PMR Dosages and Managing Symptoms

I’ve had PMR for 3.5 yrs …had my second Actemra injection and I think it is helping a bit 🤞am staying on 1 mg of prednisone for next few months anyway

I see so much contradicting information. One spot said it only caused thin skin if it is used topically, one doctor of mine said it does not, another said it does. Mine only started after being on Prednisone for a year or so. I would like a definitive answer, does Prednisone cause thin skin or not?

Not sure you will get a definitive answer @chzuck. It is listed as a side effect when taking it for a long term.

"When taking corticosteroids by mouth for a longer term, you may experience:
- Problems with the eyes, such as glaucoma or cataracts.
- A round face, which is sometimes called moon face.
- High blood sugar, which can trigger or worsen diabetes.
- Increased risk of infections, especially with common bacterial, viral and fungal
microorganisms.
- Bone fractures and thinning bones, called osteoporosis.
- Fatigue, loss of appetite, nausea and muscle weakness.
- Thin skin, bruising and slower wound healing."
Prednisone and other corticosteroids: https://www.mayoclinic.org/steroids/art-20045692

Longer term several months on moderate dose prednisone can cause thinning of the skin.
Occasionally fragility and bruising will be noticed.
Untreated inflammation can do more harm to multiple
organs. Moisturizers and sun protection are of some help. Wear covering sleeves for gardening etc.

Hi all- I has just been diagnosed a few weeks ago with PMR. I was on Prednisone & it didn't' seem to be working. My PA changed my meds to MethylPrednisolone - 4mg). I started at 4 tabs for 1 week & gradually lessened the dose by !/2 tab after one week. Now I am on 3 tabs. I felt great in the beginning, but now my mornings are not so great. I have pain in my arms & legs & very tired.
I go back to the Rheumatologist next week.
Any suggestions?
Thanks,
Debbie

"I would like a definitive answer, does Prednisone cause thin skin or not?"
---------------------------
As @johnbishop suggests --- The answer is a definite maybe!

Some people are more prone than other people. I have "thick skin" in most places so not all skin is the same. My skin in the area of my shins was thin to begin with so that area got very thin when I was on prednisone.

Overall, I didn't have a huge problem with thin skin when I took Prednisone.

Welcome Debbie @brooklyn1947. I'm wondering if a few weeks is a little too soon to begin tapering. You mentioned the prednisone didn't work so the doctor switched you to methylprednisolone which is stronger than prednisone from what I've read. It sounds like you started with 16 mg methylprednisolone (four 4 mg tabs) and then went down to 3.5 tabs and now at 3 tabs you are at 12 mg after 2 weeks if I read correctly. You might consider bumping it back up to 3 and 1/2 tabs to see if you pain goes away in the morning.

Do you keep a daily log of your symptoms (level of pain when you first get up) and dosage each day?

Thanks for the response! Some mornings I am better & some uncomfortable. I am seeing my Rheumatologist this week to discuss. I had a blood test & will discuss at that appointment.
I have eye issues, so concerned about side affects of Prednisone.
Unfortunately, I only see the PA & not the Dr & am thinking of switching offices for that reason.

Long term prednisone (oral) use, yes, it can cause thin skin.

On June 21st, 2024, after months of pain and stiffness in my hips, neck and shoulders, I was diagnosed with PMR. I had not gone to see my GP as I had assumed that this was due to my arthritis in my neck and lower back. However as it was getting worse and worse I went to see my GP. He put me on 20 mg of prednisone for one week and then said to go to 15 mg for one week and then reduce to 12.5. After 2 days of 20 mg I could not believe the difference most of my symptoms had gone. Unfortunately when I went to 12.5 they came back and bumping back up to 15mg did not help so I have now been back on 20mg for 6 days. Unfortunately I still have some symptoms. From what I have read it seems that I originally went off the 20mg too soon. It looks like in many cases people start off with either 20 or 15 but for up to 4 weeks before they start reducing. I understand that everyone is different and we react differently. As I won't be talking to my GP for a while I would like some advice. Should I stay on the 20 mg or go back down to 15 ? I know it is not good to stay on the higher doses for too long ... but I don't know what too long means .. 2 , 3 weeks or is it months?
Also I have always been a very active person. Until my symptoms became too severe I was walking twice daily, hiking once a week, gardening etc.. When my symptoms got better after the original couple of days of 20mg prednisone I started walking again around 3 KM and doing lots of garden work, painting our fence etc. Am I doing too much and is that contributing to my symptoms returning??
I would so appreciate any advice you can give me regarding dosage and activity. Thank you!