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How to combat patch irritation/rash


EasyE

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I have been very happy with the Dotti brand HRT patch, which I have been using twice weekly for the past 4.5 months. But the past few times I have made the switch, there has been a noticeable red rash where the patch had been. One area is still red and splotchy after a week. I assume it is my skin reacting to the adhesive? 

 

Anybody have any hacks to combat this? I have used hydrocortisone cream but it doesn't seem to do a lot. It doesn't really itch, it is just unsightly, especially as the number of red circles on my midsection grows. (Of course as I write this, the patch I currently have on is itching. It is getting in my head, lol.)

 

I put the patch on lower abdomen. I have been switching up spots every time. Should I try another brand? Somewhere else on my body? Backside? Upper thigh? Forehead? (Just kidding on that last one)...

 

Thanks,

Easy

 

 

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I don’t have a resolution for you, but itchy adhesive rashes are the whole reason I chose injections. I get them from bandaids and medical tape, there’s no avoiding it for me. I just have super sensitive skin and always have.

 

Needles are fine for me, but I know they’re not for others.

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  • Forum Moderator

There is a great deal of variation in the adhesives used in patches. 

 

My doctor prescribed Estradot brand, but the pharmacy switched it to Sandoz generic.  The generics were huge, meaning that I had to re-use the same site every week and a half.  And they left an itchy red rash.  After a couple of years, the rash got worse, both redder and more painful.

 

Eventually, I had to get my doctor to specify "brand name only" on my prescription, and I had the pharmacy do the same on my file.  The Estradot patches are much smaller, so I don't have to re-use the same site for a month.  And they don't cause a rash at all.

 

So definitely switch brands if you can to find one that your skin can tolerate.

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  • Admin

DO NOT put the patches in the same place on your body every time.  I use the Bayer Estradiol ones that clearly say do not apply to the same spot.  I have places on my thighs just below the panty brief elastic that frankly circle my legs, and just above the waist elastic on my panties up near my belly button that do a good job.  Check with your doctor about how to clean off the residue from the patches when they come off, also the idea of putting a cortisone salve on the spot after you clean it and put the new patch on the other side of your body.  I also use my alcohol swabs that I use when I inject my insulin on the area I put the patch just to be sure I am not trapping dust or pollen from the air under them. 

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The VA has switched up brands at times.  I have had the rash problem.  These days I put on a bit of a "soothing gel" that has Aloe in it after removing the patches..  I think it is meant for sunburn.  I put some on right after removing a patch without trying to clean off the residue.  I can wash off what's left over the next couple of days.  The gel softens it up a bit.  Scrubbing it only makes things worse.  I put the gel on the area where I use the patches every day.  By the time I'm ready to use the same spot (week and half) it is okay to use again.  

I've been doing this for a few years and it works for me.

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  • Forum Moderator
Just now, VickySGV said:

how to clean off the residue from the patches when they come off

 

If your patches have a tendency to come off in the shower (Sandoz generic, for example), the adhesive is water-soluble and will come off with soap and water.

 

If your patches are pretty much unaffected by showering, and soap and water won't remove the residue (Estradot brand, for example), the adhesive is oil-soluble.  A bit of bath oil on a makeup-removing pad will remove the residue.

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Just now, KathyLauren said:

A bit of bath oil on a makeup-removing pad will remove the residue.

The reason I say check with your prescribing doctor, or pharmacist on this is that my skin is very sensitive to what I use on it and I have certain brands and types of cleansers I cannot use or I am going to have skin eruptions over more than just the patch site. 

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Just now, VickySGV said:

DO NOT put the patches in the same place on your body every time

definitely haven't done that ... didn't really have problems until the past few weeks ... 

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I started off with the patch but after having issues with patches falling off as i perspired or showered ,as well as the irritation i started using a compounded estridol cream.  It seems a more comfortable and reliable vehicle.

 

Hugs,

 

Charlize

 

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Yikes, I am going to have to figure something quickly because I just took off my latest patch and it is a pretty noticeable red rashy circle. Cortisone cream seems to have calmed things down a bit but it almost looks like I got burned with a cigar or something.

 

Things seem to have gone into overdrive these last three cycles. Otherwise, just minor irritation that went away after a day or two. Ironically, the patch that is making my skin softer seems to be making it also too sensitive for the patch itself. 

 

Any advice on shaving and the patch because I do shave my midsection a few times a week? I am going to contact doc and pharmacist today about trying a new brand and look for some aloe lotion, more cortisone and alcohol pads.

 

Also, should you switch sides of the body every time? I generally start near my belly button and "march" either right or left for 3-4 cycles. Then start in the middle and go the other direction the next 3-4 cycles.

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IDK.   I really only use 3 locations that I rotate.  For me the Aloe gel seems to work.  I put it on immediately over the spot when I take the patch off.  It also softens the residue which makes it easier to remove the next day.  I have found that if I try to clean the residue off right away it seems to make the irritation worse.

But that's just me.

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  • Forum Moderator

Once your body decides that it is allergic to the adhesive, rather than just sensitive, the severity of the rash can increase quickly.  I was fine for a couple of years with just a red outline for a day.  Then, suddenly, within a month or two, it ramped up to intense pain.  I had to switch brands.

 

I start on one side and move across my belly.  I can go through a whole box of patches before I need to re-use the same piece of skin.

 

Shaving wasn't an issue for me, because my body hair was pretty sparse to begin with and went full femme very quickly.

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Anybody else use the Climara patch? That is what my doc is going to try next. It sounds like these are supposed to stay on for full week. I am skeptical if 3-4 days causes severe irritation that a week will be any better. But maybe the adhesive is OK? 

 

Found this tidbit interesting after doing some research:

Moreover, Lamb and Wilkinson have assumed that the sensitization to topically applied estradiol can represent a risk factor for the development of ACD (Allergic contact dermatitis) to corticosteroids ...

 

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  • Admin

I use the Climara patch.  Even though it says 7 days, my doctor tells me to simply replace patches that fall off from sweat or other reasons as they fall off, but do get that approved and ordered by your Endo so that the pharmacist will not tell you that you are getting too many at once.  Every month or two I will get some contact dermatitis on one individual site but the same will not happen on the other side of my old body for several wearings.  I primarily place mine on my upper thighs just below the line of my panty legs.  That skin for me is not as sensitive.  

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The latest - my pharmacy is going to take a week to fill this prescription (they have to order it).

 

So, do I grin and bear it for a week with the old patch and hope it isn't too bad? Or do I just go hormone-free for a week? Could be an interesting experiment to see what it feels like to "go back" briefly without E. Compare. Contrast. Will the break mess things up?

 

I hate this because things were chugging along pretty well... ... I still wonder if my shaving has anything to do with it. My skin overall has seemed more sensitive to breaking out after I shave... 

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  • Admin

Having been off it for GCS prep, and then to let a blood clot settle in, you will not lose anything you have and the trick to E (or T) is that it starts other things going for you, and those things keep going once the E has kicked them into motion.  You could get a little crabby (I did) but you have to be off the stuff, and your old hormone levels restored to lose much if anything.

 

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  • 3 weeks later...

So I may be back to square one ... the doc told me she was switching me to Climara but that is not what I picked up earlier this week. It is just a "Generic> Estradiol" - says it is made by Sandoz... seems cheaper to me...

 

I made the first switch this morning and there is a lot of redness. It doesn't hurt or itch -- and it's not as "angry" as my last Dotti patch -- but the redness is quite noticeable (plus there is a lot of residue left behind) ... sigh ... i can live with a little redness that goes away in a day or two but if these things are going to be leaving scars and long-term skin damage I may have to reconsider this direction... sigh again...

 

 

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I should note, I am using aloe gel (like for sunburns), hydrocortisone, even triple antibiotic gel ... anything to see if I can get this issue under control...

 

 

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  • Admin

I use the Climara patches, and I do get the redness without the itching, it fades in 72 hours from the specific site,  but I know part of my problem is the heat going on here. Have you been tested for general allergies, they can do it for the known "vehicle" parts of the patch medication.  Also if you have other allergies they can work with you on them.  At the minute the air here, in addition to being HOT we have an allergy alert that is very high.

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I'm not sure I understand.  Any problem I have ever had was after removing the patches.  I just smear the gel on when I take off the patch.  By the time I want to use that place again, any irritation is gone.

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  • Forum Moderator

The adhesive on the Sandoz generic patches is definitely inferior.  It gave me a rash so bad that I had to stop using those patches.  The adhesive is also water-soluble, so they don't stick in the shower.  I switched to the Estradot brand, which don't have those problems.  And they are much smaller than the generic ones, so you can go a lot longer before using the same patch of skin.

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Just now, KathyLauren said:

The adhesive on the Sandoz generic patches is definitely inferior.

That was my experience as well.  

The VA usually sends Mylan.  But they have sent the Sandoz ones in the past.  Mylan does okay as long as I use the Aloe gel when I take them off.

They stay on pretty well for me, but I don't do a lot of strenuous stuff these days.

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thanks for the advice everyone ... the thing that gets me is that everything was fine for the first 3-4 months and then all of the sudden it's like the patches turned on me ... I wouldn't a little redness that fades after a day or two, but this is a rash that is sticking around for a few weeks (will it scar?)... blah... i guess it's time to go back to the doc and request a third try at something...

 

What are injections like? I just have an aversion to this for some reason. Not so much the pain part, but just feeling like a druggie with all these needles, lol.

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3 hours ago, EasyE said:

What are injections like?

I don't know.  But I know people that use them and seem satisfied with them.  I went with the patches mostly because I heard they were the easiest on the liver, kidneys, etc.

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On 8/24/2024 at 5:14 AM, EasyE said:

What are injections like? I just have an aversion to this for some reason. Not so much the pain part, but just feeling like a druggie with all these needles, lol.

I started HRT on patches, but I got a lot of irritation at the patch sites, plus it didn’t get my E level at the desired level. Even with Tegaderm they never stuck to me properly. So then came the injections. Night and day difference. Needles didn’t bother me, and my wife was on insulin so we already had the sharps bin and disposal. Never felt like I was a druggie. 

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