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Author Topic: Dermatitis - what next ?  (Read 4131 times)

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Offline Zohar

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Dermatitis - what next ?
« on: March 01, 2011, 02:54:38 PM »
I was diagnosed with dermatitis last year and prescribed Daktacort cream (active ingredients: miconazole and hydrocortisone). For a while, this helped to reduce the inflammation but of late, it doesn't seem to make any difference.

I now wash only with water, but even this seems to cause some redness.

Are there any other dermatitis treatments I should be discussing with my doctor? Or any non-prescription options I could try?

For information:

Current CD4 count:400
Current viral load: undetectable
''Poor is the man whose pleasures depend on the permission of another.''

Offline newt

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Re: Dermatitis - what next ?
« Reply #1 on: March 01, 2011, 03:25:03 PM »
The hydrocortisone will only have a time-limited effect. There are other treatments if this hasn't worked, something to discuss with doc.

- matt
"The object is to be a well patient, not a good patient"

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #2 on: March 01, 2011, 05:51:14 PM »
The hydrocortisone will only have a time-limited effect. There are other treatments if this hasn't worked, something to discuss with doc.

- matt


Have you used any of these other treatments?

I've just remembered I was also given Diprobase, an emlolient with no active ingredients, but a) it didn't seem to make any diference and b) I found it so greasily sticky, that I had to abandon using it after a few weeks.
''Poor is the man whose pleasures depend on the permission of another.''

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #3 on: March 01, 2011, 05:54:03 PM »
Also, does anyone know of any non-steroidal treatments? I'm wary about using steroid creams for any length of time.
''Poor is the man whose pleasures depend on the permission of another.''

Offline Inchlingblue

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Re: Dermatitis - what next ?
« Reply #4 on: March 02, 2011, 08:20:27 AM »
Depending what part of the body, Calmoseptine works very well (can be sticky though).

When I had a rash, I was initially prescribed something with cortisone that did not work at all. I went back and was prescribed something else, with no cortisone and it worked great, the rash never returned.  I have to look it up and get back to you because I don't remember the name.
« Last Edit: March 02, 2011, 08:30:30 AM by Inchlingblue »

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #5 on: March 02, 2011, 09:50:13 AM »
Depending what part of the body, Calmoseptine works very well (can be sticky though).

When I had a rash, I was initially prescribed something with cortisone that did not work at all. I went back and was prescribed something else, with no cortisone and it worked great, the rash never returned.  I have to look it up and get back to you because I don't remember the name.

It's for my face, so I'd like to avoid anything too sticky.

Would be much obliged if you can find out what you were prescribed.

Thanks.
''Poor is the man whose pleasures depend on the permission of another.''

Offline denb45

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Re: Dermatitis - what next ?
« Reply #6 on: March 02, 2011, 09:57:56 AM »
I get this on my hands and legs  ??? and I can tell you it's fucking annoying too, it's a lot worse in the summer time, but usually go's away over time..Zinc Oxide works best for me, but, I'm not sure if you can put that on your face tho, check w/ your doctor or dermatologist about that  ;)
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline newt

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Re: Dermatitis - what next ?
« Reply #7 on: March 02, 2011, 06:43:27 PM »
For me, eventually, E45 cream (paraffin and lanolin) cream worked. Took ages to get over the steroid cream though, kept flaring back up.  It really depends on you, how you get on with different options, the type of dermatitis and whether this gets infected or not (in which cae, antibiotics to start). - matt
"The object is to be a well patient, not a good patient"

Offline Inchlingblue

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Re: Dermatitis - what next ?
« Reply #8 on: March 02, 2011, 09:02:50 PM »
I looked it up and I guess in my case it was fungal because the cream that did the trick is called Ketaconazole (2%), which is an anti-fungal.

If it's dermatitis that is not fungal I highly recommend Calmoseptine, which is available without a Rx.

Offline northernguy

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Re: Dermatitis - what next ?
« Reply #9 on: March 03, 2011, 03:06:39 AM »
It's for my face, so I'd like to avoid anything too sticky.

Would be much obliged if you can find out what you were prescribed.

Thanks.

Ask your doc about Elidel or Protopic, topical immune modulators.
Apr 28/06 cd4 600 vl 10,600 cd% 25
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Offline denb45

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Re: Dermatitis - what next ?
« Reply #10 on: March 03, 2011, 09:52:52 AM »
I looked it up and I guess in my case it was fungal because the cream that did the trick is called Ketaconazole (2%), which is an anti-fungal.

If it's dermatitis that is not fungal I highly recommend Calmoseptine, which is available without a Rx.

I think I may have a tube of Ketaconazole (2%)  laying around in the medicine cab somewhere, great stuff, and it works too  ;)
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #11 on: March 03, 2011, 10:24:52 AM »
My doctor seems to think that it's not fungal, although he didn't say what that opinion was based on. I've now been referred to a dermatologist, so am going to have put up with my poor skin until my appointment comes through, possibly in a month or so.
''Poor is the man whose pleasures depend on the permission of another.''

Offline Billy B

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Re: Dermatitis - what next ?
« Reply #12 on: March 03, 2011, 02:16:20 PM »
I actually found a product "Avalon Organics' Essential Lift with Minerals". It is a firming moisturizer with a SPF of 15. It contains 8.5% Zinc Oxide as the sunscreen and cleared my face up quickly. Their site is Avalonorganics.com. They have a lot of products so search for the one with the sunscreen.
Billy
VL 4420 CD4 340 CD4% 24   3/15/10 Started I&T
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VL  UD   CD4 390 CD4% 32.3 03/14/13

Offline Inchlingblue

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Re: Dermatitis - what next ?
« Reply #13 on: March 03, 2011, 09:57:52 PM »
My doctor seems to think that it's not fungal, although he didn't say what that opinion was based on. I've now been referred to a dermatologist, so am going to have put up with my poor skin until my appointment comes through, possibly in a month or so.


If you have to wait a month you really should try Calmoseptine, it's available w/o a Rx and it's amazing.


It's also very good for use on (in?) the butt.

Check out the reviews:

http://www.amazon.com/Calmoseptine-Ointment-2-5-Jar-Each/dp/B000GCHKKK


Of course if the issue ends up being fungal then only an anti-fungal will work but if you have to wait a month this is worth a try.
« Last Edit: March 03, 2011, 10:00:07 PM by Inchlingblue »

BobF

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Re: Dermatitis - what next ?
« Reply #14 on: March 04, 2011, 12:23:07 AM »
Yep, the ketaconazole cream works great for me as well, tho the condition recurs regularly  ::)


I looked it up and I guess in my case it was fungal because the cream that did the trick is called Ketaconazole (2%), which is an anti-fungal.

If it's dermatitis that is not fungal I highly recommend Calmoseptine, which is available without a Rx.

Offline seriously

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Re: Dermatitis - what next ?
« Reply #15 on: March 05, 2011, 01:51:38 AM »
I looked it up and I guess in my case it was fungal because the cream that did the trick is called Ketaconazole (2%), which is an anti-fungal.

If it's dermatitis that is not fungal I highly recommend Calmoseptine, which is available without a Rx.

I've had issues with dermatitis on my face for 10+ years, and  I've been using ketoconazole 2% cream as needed for the last 5-- the way my derm explained it to me is that yes, it is an anti-fungal, but it also has strong anti-inflammatory properties. [The wikipedia page (not that that is necessarily authoritative) also claims that ketoconazole has direct anti-inflammatory properties.]
Something to ask your dr about for sure-- for me it has worked great-- if I feel my face is becoming irritated I start applying it in the mornings, and usually im back to normal the following day.

Infected 7/25/03
In denial until 12/1/10
12/7/10 CD4 160 VL 456k
12/18/10 Started Isentress/Truvada
...
12/12/13 CD4 456 VL <20

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #16 on: March 26, 2011, 06:45:41 AM »
I haven't been able to get hold of Calmoseptine but have been using Sudocreme which also contains zinc. At first it seemed to help, but now the dermatitis is worse than ever. It's ironic that my immune system is better than it's been in a long time and yet my recently flawless skin is now a complete mess.

I had to put off a date this weekend because my skin is so bad and now the guy has told me to 'forget it'. This sucks BIG time and is making me extremely depressed.
''Poor is the man whose pleasures depend on the permission of another.''

Online mecch

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Re: Dermatitis - what next ?
« Reply #17 on: March 26, 2011, 07:22:55 AM »
Go to a dermatologist and ask for creams, soap, and shampoo that will work for you.  Don't stay on anything with cortisone for very long.  If you get casual prescripts for cortisone, think about changing doctors. 

I have found that the creams and treatment is different in Switzerland than in the US, so the solution may depend on your locale and your doctor.  If the creams are not working you need to go back to the dermatologist and insist on trying others until you get one that works. 

My experience is that the skin is the biggest organ and I have to take time and effort to get solutions.

“From each, according to his ability; to each, according to his need” 1875 K Marx

Online mecch

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Re: Dermatitis - what next ?
« Reply #18 on: March 26, 2011, 07:27:10 AM »
Also, its a vicious circle. People with reactive sensitive skin get more problems, which cause both physical and psychological suffering, creating anxiety, which causes more reaction.

Also - if you are new to haart you can get immune reconstitution reactions on your skin. 

I had one weird skin reaction after another when I went on HAART and a lot of the treatments were just calming not curative.  I think time was curative. And calming down. 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #19 on: March 26, 2011, 08:04:45 AM »
I have an appointment to see the dermotoolgist at the beginning of April. I've already tried a steroid cream which worked for a couple of months and then began to fail. Subsequently I read in other forums about dermatitis that you NEVER use them as they can damage the skin's immune system and can take forever to recover from. Wish I'd known that at the time, although I only ever used them very sparingly and not even every week.

I do try not to stress about it too much and actually had a period of not checking my skin in the mirror for days on end so wasn't even really thinking about it too much, but then when I had to ie to shave, it would be worse than before, and certainly no improvement.

I've been on my current regime since July of last year and my CD4 count is now 450 so I would have that those facts would rule out immune reconstitution.
''Poor is the man whose pleasures depend on the permission of another.''

Offline Imfree76

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Re: Dermatitis - what next ?
« Reply #20 on: April 19, 2011, 08:37:08 PM »
My Dermatologist put me on ProTopic for my dermatitis outbreaks.  I have been using it daily though I shouldn't use it every day.

Another RX that I was on for my dermatitis that has worked well was Desonide Lotion


Hope this helps
John G

Offline Tempeboy

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Re: Dermatitis - what next ?
« Reply #21 on: April 30, 2011, 09:26:19 AM »
Hey Zohar,

What medications and/or supplements do you take?  What sort of complexion do you have and are you allergic to anything?

Cheers

TB
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #22 on: May 01, 2011, 11:02:10 PM »
I've now seen the dermatologist.  He prescribed a cortisone cream. When I questioned this he was absolutely adamant that they were safe and went into wearied detail about how he always has to 'correct' medical students when they bring up the dangers of steroid creams. So, I wasn't particularly happy about being given a script for steroids but there wasn't much else I could do.

To the person who said if I should change my doctor if given cortisone, it's not really that easy to do, as you have to get a referral from your HIV doctor, and the dermatologist also specialises in immunology. Basically, he's the dermatolgist I will be referred to as long as I'm with my HIV clinic.

He did however also prescribe Protopic. So, I followed his instructions to use the steroid cream for a week or so and then switch to Protopic. My skin has really cleared up but I notice that if I stop the treatments for a few days it does start to flare again, though not as bad as before. I've heard that for some people Protopic stops working, so I'm really hoping that doesn't happen to me.

What medications and/or supplements do you take?  What sort of complexion do you have and are you allergic to anything?


I'm taking Darunavir, Norvir and Truvada, and I also take multivitamins, high does Vit D, zinc and selenium. My complexion is sort of caramel colour (think Chris Brown!), and my only allergy is to the antibiotioc erythromycin.
« Last Edit: May 01, 2011, 11:11:51 PM by Zohar »
''Poor is the man whose pleasures depend on the permission of another.''

Offline newt

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Re: Dermatitis - what next ?
« Reply #23 on: May 02, 2011, 04:06:50 AM »
Erm, Protopic is generally not recommended in people allergic to erythromycin and other macrolide antibiotics. However, this is probably a question of degree. It's one thing to bung tablets down your throat with loads of active ingredient and another to put cream on your skin.

I can also say from personal experience Protopic makes you more sensitive to sunlight.

Good luck.

- matt
"The object is to be a well patient, not a good patient"

Offline Zohar

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Re: Dermatitis - what next ?
« Reply #24 on: May 02, 2011, 05:19:17 AM »
Erm, Protopic is generally not recommended in people allergic to erythromycin and other macrolide antibiotics. However, this is probably a question of degree. It's one thing to bung tablets down your throat with loads of active ingredient and another to put cream on your skin.

I can also say from personal experience Protopic makes you more sensitive to sunlight.

Good luck.

- matt


I did tell the doctor about my allergy so presumably he didn't see it as much of a risk.  I always try and stay out of the sunlight anyway, so not concerned about that aspect of the treatment.
''Poor is the man whose pleasures depend on the permission of another.''

 


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