InSKINcurities: Steroids and Antidepressants

Dear Melancholy,

Dealing with skin disruptions and disorders can be quite a bit to handle. And honestly, if your condition becomes chronic, it can have long term effects on your self-image, your self-esteem, your mood.

Friends and family member may become concerned. Someone may even consider  antidepressants to cope with your mood, which probably fluctuates as often as your skin does.

The fact of the matter is,  by the time your condition becomes chronic -- you are probably taking a combination of corticosteroids and antibiotics to cope with the constant inflammation of your skin. 

So how do Steroids and Antidepressants interact? If neither your dermatologist or your psychiatrist can't answer this question... you need to find a new dermatologist and/or psychiatrist. Don't worry. I had to.

Remember, it's your health. It's your life.

(And personally, I think most doctors don't do enough reading anyway. Too many practicing doctors don't keep up with recent medical research, anyhow.  Your best bet would be to find a practicing doctor who also does research, probably affiliated with a university -- at least you know he or she is keeping up with the latest and greatest.)

It turns out that cortisol and other corticosteroids also affect mood, behavior and cognition through "genomic and nongenomic" mechanisms. Many anti-depressants are effective because they increase corticosteroid receptors and actually lower cortisol levels.

Meanwhile your corticosteroids are working to raise cortisol levels.  Cortisol, is an immunosuppressant which when increased lowers inflammatory effects.

On the other hand, the first month I used Cephalexin... it felt like an antidepressant. Taking it seemed to make me feel so great. I asked my doctor if antibiotics had any antidepressant qualities. She assured me they did not. I guess I was just so happy to have beautiful, healthy skin again... Meanwhile, each time I accidently forgot to take the anti-biotic for the day my mood dramatically dropped. But, hey... maybe that's just me.  Sometimes my body does what it wants, anyhow.

Stay healthy, stay aware. 

Love,

Lhea J.

Eczema Files: Systemic Steroids

Dear Anxious,

So you've been living with eczema you whole life, eh? I bet your doctors told you when you were younger, not to worry, that you would grow out of it. And, let me guess, it only got worse. 

So, you've been waiting your entire life for a miracle cure... something to ease the pain of constant itching and soreness... something to rid the embarrassment of rashes and hyper- pigmentation.

Well, I am here to give you good news and bad news. The good news is that there is a miracle cure for extreme, chronic eczema, they are called Systemic Steroids.

The bad news is: all miracle cures have side effects. 

When steroids are taken orally or injected into a muscle they are called systemic steroids, since they affect your entire body.  The systemic steroids are made to mimic cortisol, your body's natural hormone, and suppress the activity of the immune system. 

A person who is having a reaction due to chronic, contact eczema may have many open lesions, cuts and scars on the surface of their skin.  Unfortunately, when molecules enter their body through these openings, the immune system begins treating many of the molecules as if they are invaders. The molecules may just be additives from soaps and detergents or fragrances from lotions and conditioners. The immune system rushes a host of white blood sells to the area of contact and begins an unnecessary healing process similar to the formation of a scab.

Well, by suppressing the immune system, we can slow down or stop the unnecessary scabbing and rashing that occurs in the skin of people with eczema.

And, often systemic steroids return the skin cells to normal without signs of hyper-pigmentation. (No sorry, I haven't figured out the science behind that one, yet.)

Now, here's the bad news. The side effects of long term steroid usage:

--Obesity (The redistribution of fat in your body)

--Osteoporosis (The thinning of your bones. Take calcium! Take vitamin D!)

 --Glaucoma and Cataracts (Eye problems)

--High Blood Pressure

--Heart Disease

Think you want to take steroids short term? Well there are side effects for that too. After you stop taking steroids, your body goes through withdrawal and often can't even produce/regulate it's own natural cortisol.

It's a sticky situation.

Just remember, there are no miracle drugs. Everything you do has an effect. You can't just let your eczema bubble over, rash, lichenify, and leak... you'll catch an infection so quick. And your immune system will be so used to fighting off things that aren't really invaders, it won't know what to do when a real threat enters your body.

But while curing the infections with antibiotics, and lessening the inflammation with steroids, you are creating short term and long term hazards as well.

It's a tough road. Talk with your dermatologist closely. It's your health!

Love,

Lhea J.

Eczema Files: Cephalexin

Dear Eczema Survivors,

Many forms of eczema may evolve into contact dermatitis or contact eczema overtime. Regardless of what has actually triggered the reaction (food allergen, stress, etc.), the rash may grow due to ongoing infections on the surface of the skin.

Many doctors have begun to prescribe antibiotics such as Cephalexin to combat the infections that accompany and prolong the side effects of eczema.

Antibiotics are often prescribed along with an atopic steroid. However, patients may find that the antibiotic is strong enough to clear infected skin without the aid of a steroid or immunomodulator. 

The results are often noticeable within 24 hours time. Please take Cephalexin as prescribed. Taking the antibiotic in short bursts to offset minor outbreaks may build resistance within the immune system. And, eventually, the drug may be rendered useless.

Love, 

Lhea J.