AsthmaAsthma EducationSevere asthmaSteroids ( prednisone)

Prednisone Skin

Just one of the many joys of taking prednisone.

I know chronic steroid use can cause paper thin skin ( what we call “crepe paper” skin in the biz), which then makes you more susceptible to spontaneous bruising, but Ive noticed lately that if I brush up against almost any surface, no matter how gently, that my skin will actually tear open. Even wearing a long sleeve shirt or sweater causes my skin to bruise up like a ripe banana. The medical term for this condition is Actinic Purpura. It’s actually pretty common benign skin disorder seen mostly in older folks from years of sun exposure and/or individuals who have been on prednisone or inhaled steroids for a long time. The tiny capillaries under the skin become leaky and fragile and bruising can occur almost spontaneously.

Well, a few days ago I was standing in line at a grocery store waiting to checkout, when a women behind me says hysterically… sir sir you’re bleeding!!! I looked down and my forearm was dripping blood like crazy from 3 different places. It was like someone sliced me with a razor. There was actually a puddle of blood forming on the floor and the clerk had to call for someone to clean it up. I must have accidentally brushed my arm up against something on the counter? Ive had small cuts and scratches that I wasnt aware of that bled a little, but nothing like this. How embarrassing. And to he totally honest, a little disconcerting.

I guess this shouldn’t come as a total surprise. I taken prednisone pretty much my entire life ( plus Im out in the sun a lot), but for the past 10 years Ive only been on burst therapy a few times a year for maybe 3-4 weeks at a time, so I figured my risk for this type of side effect was substantially reduced. Ah, but according to Dr Wenzel, there’s also have a cumulative effect where in the longer you’ve been on the drug, even if it’s only intermittently, the more likely you are to develop these kinds of problems. Luckily, bleeding from the skin is more scary looking than dangerous, as superficial skin cuts tend to clot over pretty quickly. But still, does this mean that that I gotta be on guard now every time I’m in a public place so that I dont accidentally bleed on someone? It’s always something.

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( Notice the reddish blotches and scratches? That’s from simply leaning against something.)

Anyone else have this problem?

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22 thoughts on “Prednisone Skin

  1. Hey Steve,

    I find my skin cuts a lot easier but no as easily as your saying. The main thing I find is the bruising. I can get bruises from lying with my legs crossed for a prolonged period of time or leaning too long . I look like someone had beaten me up sometimes!! I also find I get blisters really easily I think it’s to do with the skin thinning and everything takes forever to heal too!! Hope your well and don’t get too many more cuts and scratches xx

    1. It’s odd that you’re getting bruising on your legs, as the skin on your legs is generally thicker than the skin on your arms.
      I think age has a lot to do with it as well. The older you get, the easier you bruise. Add steroids to the mix and you get bruising AND bleeding. It’s always something.

      1. Not true. I had severe bruising on my legs in my mid 20’s. I’m down to 5mg now so the bruising is much better.

  2. I’ve never heard of this. That is a very scary thing in my opinion to be always on the look out so you don’t get cut or bruised. I have eczema, so rubbing and sweating causes irritation, but nothing like this. Hope you are ok Steve!

    1. Hi Justin,

      My Mom has psoriasis and gout, she’s had an awful time with it.

      The prednisone skin thing is pretty common in steroid dependent asthmatics . Like with other skin conditions, it tends to be more severe in older people. Its just weird to me that you can bruise or bleed all over the place and not even know it.

  3. I get big bruises and cuts and don’t even notice until someone points it out. I work in healthcare and noticed folks with a history of prednisone use get it too, so I assumed that’s where it was from. My allergist for years has said the same thing that Dr. Wenzel said, his concern is with the long term cumulative effect of prednisone even though I take it in bursts. He doesn’t like the frequency of bursts and says the controllers aren’t holding me as good as they should and he doesn’t like the amount of prednisone it takes to turn things around. But I just look at him, shrug my shoulders and say I already do all I can, so what does he want me to do? He says he doesn’t know what is going on, but it’s the best medicine available, so told me that he expects either the asthma will get me or the prednisone will and it’s just a matter of which one gets to me first. So, that’s life…it is what it is. I don’t know what helps the bruising and cuts. I only know that I have eczema and I moisturize the skin after bathing and that seems to help the itching problem a lot.

  4. I came across this site while researching my issue. I’ve been on prednisone only for about 4 months. I did a 2 week pack and then my doc has kept me on 10mg for about 3 months, to end next month.

    I’ve had 4 instances of glancing down and finding my leg (always one of my legs) bleeding and I don’t recall a bump, hit, or anything. I don’t even see a cut but I’m bleeding a lot. I assume it’s from the steroid?

  5. Some good news. I have learned I bump into things more when I’m tired, so I have to take care of my need for sleep. My skin tears dropped about make 80% after I was diagnosed with sleep apnea and started using a CPAP every night. I also learned to make it harder to bump into things. For instance, I have two medium-sized plastic wastebaskets on both sides of the corner of my bed platform. That corner was responsible for half my skin tears. No more.

    Finally, my pharmacist tipped me off to Amlactin. Over time it actually thickens the skin while moisturizing. I use it on my lower legs and forearms. I have also found that Gold Bond Ultimate Diabetics’dry skin relief hand cream thickens the skin. I’m not diabetic. Just figured that I needed a drastic solution.

    After years of monthly emergency room trips for major skin tears from minor bumps, I can’t remember my last skin tear.

  6. I have had the same problem for the past 4 months. I’ve done two bursts of prednisone, one a few months ago, and I’m on one now. I bleed at the drop of a hat.
    It’s extremely frustrating. I had a bad skin rash and the first round knocked it out fast. This round hasn’t seemed to do anything. I’m now getting checked for Celiac’s disease? I’ve been to a dermatologist 5 time, and allergists 2 times then back to my PCP. I think Im just going to stop taking this stuff?

  7. I don’t seem to bruise any easier but tears are the worst, especially in delicate areas. I was prescribed one Zpack for a lung infection and I’m sure it actually saved my life but since coming off the Prednisone I’ve been dealing with so many other “left over” side effects that I’m embarrassed to even admit.
    Thinning of delicate tissues making daily life so painful, temporarily blurred/double vision, loss of apatite, “fuzzy brain” and the feeling like my muscles are made of lead. Just getting up from a chair or my bed is a chore, walking is laborious. I just feel like I have a 300# gorilla on my back.
    It’s effecting my daily life, my work, my ability to even take care of myself…which is all leading to dealing with renewed depression I’d finally gotten under control before getting sick.

    1. This doesn’t sound like prednisone side effectd or after effects..
      Perhaps see a rheumatologist and check if you have an auto immune disease.

  8. Thanks for your blog. I am 58 and have had lifelong severe spring fall allergies that manifest themselves through lung inflammation. Every spring and fall I do 2-4 rounds of steroids. I am also on inhaled steroids LABA. I kept wondering why I was bruising and my skin would tear like paper.
    I have not been intubated yet but I am sure it is in my future. My lung function is now 30% and we are looking down the road at transplant.
    In 2011 I was diagnosed Celiac and now know I have had that all my life just never knew it. It makes me wonder if it was not the culprit in all this.
    It is a pretty hard reality for someone who ran, hiked, climbed, mountain biked, road biked, cross country skied, 2nd-degree blackbelt…..I think those things may actually be working against me now as I push through pain and poor breathing which probably is not helping my heart. Although I am on O2 I still try to work around the house, do home repairs , paint…. It does take me much longer these days but it keeps me sane and focused on something constructive. I retired at 50 thinking I would have a short life so I may as well enjoy a few years.
    It is odd, I go through all the stages of loss and grief. My periods of acceptance are getting much longer before I have to cycle through it all again.
    If nothing else it does make a bit stronger in some ways.

    1. Hi, Greg, I’m Carol and I’ve been diagnosed with moderate COPD. I lived in Boston my entire life, until 4 years ago, when I moved to South Carolina. The weather was extreme in New England, you never know…Like Mark Twain said, if you don’t like the weather in New England, wait a minute!! But, South Carolina is extreme in the heat and humidity, which is not good for my COPD. I never had symptoms or episodes until I moved here. I like South Carolina, but I have to be careful. I’ve had to rethink the ways in which I do things to avoid the hot, midday sun. I love to garden, and am slowly trying to replant around my home. I go out in the early morning or evening. It’s a lot cooler when the sun goes down. I have oxygen and a nebulizer, which I use 3 or 4 times a day, depending on how good or bad I’m doing. I have a rescue inhaler and one I take once a day. I’ve been hospitalized 4 times in 4 years, but I’ve got it pretty well under control. The other hard part about moving here was having seen my doctor for well over 20 years, I was lost without her!! I had to search really hard for a doctor who could help me and treat my COPD as well as my depression. I’m finally on the right meds, have a doctor whom I trust and I’m feeling better about myself. It’s easy to beat yourself up, Oh if I did this or that, I maybe wouldn’t be sick, etc. I had to stop that too. I try to take things as they come and not think to far ahead. I don’t get upset about the small stuff anymore. I have so much I want to do and I’m going to explore South Carolina, take a vacation with my daughter and her fiancé, and so I just wanted to say your not alone, I know how you feel and it can be lonely too at times, people close to me sometimes don’t get what I’m going through. “You look fine, you don’t look sick” or the other one that kills me is that “I sit around a lot so I’m lazy” If I don’t feel well, I do take it easy and if that makes me lazy, well so be it. I don’t care what other people think anymore, I do my own thing. If you ever need someone to talk too, I’m a good listener and a good empathizer too, lol. Take care and let me know how you’re doing. You sound like a fighter, so don’t give up, we are stronger than we realize.

      1. :Greg and Carol, I too have been diagnosed with moderate copd, and use prednisone daily with several tapers a year.After reading your’s and Greg’s posts, I just wanted to introduce myself and say thanks for writing about it, I suffer from depression, and at times I am pretty hard on myself. I live near Boston, in Wakefield, and I am 61 I just wanted to tell you that I like your attitude, and I enjoyed Your’s and Greg’s posts very much. Good luck this spring with handling the asthma and COPD.

  9. Hello Stephen,

    I am Carmen from Queensland, Australia, have always been a bit unfit, but after a motor vehicle accident 5 years ago where I was in bed, for 3 months, have now been diagnosed with severe Emphysema, however I have also had Crohns Disease, taking a lot of Prednisone 20 years ago, play Lawn bowls and have shocking thin bruising, tearing thin skin, that becomes easily infected, also have just found out I have Kidney disease with shrunken kidneys and cysts, so am not having much meat and have cut out salt, I have also read that Kidney disease can cause breathlessness, I can put up with everything else I have except the severe breathlessness. I have a burning throat all the time and severe heartburn.

  10. Have any of you heard or are you aware if your skin becomes better if you stop taking prednisone? I have been using it for about 5 years now. Only 1mg the past year or more. I’m in my 50’s and my skin on my arms and legs look like that of a 80 year old.

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