How Much of Topical Steroid Is Absorbed Through the Skin? Can It Make Tinnitus Worse?

Hi, not sure if this is the right place to post this but I was wondering if anyone has had any issues with topical steroids before. I haven't found much information online or on these forums. Only a few posts about inner ear creams.

I know Prednisone is used orally and even injected into ear drum. And plenty use nasal sprays with steroids.

But what about topical? Surely not too much could be absorbed?

My eczema is really flaring badly and I could use some meds. I am concerned because my latest tinnitus spike (getting better 7 months on) started around the same time I started using Clobetasol cream again on two small spots on my hands. I had used the medicine before with no issue but the timing of it all is close enough to make me worry.

So yeah... fellow eczema sufferers... any issues or links?

Thanks.

 

I have severe eczema. I’m actually on Dupixent, but I do have a steroid cream to use when I get a breakthrough. I don’t think it caused your tinnitus to worsen. I think it was just a coincidence. Particularly, if you’ve used it before with no problem. Those medications are not listed on the ototoxic list.

There are so many things that do/can cause tinnitus that you almost never really know, save for hearing loss. Did you rule out that you did not have any hearing loss? I went through a period where I thought that Zyrtec was giving me a spike. I had taken it for years with no problem. And then I took it a few times and I got a spike. Then I continued to take it again and no spike. And I realized that I personally have fluctuating tinnitus. So it goes up and down a lot. Even within one day. It was very unlikely that the Zyrtec was causing a spike.

I know it’s easy to be concerned that everything you possibly ingest or is absorbed by your skin could aggravate your tinnitus. I know I feel the same way. And you can read many posts on here where people with very great conviction announce that they got their tinnitus from this or that, including things not known to cause tinnitus, which may or may not actually be true. It’s a guess.

You can always check with your dermatologist, ENT or PCP if you want to make sure.

 

Thank you. Sometimes I just need a sanity check... the anxiety over not knowing what caused my latest issue and potentially making it worse is quite extreme at times.

It could totally be a coincidence as I haven't found any steroids on an ototoxicity list. And nobody here on forums talking about it much either.

I still have some slight concerns. My original tinnitus problem came almost 8 years ago after I had a Kenalog injection for my eczema. I had the shot before with no issues until one disastrous time. So now I worry about all medications. Never thought topical steroids could do the same to me but who knows.

Right now I'm trying out low dosage stuff and have been using over the counter hydrocortisone 1% for a few weeks. No issues at all so maybe I need to work my way up the chain again. Though I know even low dose aren't great to be on long term.

How is Dupixent working for you? I was looking at information for that the other night with regards to tinnitus as well. Injection seems scary! Have you tried any of the non-steroidal creams like Protopic or Elidel too? I was looking at those but I saw some info that said they could be ototoxic, but perhaps that was only systemic not topical.

Thank you.

 

Hello.

Glad I could help.

I think we all have to give each other a sanity check every now and then. Tinnitus is crazy making. At least for me it is. I would be very surprised that your original tinnitus was caused by Kenalog. I’ve had many, many Kenalog injections and I’ve never had a problem. And again, as you know, Kenalog is the steroid and they are not known to cause tinnitus. I’m betting your etiology is something different. Perhaps hidden hearing loss, or exposure to loud noise. Damage to your ears is cumulative over the course of our lives. It could’ve just been that moment that tinnitus started for you due to hidden hearing loss as a result of damage from noise exposure over time. Generally speaking, most people don’t realize how much damage they do to their hearing. I certainly had no idea. I can’t tell you how many concerts I went to and never considered earplugs. None of us did. It never occurred to any of us the damage we were doing to our ears. Other causes could include problems with your Eustachian tubes or neck and jaw issues. I have major TMJ because I’m a clencher, and I carry all my tension in my jaws. My tinnitus gets louder when I yawn, move my head in certain directions, chew. Super annoying. And then just for kicks and giggles it will just get loud, then get quiet, then get loud again. No rhyme or reason. Ugh.

As for the Dupixent, I love it. About two years ago I developed eczema over about 80% of my body. My head and neck and shoulders were not affected. Pretty much everywhere else was. The type of eczema I had was not the dry scaly kind but the inflammatory kind. I literally had large swaths of skin that were red and highly inflamed. No amount of steroid cream worked. They tried light therapy. That didn’t work. No matter how many antihistamines I took I could not control the itching, but the itch from eczema is not a true histamine response so that figures. It got so bad that my skin was actually painful. I couldn’t wear regular clothes because I couldn’t stand the feel of the clothes on my skin. I finally went back to my dermatologist and I said to her, “Either you do something for me today or you going to read about me being fished out of the Charles River“. Clearly I live in Boston. I was beyond miserable. So she actually put me on Cyclosporine initially. It was like a wonder drug. My legs were clear within two days. You probably know it’s an immunosuppressant. It’s also a really dangerous drug. At the same time she started me on to Dupixent. You have to build up your Dupixent level to be therapeutic so I took two medications at the same time. Finally, I came off the immunosuppressant. I’ve had great luck with Dupixent, and I’ve had almost no breakthrough episodes until I had my first COVID-19 vaccination shot.

Dupixent is an injectable and you need to inject every two weeks. I will tell you that it burns when you inject it. It’s a spring loaded syringe. My husband actually injects me in the thigh. It’s so worth it. Takes maybe a few seconds because they want you to inject slowly. I’ve had absolutely no side effects, which apart from an allergic reaction, are primarily ocular in nature.

It is very expensive. In the US it’s about $39,000 a year. Thankfully my insurance covers it.

Good luck.

 

I've thought about that Kenalog injection I got a lot and I am still convinced it was the main trigger. I was fine before it, 3 hours later I was not. I had an issue with the previous injection giving me headaches but figured I'd just deal with that again. It turns out steroids can really mess up your body and amp up your anxiety to an almost manic state. That is what happened to me.

I find it unlikely that my cumulative hearing loss hit at the same as the injection. I've had some hearing loss since I was a teenager and tinnitus first started. It was so mild any sound covered it though and not a big deal. Perhaps it was a combination of the injection and all the stress I had going on in my life then. But I still blame myself for taking the shot when I was nervous about it.

Tinnitus is so odd in that everyone has different thresholds and limits. I would regret it if I didn't do my due diligence and at least research a bit to see howsafe topical steroids are around this community. That is where I am at right now... not sure how to move forward and lead a normal life if everything seems dangerous.

I'm really glad Dupixent is working for you though. Never knew it was once every 2 week thing or so expensive. Definitely out of the question for me as I have no insurance. But maybe in the future.

No other steroid creams or systemic steroid options worked for you? I remember being on Prednisone pills for 2 weeks once and wow it was a game changer... it felt WEIRD not feeling any itch. Though I never took them again as I had a month long spike around same time I finished up the pills. I didn't think it was all that related though as I was uh, on other things as well at the time that seemed far more likely.

Eczema when it's bad can really be hell. 80% of your body and just feeling blah to touch clothing all the time sounds horrible. I've never had it that extensive but close. And man, having to deal with skin infections too and antibiotics. And winter is soooo bad. All this summer didn't have to moisturize after shower now I have to or I just break out itchy all over.

I've finally gotten body and stuff under control but now the palms of my hands just won't heal. I'm trying to cut down on hand washing but man it's so difficult. I know the Clobetasol will clear it up in a few days but I'm trying everything I can to get rid of it first. Palms have never been a huge issue for me and man it is a challenge.

 

Carl, I think antihistamines you take might causing the spike.

Just do some research, I could be wrong but I remember reading Benadryl causing tinnitus. Claritin is second generation antihistamine as it doesn’t make you drowsy. I wanted to take Benadryl for panic attacks at night but I decided not to take it after what I read.

 

Thank you for the reply. I did look into antihistamines and tinnitus back in May. I considered stopping it just in case it was the cause, but I thought my ears were spiking from a bad allergy attack as the spike happened on a day where I was sick with allergies. Did not want to risk having another big attack.

Now I'm not so sure, as looking at my daily journal my ears were feeling weird for a week leading up to the big spike event. I suppose allergies could build up, but I also started that topical medicine a few days before it all started too.

Could there be a possible link or is it all in my mind? Nothing else had really changed in my life. And medicines are just weird. I think Claritin is safe for me but maybe I can take a break this winter to be sure. Everyone reacts differently to medicine, like some can do NSAID with no issue and some get spikes. Some medicines like Prednisone are used to treat tinnitus but can also worsen it too. It's wild and always a scary balancing act.