Cortisone and Skin Damage

[Forest Walker]

In April 2021, I began using Augmented Betamethasone 0.05%, Desonide Ointment 0.05%, and over the counter cortisone cream.  My dermatologist told me the rashes could take months to heal.  His prescription included 11 refills of each.  The visit notes said to use sparingly twice a day as long as rash was present and that thinning skin could develop.  But there were no specifics as to amount to apply or duration of usage.  

April--started liberally using steroid ointments
August 25--quit using steroid ointments due to bleeding
August 31--resumed using steroid ointments & found Psoriasis Club
September 1--quit using steroid ointments
Began coconut oil, started a food diary and altered diet
September 16--resumed using steroid ointments

I'm going to continue reducing and eliminating possible dietary triggers, continue using the lovely unrefined coconut oil daily, and use the ointments twice daily for a week and then begin a tapering.  But I'm applying the steroid ointment only to rashes from knees to toes and not those on my thighs.  I'll use over the counter cortisone cream on genitals.

I just couldn't take it.  As tough as I think I am, the rashes on my lower legs won this battle to stop using steroids.  I hope that the ointments will quiet them down and that dietary changes will help.  It makes sense to me that if alcohol can make this worse, then other foods may as well.  

It really hurt to skate this week.  And I found that while standing, the rashes on the lower legs hurt.  If I reclined, the soreness subsided.  I wonder, too, if poor circulation or gravity cause the pain.  Last night, the tops of my feet were burning, and that's when I decided to resume the ointments.

Thanks for reading.  Have you all been through a similar struggle with topical steroids?  Have they helped you?  What was your history with them?  How long were you on them before using an oral or injectable therapy?

[Caroline]

Hi Forest,

Your psoriasis is in a very active state.

Can’t tell you about my struggle with psoriasis, as it is a very different one. I am the exception who only has Psoriatic Arthritis. 

I started with MTX, which I left again very quickly, after that I tried many many things in the alternative corner, with differing results, from nothing to amazingly spectacular but short living. These experiences are spread over the forum in different posts.
Finally found DMF, also reporting spread all over the forum.

[KatT]

Hi Forest 

I was prescribed Dovobet and something for the scalp in 2006 but gave them up after 2 months.

1. Had too many plaques
2. Knew the side effects 
3. What was prescribed for my scalp made my hair greasy

That being said, since March, my psoriasis came back with a vengeance and I will discuss with my GP what we can do.  She's probably going to send me to a dermatologist.

[Forest Walker]

Thanks, Caroline and KatT. 

[Forest Walker]

After using the topical steroids twice a day (as lightly as I can) for four days, the pain in the spots on the legs has stopped.  The skating boot is still uncomfortable, but it's no longer so painful to skate.  I know this is not a cure.

How long can I use this?  Should I plan on just 7 days and then begin a tapering off, having quieted the worst of it?   Or is it okay to maybe continue for closer to two weeks and then taper off?  

Meanwhile, continuing to use the coconut oil, make dietary changes, and craving the sugar of my olden days.  

[Forest Walker]

After a week of applying the topical steroids twice a day, I reduced application to once a day and upon fewer rashes.  This lasted only three days until I went back to applying twice a day, yesterday.  The patches had returned to painful and textured.  I felt discouraged, hoping that the dietary changes would make a bigger difference.  

It's been three weeks without gluten and with added sugar only in my coffee twice a day (but a rare indulgence in ice cream and then baking a GF dessert and eating it twice).  I'm using dairy only as yogurt and cream in my coffee (and the ice cream).  Alan's experience of clearing his skin through diet still inspires but this isn't fun and it's difficult.