpful. :) I noticed that so many personal-care products(shampoos, lotions, shaving creams, deodorants, and even calendula oils (I looked for it the other day in a strictly health store), have not one, but several forms of parabens (methylparaben,ethylparaben,propylparaben etc.) in them.

Since we use such products every single day of our lives and since the skin is the largest organ of the body, these nasty chemicals go straight into our bloodstream. Once they get inside us, they mimic estrogen, disrupt the endocrine system, and throw the hormones out of whack, so to speak. Essentially, one should not trust the “all-natural” label. Just because a product says it’s natural, it doesn’t mean it is, as parabens at the label demonstrate, so ALWAYS check the label. I presume you know of this since you advised using oils from organically grown herbs, and from attested manufacturers, but I am writing it all the same. Hope you will find this helpful as well as everyone else reading this. :)

I didn't see any link you mentioned for Mustela products in your post - maybe medhelp erased it as per their anti spam policy. If you would be so kind to send me a personal message with it, I would be most grateful.

I will try to maximize the time I am exposed to air for the afflicted area. It will be tricky though...

Once again I can't thank you enough for the time and effort you have provided. Rest assured I find your advice most helpful. :)

[Faithpill]

Dear doctor, I have a few questions concerning my previous posts here, that would really mean a lot to me if I got an answer to them. :)))
1.What would be the best way(s) to find out if this sticky secretion I have in my groin area is due to bacterial,viral or fungal infection(symptoms are persisting)?
2.Do you recommend to avoid cosmetics for this area (groin) or cosmetics in general(whole body) for the time being?
3.If I am to watch/search for treatment options for corticosteroid side effects, then I need to have proper definitions of the side effects I have from corticosteroids. Would you be so kind to answer me on these questions:
a)On the prepuce on the places where I applied the corticosteroid drug the underlying tissue formed some sort of hard "bubble like thing" (edema,atrophy?) and that "bubble" is what pushed the veins and capillaries to the surface and of course stretched the skin a bit. What effect of the corticosteroid drug could cause this and how would this be called?
b)What effect of the corticosteroid drug would cause tiny blood vessels to become dilated in some places and how would this be called?

The rest of the side effects I gather I have are teleangiectasias and skin thinning, but for these above I haven't found much info on.

Thanks in advance for any answers
Wish you all the best

[Faithpill]

Can someone please advise me on my last post...doctor...anybody? sigh...help...:(