How long does it take Triamcinolone to start working?

June 22, 2014 7:09 PM

I have this crazy rash thing on my legs, started a couple weeks ago with a small patch and has gradually spread. It is blotchy and itchy and generally unpleasant. I finally went to the doctor on Friday morning and was diagnosed with eczema and prescribed Triamcinolone, 2x a day for up to 2 weeks. How long should it take to start helping? Because my blotches are still spreading!

Seriously, this is nearly unbearable. It started with a small patch on my calf, where I've had an itchy red patch before, and then suddenly appeared on my other leg and on both thighs. It is now circling around both calves and as of today on my ankles. There are also small patches on my arms near my elbows. I have been lotioning and lukewarm showering and using the fancy cream as prescribed. When will it start to work? Is this normal? Is it possible I was misdiagnosed? I should note that I already use all sensitive skin/unscented lotions/soaps/detergents due to allergies, so I don't /think/ this is allergy-related. I will also admit to scratching it, though I really try not to, which is probably not helping. Basically I'm trying to decide if I should call my doctor's office tomorrow or wait a couple more days to see if things improve.

posted by leesh to Health & Fitness (19 answers total)

Triamcinolone may not be strong enough to deal with your eczema. Doctors will often prescribe Prednisone, an oral steroid, for eczema, so perhaps you can talk to your doctor about that. Go sooner rather than later. Hang in there!
posted by number9dream at 7:19 PM on June 22, 2014

You have never had eczema and now you suddenly have this? I'm not a doctor, but that seems odd to me.
posted by Dansaman at 7:28 PM on June 22, 2014 [1 favorite]

I have pretty mild eczema that I have sometimes used triamcinolone for, and it has typically given me relief by the next day, although not always totally cleared the itch. I generally don't continue to feel the itch spreading. If you don't start to feel better tomorrow, I would definitely give the doctor a call and see what their idea of a timeline is.

Also, you mention that you notice areas of blotchiness appearing. Do they appear before you are scratching? Eczema is known as the "itch that rashes"; it usually doesn't spontaneously rash. First, it is very itchy, then you scratch it, and then there is a rash. Is yours happening like that? (SOrry if you're already very knowledgeable about that, but just in case not). Sympathies for the itching; please don't feel like you to have to "admit" to scratching; it's impossible not to.
posted by Tandem Affinity at 7:30 PM on June 22, 2014

I've only had triamcinolone prescribed for fungal infections, not for eczema. If it's for the the former, you should get relief within a day or so, but don't forget to keep using it for several days even after the itch stops, otherwise you won't kill the fungus.

But, if this is eczema, well, I guess I'm surprised. For my long-lasting and annoying eczema, I used the OTC lotion Sarna plus a diet change to help my skin heal itself (topical steroids, if used sparingly and quickly are great, but should not be used long-term).
posted by ArgyleGargoyle at 7:33 PM on June 22, 2014

I've only had triamcinolone prescribed for fungal infections

Not alone, I hope. It is only used in conjunction with an anti-fungal since triamcinolone alone would make a fungal infection worse.
posted by Justinian at 7:55 PM on June 22, 2014

Response by poster: You have never had eczema and now you suddenly have this? I'm not a doctor, but that seems odd to me.
I have that thing where I get little hard bumps on my fingers in summer, which I think is a kind of eczema. and I have had a scratchy/rough patch in the exact place on my calf where this all started, a few months ago. My sister and I have both suddenly become allergic to things as adults, and apparently that can be related?

Also, you mention that you notice areas of blotchiness appearing. Do they appear before you are scratching?

It's like little red bumps that then become large blotchy areas over a couple days (because of the scratching?). And then the little bumps pop up somewhere else on my leg and become large blotchy patches.
posted by leesh at 8:05 PM on June 22, 2014 [1 favorite]

Is the doctor you saw a dermatologist? If not, you might consider seeing one.
posted by harrietthespy at 8:11 PM on June 22, 2014 [1 favorite]

Yeah, that sounds about like how my eczema manifested at one time. Yours sounds bad, but within the range of normal. My experience was that I went through two or three less strong topical steroids and then triamcinolone and they all eventually quit working. (What helped me in the long run was a diet change.) I'm surprised to hear that prednisone is commonly prescribed for this, because my flare-up got very very bad and very persistent, and nobody thought prednisone was a good idea at any point. But to answer your actual question, I would keep it up with the triamcinolone for up to two weeks like your prescription says, and I would probably not go longer than that unless you can see/feel the rash starting to clear. It might work and it might not, unfortunately, because eczema is a wily bastard.
posted by clavicle at 8:17 PM on June 22, 2014

Response by poster: No, it was my general doctor and she looked at it for like two minutes tops, and I was the one who suggested it could be eczema. Here, I made an album of my gross rash, so you can see how it's progressed pretty rapidly. Maybe it's something else?
posted by leesh at 8:18 PM on June 22, 2014

Triaminoclone is an immunosuppressant; if I applied an immunosuppressant to a skin eruption and it got suddenly worse, I would presume I was dealing with an infection rather than a simple autoimmune problem.

If I were you I'd try an athletes foot antifungal on one small isolated patch and Neosporin on another as tests of a possible stopgap treatment until I could see another doctor, which I would do as soon as possible.
posted by jamjam at 8:44 PM on June 22, 2014

I think it would be a good idea to visit your GP again and get a skin scrape/microscope assay of the rash to find out if it is ringworm.

Recently I suffered from a systemic ringworm infection for far too long because I initially thought I had eczema myself. I had eczema as a child and the symptoms were similar in the beginning, so I watched and waited and itched profusely. 18 months later, I marched into my GP's office, armed with knowledge I Googled and determined to test for ringworm. In that time, a tiny patch on my neck had grown into many patches covering my whole body. None of them looked like a characteristic "ring."

Sure enough, I had ringworm. An ointment/cream/spray wouldn't work because it was too far gone. I had to take tablet-form Lamisil which saved me, but can have very unpleasant side-effects for some.

I wouldn't wish the experience I had on my worst enemy--please do check because in my experience it also spread quickly and I wish I had caught it when it still could have been treated topically.

I was also prescribed a cream-it was a combo of clotrimazole (for the fungus) and betamethasone (a steroid). For reference, relief was/is almost immediate.
posted by mustachio at 9:29 PM on June 22, 2014

I think you should see a dermatologist, especially because the rash is still spreading. Rashes are notoriously hard to identify - try googling the word rash and checking out Images - and some rashes can indicate a deeper, more serious problem. The dermatologist can tell the difference.

Makes me itch just looking at it ...
posted by aryma at 10:07 PM on June 22, 2014

(1) As everyone else is saying, see a dermatologist, and stat.

(2) If it is eczema: PHOTOTHERAPY. I cannot stress this enough. Skip the topicals, skip the scary immunosuppressant drugs with awful side effects - TRY PHOTOTHERAPY FIRST.
posted by sevensnowflakes at 10:37 PM on June 22, 2014

If you press down (gently but firmly) on one of your lesions and then let go rapidly, does the lesion blanch and then turn red again, or does it stay red?
posted by gingerest at 11:32 PM on June 22, 2014

Response by poster: It blanches.

I'm going to call the doctor's office today and ask for a referral to a dermatologist--thanks!
posted by leesh at 5:06 AM on June 23, 2014

Could you have developed cellulitis? It's a bacterial infection of the skin that can cause an expanding rash, usually on the lower leg. If you scratched a lot due to the excema or whatever caused the initial itch, then bacteria could have gotten in through the broken skin. It can really get out of control. I would definitely call your doctor ASAP. You might need an oral antibiotic.
posted by pizzazz at 11:49 AM on June 23, 2014

pizzazz, it does not seem like typical cellulitis, and it would be odd to get that on both legs (I have had it numerous times ... sigh.) You are correct to urge caution though. leesh, do keep the rash clean and if any part of your skin starts to get swollen and feels hot when you touch it and tender, then go to urgent care or the emergency room asap. I have eczema also and my cellulitis was swollen, red, and hot and was not itchy.

Fungal infection or ringworm are good thoughts. Rashes are indeed hard to diagnose though, so I am echoing everyone else that dermatologist now is a very good idea. Glad you are following up today.

Also, do you shave your legs or exfoliate or do any kind of hair removal? Your legs seem pretty hairless in your photos. Stop any of that while you have your rash.
posted by gudrun at 12:21 PM on June 23, 2014

Response by poster: Just to update, I went back to the doctor's office but saw a different doctor, he said the meds could take up to a week to work, but thought it might be fungal, or anyway might not be eczema. I'm waiting to hear back about an appointment with a dermatologist--apparently they get very backed up.

I have only shaved once since the rash started and I only shave to the knee anyway, but will definitely give it a rest for now.

Thanks for the advice, I'll keep an eye out for cellulitus!
posted by leesh at 12:25 PM on June 23, 2014

Response by poster: To update again, it turns out to be hives, and not eczema at all.
posted by leesh at 6:51 AM on July 9, 2014