Resolved question:
All my life I have suffered from dry skin all over my body. This in result has given me what you could say: old man hands. Therefore, I am forced to moisturize every day to get relief from it and many of times I have tried steroid creams and other products that gave no greater relief. I am a 17 year old male. At 14 I was diagnosed with rheumatoid arhtiritus. I am on medication called methotrexate which I take once a week, and humira which I inject every second week. I frequently get bad nose problems which make it become very agitated and runny. This, a lot of the time, comes with cold sores which I am renound for amongst my friends. When I get run down like this I turn into a kind of zombie! I have always been the kind who gets little sleep (sleep in fragments) and who always seems to be tired; not so tired that I would fall asleep at any given time, but I would never really feel 100%. Over the last 2 years I have began to notice a lot of grey hairs which I try to pluck out but can't ever seem to get all of them and are evident in my jet black hair. Also my hair is starting to thin by the hairline. I have always been extremely outgoing and sporty: I play soccer and football. But since I have began to take notice of all of these problems im having with my body, I have realised that i get an extremely red face and sometimes heartburn when training. I occasionally get heartburn at home too.
I am lately extremely depressed. I have always been very self conscious due to my dry skin and that is foremost the hardest thing to live with every day of my life. About 100 times a day I would think about what it would be like to have normal skin that I wouldn't have to worry about. I have always been told by doctors that it's just unfortunate and nothing can be done, just moisturize. I constantly feel miserable and always feel like the most unhealthy person ever. My diet is good with the obvious addition of sweets and stuff but nothing dramatic and I have a good figure. Over the last month I have lost all motivation and I feel worthless, mainly due to acknowledging all the things wrong with me!
May I add that my father suffers from depression bi polar, similar skin problems (nowhere near as bad), diabetes, arthiritis. I have 5 siblings ( 2 brothers and twin sisters). One of my brothers and one of my sisters also have same skin problems as me, leaving the other brother and sister with normal skin.
I take cod liver oil, clonfolic acid (necessary for the meds I'm on) and have began taking centrum tablets each morning.I just want to find out if all of these things are symptoms to something wrong with me, as there is a lot of things wrong with me!! All in all I have come to a stage in life where I just need answers as to why I have all of these problems and not to be patronized and told nothing can be done.
Thanks. :)
Submitted:
4 Days
Category:
Family Physician-GP
Hello,
Thank you for choosing DoctorSpring.
I have gone through your query. I am sorry to hear about your concerns and I will try my best to help you here. Since this is an online consult without a face - face interaction I hope I would be able to give some objective recommendations without patronising !
1. The dry skin is a part of the disease (RA) manifestation. Although it can be well controlled, some amount of dry skin is always there. You should not keep worrying about it as it will only lower your self esteem and cause anxiety.
2. Again moisturise - I know you might have heard it a lot of times, but this is the most important factor (especially in long term). Use them immediately after bath. Try to bath twice a day. Apply it immediately. You can use simple and un complicated lotions like Vaseline. DO a trial and error.
3. Discuss with your Doctor regarding the RA treatment. The disease activity has to be completely suppressed. This will have an effect in your skin and hair. Consider Prednisolone low dose.
4. Prefer whole food, fruits and vegetables over supplements.
5. De-worm . Take an anti helminthic medicine like Albendazole in consult with your Doctor. This will improve your nutritional status.
6. Try retinoid /Vitamin E based creams in consult with your Dermatologist.
7. Aerobic Exercise (without direct exposure to sunglight)
8. A Psychiatric evaluation ( very important) . There might be a masked underlying depressive disorder. Kindly get an evaluation
Sorry if I am being blunt. You should be glad that you are able to maintain a healthy lifestyle even if you have RA. Focus on the positives , get motivated and get set for higher purpose in life.
Hope this helps
Please feel free to ask followups
I also want to note that I have had the dry skin before I started medication (all my life), and that my brother, 19 (older), was diagnosed with RA around the same time I was and he has normal skin. So is my Dry skin definitely a part of my RA?
With regards to point 1- When you say my RA can be well controlled, do you mean that my RA is controlled well at the moment or that it could be controlled better? Is there a way of treating it which will make my skin better than it is now? I know this isn't one to one so it's hard to tell but it helps to get good knowledge of what's wrong.
Point 3- What exactly should I discuss with my doctor over it? Will the RA uncontrollably have effect on my hair and skin?
Point 5- Is the medicine you mention here a once off thing or is it a course of medication?
Lastly, do you think that my problems are all in conjunction with my RA?
Yes, it think unless ruled out otherwise it is prudent to consider the skin manifestation in conjunction with RA. Individuals can have varying manifestation of the disease. Ref : http://www.ncbi.nlm.nih.gov/pubmed/16021111
The disease activity should be assessed. You can discuss about the skin dryness and possible treatment additions for this. Predinisolone is a steriod and yes its a long term treatment. Another possibility is a associated Rheumatic disease like Xerostromia. This should be also considered. (to be discussed with your Rheumatologist_)
Hope this helps
Thank you