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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.
ok so I quit the antibiotics since it doesn´t help me anymore...I don´t understand why it helped and then stopped working. But now I just put on protopic for the first time 5 minutes ago. So let´s see what happens. I think I´m gonna book a meeting with a plastic surgeon to discuss what fillers or fat transplant or skin graft can do. If it´s even possible at all. I read a lot about people who got fat transplants for steroid induced atrophy from injections and some have good results. Don´t know if this can be done on my penis shaft skin though. Today the itch was hell and it feels like ants are biting me and the burning sensation. When I look closely i see shiny striae stretchmarks going reddish and irritated. There is nothing I can do about it..I stopped moisterizing creams all together..there is simply no point anymore...the skin will never heal on it´s own.never ever.
http://journals.lww.com/dermatologicsurgery/Citation/2016/11000/Therapeutic_Use_of_Hyaluronic_Acid_Fillers_in_the.16.aspx
Abstract
BACKGROUND:
One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our knowledge, laser therapy for steroid-induced atrophic scars has not been investigated to date.
OBJECTIVE:
The aim of this study was to evaluate the efficacy and safety of pulsed dye laser in the treatment of steroid-induced atrophic scars.
METHODS:
In this pilot study, 15 patients with at least one atrophic patch were treated with the 585-nm pulsed dye laser at 4-week interval sessions until achieving complete improvement or until patient were lost to follow-up. Clinical outcome was assessed via standard photographic method before each treatment session and after the final visit. An independent dermatologist evaluated the photographs.
RESULT:
All of the patients (13 females and two males) with 25-59 years of age experienced some degree of improvement, except one patient who withdrew from the treatment after three sessions. The treatment was well tolerated.
CONCLUSION:
The results of our study indicated that pulsed dye laser therapy could be employed as a new method in the treatment of steroid-induced atrophic scars. Pulsed dye laser might affect the lesions through inducing collagen deposition and production of more superficial dermal elastin as well as less unidirectional collagen in clusters.
BACKGROUND:
One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our knowledge, laser therapy for steroid-induced atrophic scars has not been investigated to date.
OBJECTIVE:
The aim of this study was to evaluate the efficacy and safety of pulsed dye laser in the treatment of steroid-induced atrophic scars.
METHODS:
In this pilot study, 15 patients with at least one atrophic patch were treated with the 585-nm pulsed dye laser at 4-week interval sessions until achieving complete improvement or until patient were lost to follow-up. Clinical outcome was assessed via standard photographic method before each treatment session and after the final visit. An independent dermatologist evaluated the photographs.
RESULT:
All of the patients (13 females and two males) with 25-59 years of age experienced some degree of improvement, except one patient who withdrew from the treatment after three sessions. The treatment was well tolerated.
CONCLUSION:
The results of our study indicated that pulsed dye laser therapy could be employed as a new method in the treatment of steroid-induced atrophic scars. Pulsed dye laser might affect the lesions through inducing collagen deposition and production of more superficial dermal elastin as well as less unidirectional collagen in clusters.
Abstract
BACKGROUND:
Topical corticosteroids decrease collagen synthesis during short-term treatment and can induce skin atrophy when applied over the long term. In contrast, short-term tacrolimus ointment therapy does not affect collagen synthesis.
OBJECTIVES:
Our aim was to evaluate the long-term effects of 0.1% tacrolimus ointment on collagen synthesis and on skin thickness in adults with moderate to severe atopic dermatitis (AD) and to compare the findings with the effects of conventional steroid-based therapy.
METHODS:
Fifty-six patients with AD were treated with 0.1% tacrolimus ointment in a 1-year, open-label, prospective clinical trial. Thirty-six patients with AD applied conventional steroid-based therapy and 27 healthy subjects were recruited as controls. The primary endpoint was the change in levels of procollagen propeptides I and III measured by radioimmunoassay between baseline and month 12. Additional endpoints included the change in skin thickness measured by ultrasound between baseline and month 12.
RESULTS:
Procollagen propeptide baseline values were significantly lower in the group to be treated with tacrolimus ointment than in healthy controls. One-year treatment with tacrolimus ointment was associated with an increase in collagen synthesis; the median increase in combined procollagen propeptide levels was 272 micro g L-1 (+ 140.9%, P < 0.001) and was accompanied by a significant increase in skin thickness. In three patients with visible skin atrophy, this condition ameliorated. Corticosteroid-based therapy had no significant effect on collagen synthesis; the median increase in combined procollagen propeptide levels was 11 micro g L-1 (+ 3.9%). A significant reduction in skin thickness was demonstrated.
CONCLUSIONS:
Long-term tacrolimus ointment therapy in patients with AD is nonatrophogenic and reverses corticosteroid-induced skin atrophy.
BACKGROUND:
Topical corticosteroids decrease collagen synthesis during short-term treatment and can induce skin atrophy when applied over the long term. In contrast, short-term tacrolimus ointment therapy does not affect collagen synthesis.
OBJECTIVES:
Our aim was to evaluate the long-term effects of 0.1% tacrolimus ointment on collagen synthesis and on skin thickness in adults with moderate to severe atopic dermatitis (AD) and to compare the findings with the effects of conventional steroid-based therapy.
METHODS:
Fifty-six patients with AD were treated with 0.1% tacrolimus ointment in a 1-year, open-label, prospective clinical trial. Thirty-six patients with AD applied conventional steroid-based therapy and 27 healthy subjects were recruited as controls. The primary endpoint was the change in levels of procollagen propeptides I and III measured by radioimmunoassay between baseline and month 12. Additional endpoints included the change in skin thickness measured by ultrasound between baseline and month 12.
RESULTS:
Procollagen propeptide baseline values were significantly lower in the group to be treated with tacrolimus ointment than in healthy controls. One-year treatment with tacrolimus ointment was associated with an increase in collagen synthesis; the median increase in combined procollagen propeptide levels was 272 micro g L-1 (+ 140.9%, P < 0.001) and was accompanied by a significant increase in skin thickness. In three patients with visible skin atrophy, this condition ameliorated. Corticosteroid-based therapy had no significant effect on collagen synthesis; the median increase in combined procollagen propeptide levels was 11 micro g L-1 (+ 3.9%). A significant reduction in skin thickness was demonstrated.
CONCLUSIONS:
Long-term tacrolimus ointment therapy in patients with AD is nonatrophogenic and reverses corticosteroid-induced skin atrophy.
my theory is that steroid atrophy and nerve pain go hand due to the fact that skins barrier is weakend and therefor more prone to pain. I have had this for 7 years now. There is no way in hell we can find something that will rethicken the skin. This **** is permanent. However surgery is one option and annother option is fat transplant injections.You can just google it and find lots of info about that. For the pain itself antidepressive medicine like cymbalta, lyrica or antiepileptic medications could work. Local lidocain will work wonders but just for an hour. Protopic and antibiotics could ease as well. Then creams to help the skin hold water.
But as far as it comes to find something magic that will thicken the skin again back to normal...I mean just give it up please...I still see this debates and conversations all over the internet in different forums like these.
My doctor said she will prescribe me all these meds and let me trial and error on myself to see if the pain will ease. So far I haven´t tried anything more than the antibiotics I told you about. I will try lyrica, cymbalta, protopic and everything else under the sun...2017 will be another year down here in hell due to the doctor that destroyed my life in 2010. If all this will lead me to suicide one day I will find him and kill myself in front of him. These doctors all over the world prescribing this **** should be tortured and beaten to death. My life will never be the same...Everyday I have pain, itch and burning sensation on my penis shaft skin. My sexlife is dead and all thoughts of sex is combined with thoughts of pain.
I often pray that I will die in my sleep
But as far as it comes to find something magic that will thicken the skin again back to normal...I mean just give it up please...I still see this debates and conversations all over the internet in different forums like these.
My doctor said she will prescribe me all these meds and let me trial and error on myself to see if the pain will ease. So far I haven´t tried anything more than the antibiotics I told you about. I will try lyrica, cymbalta, protopic and everything else under the sun...2017 will be another year down here in hell due to the doctor that destroyed my life in 2010. If all this will lead me to suicide one day I will find him and kill myself in front of him. These doctors all over the world prescribing this **** should be tortured and beaten to death. My life will never be the same...Everyday I have pain, itch and burning sensation on my penis shaft skin. My sexlife is dead and all thoughts of sex is combined with thoughts of pain.
I often pray that I will die in my sleep
Dermal atrophy secondary to potent steroid use can be permanent. It is a good idea never to use potent steroid creams or ointments for more than 7 days at a time.
While mild atrophy and telangiectasia might be reversible upon discontinuation of corticosteroids, overtly visible changes in skin texture and striae are considered permanent manifestations of corticosteroid-induced atrophy and are resistant to treatment.
The therapeutic effects of topical steroids can be negated by the resulting thinning of the stratum corneum. Such thinning impairs its barrier function and allows transepidermal water loss that can lead to skin irritation.
Sometimes, the visible and textural changes to the skin are described as looking like “cigarette paper.” The skin thins because of decreased production of fibroblasts and abnormal deposition of collagen and elastin. Loss of hyaluronic acid leads to decreased retention of dermal moisture.
The structural changes and the signs and symptoms of chronologically aged skin and those of corticosteroid induced chronic atrophy of the skin are partially very similar. Thinning of epidermis and laxity as well as dryness, purpura and echymoses occur in both conditions. However, in chronologically aged skin striae are not observed, while in corticosteroid atrophy premalignant or malignant tumours are seldom observed.
While mild atrophy and telangiectasia might be reversible upon discontinuation of corticosteroids, overtly visible changes in skin texture and striae are considered permanent manifestations of corticosteroid-induced atrophy and are resistant to treatment.
The therapeutic effects of topical steroids can be negated by the resulting thinning of the stratum corneum. Such thinning impairs its barrier function and allows transepidermal water loss that can lead to skin irritation.
Sometimes, the visible and textural changes to the skin are described as looking like “cigarette paper.” The skin thins because of decreased production of fibroblasts and abnormal deposition of collagen and elastin. Loss of hyaluronic acid leads to decreased retention of dermal moisture.
The structural changes and the signs and symptoms of chronologically aged skin and those of corticosteroid induced chronic atrophy of the skin are partially very similar. Thinning of epidermis and laxity as well as dryness, purpura and echymoses occur in both conditions. However, in chronologically aged skin striae are not observed, while in corticosteroid atrophy premalignant or malignant tumours are seldom observed.
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