Steroid Acne

[Jandersen20]

My 17 year old son might have to get on another round of Prednisone. It breaks my heart because he got pretty bad acne and started getting a little fuller in the face during the first round of Prednisone when he was first diagnosed in July.
Is there anything at all to help with the acne? We’ve used some Benzoyl Peroxide spot creams, but they didn’t seem to help that much.
Is there anything better than having to take Prednisone? When I called our GI, they said they don’t typically prescribe Budesonide for Crohn’s - just Prednisone…So we may not get a choice.

 

[my little penguin]

Really ….they don’t prescribe budesonide for crohns … is it a pediatric Gi associated with a university hospital ????
Wow …
Even 11 years ago Ds was offered budesonide at age 7.
Een formula only is as effective as steriods
But none of the side effects including acne
When inflammation is worse in the body
Acne for teens is so much worse
A derm can prescribe acne creams that can help
Some but not completely

 

[Jandersen20]

Really ….they don’t prescribe budesonide for crohns … is it a pediatric Gi associated with a university hospital ????
Wow …
Even 11 years ago Ds was offered budesonide at age 7.
Een formula only is ass effective as steriods
But none of the side effects including acne
When inflammation is worse in the body
Acne for teens is so much worse
A derm can prescribe acne creams that can help
Some but not completely

I’m surprised about the Budesonide too. I actually talked to the nurse today and she told me our GI typically only uses it for some other condition-forgot the name, but maybe something with the esophagus. We have an appointment next week so I’m going to ask again about Budesonide. Maybe they think Prednisone works better, I have no clue…
I will make an appointment with our derm if he does have to start another round to see if there’s anything he can get for the acne.
Thank you!

 

[my little penguin]

Swallowed budesonide is used in eosinophilic eosphagitis (EoE) some use a slurry of it or Flovent

He may have confused your request with that .

Versus Uceris (brand name ) is a pill form used for crohns of the lower colon (doesn’t hit small intestine if I remember right )
Prednisone hits the whole Gi track
Uceris foam is used for the rectum /sigmoid only

 

[Scipio]

That's very odd. In my experience, and according to the medical literature, budesonide is very commonly used to treat Crohn's disease. It was the first drug I was given for my Crohn's.

According to this publication, it works just as well as prednisone for Crohn's that is located in the terminal ileum and right colon:

https://pubmed.ncbi.nlm.nih.gov/9753485/

 

[Jandersen20]

My son’s affected areas are both large and small intestine, but I’m not exactly sure other than that. I’ll ask the doc at our next appt. I do remember being told the TI and maybe rectum were also affected.

I didn’t realize that Budesonide works best for targeting certain areas.

I wonder what would work better between Prednisone and Budesonide for my son given both large and small intestine are affected.

The main thing right now is trying to get a little help with the frequency, urgency, and bleeding.

Thank you.

 

[my little penguin]

https://www.crohnscolitisfoundation.org/sites/default/files/legacy/corticosteroids.pdf

This explains it better
There is entocort as well

 

[Jandersen20]

https://www.crohnscolitisfoundation.org/sites/default/files/legacy/corticosteroids.pdf

This explains it better
There is entocort as well

Thanks so much for sending.

 

[crohnsinct]

Entocort is budesonide. It is a brand name. Entocort releases sooner than Uceris...it has to do with the coating on the tablet. It all depends on what area you are trying to hit. My daughter has TI and colonic disease and she used budesonide/entocort for about a year (mind you this amount of use is not in the prescribing literature but it is somewhat common to go longer). Once her T.I. was relatively under control she switched over to Uceris.

It is strange that your physician is not familiar with using budesonide for Crohn's. I will say, my daughter had a much more complete and quick response to oral prednisone than budesonide.

IDK if he would be willing but another option is Exclusive Enteral Nutrition. Nothing but formula and water for about 6-8 weeks. It is just as effective as steroids and actually a little better because it does encourage mucosal healing where prednisone does not. It might be tough for a 17 year old but might be worth try.

 

[Jandersen20]

Entocort is budesonide. It is a brand name. Entocort releases sooner than Uceris...it has to do with the coating on the tablet. It all depends on what area you are trying to hit. My daughter has TI and colonic disease and she used budesonide/entocort for about a year (mind you this amount of use is not in the prescribing literature but it is somewhat common to go longer). Once her T.I. was relatively under control she switched over to Uceris.

It is strange that your physician is not familiar with using budesonide for Crohn's. I will say, my daughter had a much more complete and quick response to oral prednisone than budesonide.

IDK if he would be willing but another option is Exclusive Enteral Nutrition. Nothing but formula and water for about 6-8 weeks. It is just as effective as steroids and actually a little better because it does encourage mucosal healing where prednisone does not. It might be tough for a 17 year old but might be worth try.

Thank you.

I’ve been reading a lot about Uceris Foam, so I’m going to ask our GI next week. I don’t recall specifics as to exactly what areas are impacted, but I do know it’s in both his large and small intestine.

 

[crohnsinct]

There are steroid rectal therapies and 5 ASA therapies. Sometimes insurance will dictate what you use. O gets the best relief from steroid suppositories, next best result is foams but for some reason our insurance only covers enemas.

 

[Maya142]

It really depends on where the disease is - if I'm remembering correctly, Entocort works best in the last part of the small bowel (terminal ileum or TI) and the first part of the colon ( the ascending colon). If your child has inflammation in his TI AND his rectum, that may be why they want to use Prednisone. Entocort would not reach his rectum, but Uceris would not reach his small bowel.

But you could do a combination of Entocort and steroid suppositories or enemas to reach his rectum or Proctofoam. My daughter actually has disease in those two areas - her TI/cecum are worst and but she does have inflammation in her rectum. So we have done Proctofoam and Entocort before because she absolutely hates being on Prednisone.

Prednisone will often cause the puffy, round face but that does go away once you stop it - it may take a few weeks, but it does go away. It is tough though, while the kid is on Pred because there's really not much you can do (though as my daughter says with COVID, masks cover the steroid puffiness at the very least, hopefully some of the acne . Of course, not all school have mask policies in place now!). Acne is also very common with Prednisone but thankfully we haven't had to deal with that so I can't offer tips.

 

[Jandersen20]

It really depends on where the disease is - if I'm remembering correctly, Entocort works best in the last part of the small bowel (terminal ileum or TI) and the first part of the colon ( the ascending colon). If your child has inflammation in his TI AND his rectum, that may be why they want to use Prednisone. Entocort would not reach his rectum, but Uceris would not reach his small bowel.

But you could do a combination of Entocort and steroid suppositories or enemas to reach his rectum or Proctofoam. My daughter actually has disease in those two areas - her TI/cecum are worst and but she does have inflammation in her rectum. So we have done Proctofoam and Entocort before because she absolutely hates being on Prednisone.

Prednisone will often cause the puffy, round face but that does go away once you stop it - it may take a few weeks, but it does go away. It is tough though, while the kid is on Pred because there's really not much you can do (though as my daughter says with COVID, masks cover the steroid puffiness at the very least, hopefully some of the acne . Of course, not all school have mask policies in place now!). Acne is also very common with Prednisone but thankfully we haven't had to deal with that so I can't offer tips.

Very helpful, thank you.