Prednisolone withdrawal - skin rash

I have been taking Prednisolone at varying doses for pretty much the last 12 months, i was initially waiting for surgery on nasal polyps and taking steroids for a prolonged period of time, after the surgery I was prescribed a heavy course again by the surgeon.

Since the surgery I have had problems with nasal polyps again and have now been back on them for about 5 months solid.  I recently stopped taking them, within 48 hours I was very ill, flu like symptoms sleeping for 14 hour periods.  when I woke up on day two I was covered from head to toe in a lumpy rash, this disipated within 24 hours.  Since then I have been back on steroids for a short sharp course lasting almost two weeks.   This course ended on Friday, I now have a skin rash mainky on my legs and arms, I do not feel ill and have no other real symptoms other than some aches and pains.

I wondered if anyone else has experience with skin rashes after using oral prednisolone.

Thanks

 

Hi yes I have, some people are more sensitive than others so you may need to come off steroids slower than other people, reducing over a longer period of time 20,10,5g etc.. You should never just stop medication straight away, you should reduce slowly to allow your body to adapt. The ski rash could be a side affect of the sudden change. Hope this helps.

Hi Cathy thanks for the reply, so just to confirm you have had experience with skin rashes when finishing a course of steroids?

Just to clarify, this second time around I have tapered down I was on 30mg for 6 days then 25 for one day, 20 for one day, 15 for one day, etc etc.  But still two days later after my last tablet i have a skin rash again.

Yes I had a rash during my reduction of steroids but it went a week after I had stopped. The rash got worse in the heat and when I had hot baths. So I was advised showers and a product like sanex that has no soaps to irrate it. It did work in the end. I still have to be careful as my skin is still sensitive as a result of being on and off Prednisalone since I was 14. I am now 28.

Hi Cathy again many thanks - I can't begin to imagine what it must be like to be on and off for such a  long period of time i thought that i was bad I have been on  and off since about the age of 25 I am now 34... (i had to think about that for a moment then).

This is the first time that i have experienced a skin rash.  It isnt itchy just red and blotchy, kind of like small red rings that join together.  it starts on the underside of my arms and then appears on my legs later on, it seems to be subsiding even now but i know that it will come back again.

many thanks for all of your help and advice, I will also try the sanex.

Hi mh91,

I have been on Prednisolone for 20 years due to a lung inflammation at the time.

just after I started, I developed a rash on my forehead, sometimes extending to either side of my nose. It is aggravated during hot weather, sweat, and hot showers, and I have been treating it with a 1% Sigmacort, a cortisone ointment.  It causes the rash to form pimples, which form scabs and drop off over 2-3 days.  I then get a week or so of almost normal skin on my forehead until the rash again returns. Two skin specialists that I have visited both suggest to continue, but use the ointment sparingly.

Because of the hotter temperatures in Australia, plus the fact that I play golf 3 times weekly, I have also found that 30+ Banana Boat sun cream lengthens the periods between rashes with great effect.  I am on 5mg daily, except for increases when I have the occasional adrenal crisis when I get a cold etc.

The above certainly works for me.

Hi Neil,

Thanks for your response, I have to say though unfortunatley we do not get weather over here that warrants sun cream that often.

Out of interest is it common to feel generally unwell for a week or so when you finish your course of steroids?

As well as the rash I just feel rough in general, sore throat muscle aches and just well like i have a cold or mild flu really?

Was the rash all over?

Mostly on face and upper body. 

Blotchy and stingy. 

Amy,

Not sure about theirs, but mine is anywhere I've scratched or has high friction. Currently inner thighs, chest, right leg, upper back. It was on my face the first time and I'm expecting it to come back. I've decided to stop taking my flovent(inhaled corticosteroid) because every time I forget to take it the rash flares up/re-appears. Not fun, especially since I felt way better before I started taking it...

Hi Jason. 

Sorry for late reply. 

Hurricane town over here. I am in a Floridasad

It's frustrating... prednisone withdrawal rash.  The Zyrtec seem to help but I had to stop due to racing heart. 

But any pressure on the area or scratch immed for me turns red. 

The face is def red and arms. Blotchy. 

And itchy.  Stingy too.  The heat from sun aggrevates it.  U can touch the skin and it will feel hot. 

Did you ever confirm w a doctor if this is from coming down from prednisone. 

Are you completely off? And how long did the rash last ?

I took oral cortisone for a month. I took it two weeks coming off the med. I have a itchy very aggravating rash. I tried all kinds of things and it will not go away. It has been 2 weeks of this. Called Dr. And was told it had nothing to do with what he was treating. If you or anyone can help please let me know. At this point I would try most anything. Thank you. Barbara

So here's the story: I was on Flovent and Zyrtec for about 4 or 5 weeks, then went on a vacation for a weekend and forgot to bring my meds, first day missed (of both) was Friday. Not knowing about the consequences, a rash started on the third day (Monday) and got fairly uncomfortable. Thinking it was an allergic reaction to something I restarted Zyrtec and benedryl, and thinking it could be bacterial related I didn't take my steroids (yes I now know I'm an idiot). By Wednesday part of my face was swollen (but hydrocortisone I picked up that night made it go away), by Thursday I couldn't cover the rash on either thigh with both hands. Friday sucked, I kept trying home remedies from the internet and everything failed. Saturday I called the military nurse advice line, and they said I need to see a doc within 8 hours. Being a weekend and my base having no minor emergency and only an ER, I went to the ER for a rash. There they gave me a methylprednisolone dose pack and said it was probably from stopping the Zyrtec (which I've done many times before, it doesn't do this) or coming into contact with poison ivy... When I was downtown in a major city all weekend... The dose pack (and restarting flovent) cleared everything up, but left me still itchy everywhere. Now a few weeks later(still itchy at this point), I forgot to take my flovent over a weekend again (sheer laziness, I kept talking the Zyrtec), and the rash started to return. Realizing the issue was flovent, I wanted to document the relapse but... I had a 5k in the morning so I took one more dose. This pattern of being off till the first signs of rash then taking one dose, and staying on Zyrtec, was enough to avoid a major rash the second time. In fact, the itchiness has almost completely gone away! Now that I know how to safely stop taking flovent, I'm more comfortable starting it again but haven't yet.

Sorry for such a long and indirect answer. The short version: it lasted till I took steroids again and the itching didn't stop till I weened myself off.

Uncertainty: the timeline I experienced almost exactly matches that of poison ivy, maybe I somehow came into contact with it. More experimentation is required.

Hello Amy and dJason, I too am in Florida and in the middle of an allergic reaction, but I am confused as I thought it was caused by the Prednisolone, am I now to understand Amy that you are saying the withdrawal causes the rash? Yesterday was my last day of the Prednislone pack, I also did a Prednisone pack before the Hurricane, (went through 36 hours with acute sciatica pain, no power, or ac) at first I thought it was a Heat Rash, was so focused on getting help for my Sciatica pain after the storm that I didn't deal with the rash except to put some aloe on it. The rash spread yesterday to my back and along the band of my underwear with red welts, the pain and itching was so bad we called the dr who recommended Benadryl which thankfully knocked me out! Back up this morning, same thing, itchy and red. So confused now, is it an allergic reaction or withdrawal, not sure how to deal...going to try and see a dermatologist next I guess...

Hello Barbara, I am in the same position, I find washing with warm soapy water then air drying and putting calamine lotion has given me a lot of relief, I also got a perscription creme and took Benadryl last night which stopped the itching, still searching for cause, I thought it was an allergic reaction to the steroids but now am thinking it is withdrawal from them. Have you found any solutions?

Hey Helene and Jason,

My story. 

I have been on and off prednisone for about a year. Due to joint pain. 

Finally did a epidural series. Which helped. At the time I did it. Was off the prednisone. But epidurals are prednisone. 

I would say It was almost 2 wks off the prednisone. I decided to go into a cryochamber to decr some of the back pain due to epidural. 

24-48 hrs late. Boom. Facial rash, and skin all over on fire. Stingy tender to touch like I went to the keys but didn't. 

It def was not a burn from the cryochamber. Per dermatologist. 

He put me on prednisone calmed it all down about 90%. The on the last day of the pill it went full blown again. 

So he put me on 3 wks worth. Ugg. 

Again helped but not fully. 

I am weaning off. As I wean off it seems to antagonize the rash.  It's feels like a all body heat and stingy. But obvious on my face and arms. Idk. 

Seeing a allergist to run blood work. He feels it's something I am allergic too. No infection noted in prior blood work. 

From my own personal research it said my symptoms could be a withdrawal. 

But when I ask the docs they didn't think so. 

So that's why I came here to see if anyone had had my situation. 

I live in south Florida too. 

Hi Helene1111, to add onto the discussions....  

I relocated from Australia to California and after a year developed a severe Poison Oak rash.  

The family Doctor prescription a week of oral cortisone, after stopping for a day my entire body broke out in a red skin rash on top of the Poison Oak rash.  I visited the Emergency and was informed early withdrawal symptoms from steroid and was prescribed further two weeks dose.   Once again, couple of days after completion of last dose the rash reappeared.  I have been off steroids for a week however after consuming food my body temperature rises and with a vengeance the red rash appears.  

In reading numerous forum posts on 'Prednisone - cortisone steroid', skin rash is a side effect of the steroid and could last up to two weeks.

Bathing in Colloidal Oatmeal and Ice packs are my relief options.  Benadryl and Calamine lotion was my go to for the Poison Oak rash. 

Hope that helps, happy to keep all informed.

 

Interesting! I noticed some small mosquito bite type red spots when weaning from about 10mg to 5mg. This was after I had first weaned from 50mg (Prednisolone prescribed for my PMR diagnosis) down to 10mg over a 6 month period of time.

I first had the red extremely itchy spots on my middle lower back. They then moved to my lower legs and lower arms. The lower back improved but the spots and resulting itch then moved up my legs to my thighs and arms up to my shoulders. This first occurred when I weaned from Pred. on the first attempt dropping quickly in 5mg doses from 50mg back to nothing within 6 months.

It has happened again even though I am reducing far more slowly in 1mg doses now over the same period of time.

I am currently on 4mg switching to 3mg slowly. The itch although still there has eased off quite a lot except that the red spots are still visible. When the itching hit me during my first attempt at weaning off the Pred., I suspected the itching as withdrawal symptoms then, but am reasonably satisfied that after suffering similar itching after my second attempt at withdrawal that the red spots with associated itching are caused by the withdrawal of Prednisolone

Any other thoughts?

Hi,  I have been taking high doses of prednisone and then lowered to a steady 10mg for over a year for asthma after a shoulder surgery. 

This is the second time I have experienced this rash. My legs look like diabetic legs (i do not have diabeties) and the itch and heat are unbearable. It has been a month and a half since I am off of it. It took a few weeks to get this bad and nothing I am doing is changing it. It is starting to spread to my hands upper legs at the underware band and my head and face have been itchy. 

I see my gp next week and am hoping she can help. I never thought to ask the allergist who has been treating the asthma.   Any thoughts are VERY much appreciated. 

Hi. I, too was on prednisone for just a month. I had a very high dose of 60 mg, tapered back slowly to start and then more quickly. Two days after ending I broke out in rash and now on day four, it’s worse. Arms, legs (inner thighs really bad) torso and now my face.  Does anyone have an idea as to how long this should last?  Is it a permanent issue that I’ll have to deal with or just temporary?

My doctor who treated me with the steroid said he’s never heard of this and seems to doubt it’s the steroids. He advised me to see dermatologist.  Thanks

Hello,

I strongly recommend that prednisone be avoided completely.

My neurologist insisted I take it for my approx 2 x yr allergy asthma since inhalers other than Advair cause my heart to race and my ins doesn't cover

Advair ($400 out of pocket) .

He prescribed it to "take 1 with flare up", then @ my follow-up a month later he asked if I was taking it daily and I told him that I didn't need it daily, he got upset and told me I had to take it every day.

When I asked him why he said it would prevent my ever having allergies again, that" it is perfectly safe, no side effects, that (he himself) and hundreds of other patients take it everyday and no tolerance could be built up".

My gut feeling was to not take it but he's an old experienced doctor so I ignored my inner knowing and my health, my life will never be the same again.

*Doctors get paid from the pharmaceutical companies for every prescription... And will not take accountability for misdiagnosis or damage to their patients health caused by their treatment. Ever.

Otherwise they face liability.

I've suffered with nearly every side-effect and I'm lucky to be alive. I had to call him/see him or other specialists @ least twice a month for nearly a year.

When the skin on my thumbs and fingers and fingernails kept coming off and my hands were swollen to twice their normal size I went to my primary care physician and he thought prednisone would make it better so he doubled the dose for one week. When I went to follow up with my neurologist and was explaining all of the side effects I was experiencing and showed him my hands and informed him that my primary care doctor increase the prednisone amount, my neurologist got very uptight and insisted that my PCP didn't know anything & that amount of Prednisone was too much and not safe so he told me to only take it for one week. After one more week I quit taking the prednisone and I noticed that my hands were healing. My neurologist called to see how I was doing and how much I was taking and I told him that I had quit taking it for a week he got very upset told me I couldn't do that but I had to keep taking it or my hands would get bad again so he put me on a double dose taking it 3 times a day! Immediately my hand swelled up and my skin and nails started coming off again. I spoke with my dermatologist he was shocked and horrified that I was on such a high dose of prednisone for so long and that it was definitely the cause of my issues but that my neurologist had to take me off of it since he had prescribed it. But my neurologist insisted that a dermatologist isn't a real doctor and didn't know what he was talking about and kept me on the high dose. After a few weeks I developed scurvy I had sudden very severe allergic reactions to Foods I've always eaten, I ended up in the emergency room twice became urinary incontinent. I've lost a significant amount of vision, I had severe insomnia sleeping only once every fourth day with high doses of sleeping pills and when I did sleep I had parasomnia which became very dangerous because I was using knives all night during my sleep. I became narcoleptic during the day etc etc. So I spoke with my neurologist last April and told him I wasn't taking prednisone anymore and he said okay.

A week later I had to go to the E.R. because I was so swollen my entire body I couldn't walk was having trouble breathing my heart was racing I was going into cardiac failure my doctor asked me how much prednisone I was taking and I reminded him that he had said I could quit, he turned pale and said that it could kill me to stop suddenly and that I better not tell the emergency room that he gave me permission to stop taking it or that he had verbally increased my dose( he'd even written himself prescriptions to bring prednisone to my house! But he would peel off the label.)

While I was in the emergency room talking with the doctors I looked up and saw him standing right outside of the room I was in watching me and pulled the doctors aside saying he was very concerned about me because I have epilepsy and I'm alone and I have a tendency to overdose! Out of fear due to their reaction and seeing him right there I told them that I had just stopped taking the medication. I was terrified!

I told him I felt I needed a new doctor and immediately he told me that I was driving illegally and I asked him why and he just looked at me with a warning look basically letting me know that he had the right to take my driving privilege away because I have epilepsy even though I am seizure free.

He wrote down in detail the dosage for me to taper off of prednisone and then called me after 2 weeks and asked me how much I was taking and I told him I was done then he increased the dose again and had me taper for two more weeks. Ever since then (June 2017)I have had terrible rash/eczema which started on my arms then my upper back and my hips then my lower back and anywhere clothing would rub against my skin.

I find it ironic that prednisone (steroids) cause this rash then they prescribe steroid cream to treat the rash however; because of the prednisone my body is steroid resistant and going through steroid withdrawal which causes the rash and the cream only worsens it!

I had to take a lot of Benadryl just to get some sleep about a month ago I was doing everything I could to figure out any type of relief because nothing the doctors recommended was working.

Then I remembered that 30 years ago when I started having psoriasis the treatment for psoriasis was to have sunlight or go to a tanning bed but too much sun can make it worse. I figured

It was worth a shot. I have avoided the Sun for 20 years but I was desperate so I went tanning once a week for 4 weeks and at first the stinging was worse so at home I just wore long sleeves and took Benadryl and after four visits my skin is still lumpy and rough and mildly itchy but the redness and the sores and the severe itch and burning are gone! The only place I still have a rash is my forearms :-)

The one thing that worked best once I started tanning was aloe vera gel. It's the only thing that's provided any relief. When I got tennis elbow a few months back because- I get every injury very easily now because my body is so weak and from the prednisone that I finally had a cortisone steroid shot in my elbow which caused the rash to worsen.

One thing I realized and get to remember is that these prescription drugs are made of toxic chemicals they are not often invented to improve health but to increase scientific discovery and wealth for the scientific and medical community.

Their focus is to keep people on prescription medications so it worked perfectly for them to give steroids to make us need steroids to treat the side effects of the steroids!