This has been working incredibly well for me...

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Originally posted by Debra

A few weeks ago I saw a post about using Diprosalic for KP. Depending on whether it's in lotion or ointment form, Diprosalic is .05% betamethasone and 2% (or 3%) salicylic acid.

By coincidence, I had been prescribed Diprolene for a completely unrelated (and minor) skin condition, and had a nearly full tube sitting in my medicine cabinet. Diprolene is the same as Diprosalic, but without the salicylic acid. I also had several tubes of Keralyt, which is a 6% salicylic acid gel. I have been using Keralyt and Diprolene together for about three weeks now--because of the higher percentage of salicylic acid, this combination is even stronger than what you'd find in a tube of Diprosalic. My KP is almost completely cleared up--my skin is smooth with very few bumps, and I have hardly any redness or spottiness.

My regimen is as follows: exfoliate in a morning shower using a "Scrubbica." The Scrubbica is made of the same synthetic cloth as those exfoliating gloves, but is in the shape of a long scarf--I use both hands to stretch it across my back to make sure I'm exfoliating completely there (same thing with my butt and back of thighs). I bought the Scrubbica at www.blissspa.com (888-243-8825) for 15 bucks plus shipping, but I think they're available a lot cheaper elsewhere (try Bed Bath & Beyond, Linens 'N Things, health food stores, not necessarily under the "scrubbica" name).

After my shower I spread a small amount of Keralyt gel on my arms, following it up with the Diprolene. The gel is slippery enough to help spread around the very thick Diprolene ointment. I do the same thing in the evening, minus the shower.

Now for the downside: Betamethasone (Diprolene) is a super potent steroid and can cause real problems if too much is absorbed systemically. Follow the link that "Twinspeak" posted on June 18 to read about steroid strengths. Patients are not supposed to use more than 45 grams of topical betamethasone per week. I use it so sparingly that I estimate I'm using--at the most--5 grams a week. However, I only have KP on my upper and lower arms. If you have a really bad case all over your legs and torso too, a super potent steroid is probably not a good solution for you. It's just too dangerous to use as much as you'd probably need.

"JC", another poster to this site (he's actually working with a group doing R&D on pharmaceutical solutions for hyperkeratotic disorders), strongly recommends using the LOWEST potency steroid that is effective, and also recommends using higher concentrations of salicylic acid to speed desquamation.

If you want to try this without seeing a doctor, try getting a tube of Keralyt and a tube of 1% hydrocortisone cream. Hydrocortisone is a low-potency steroid, and 1% is the highest concentration you can buy over the counter. If that's not incredibly effective, ask your MD for a higher concentration hydrocortisone prescription, and if THAT doesn't work, then move up to medium-potency steroids, etc.

If your doctor balks at giving you steroid ointments, you might mention that you can get them over the internet, so wouldn't s/he prefer monitoring you rather than you getting some on your own? You can get both Diprolene and Diprosalic at www.pharm-international.com. (They're in Brazil and I haven't ordered from them.) You probably won't be able to find Keralyt at your pharmacy, but it's available for 10 bucks a tube at Dermstore.com and Dermadoctor.com.

I should also mention that I do NOT have particularly dry skin on my arms, just the KP. The salicylic acid concentration may be too high for those of you with really dry skin. And it goes without saying that there's no way this solution should be used on children, no matter how briefly.

The deal I have made with the devil is to use the Diprolene just during short-sleeve season, and then ratchet down to Keralyt plus hydrocortisone. In one of JC's posts, he cautions that this could cause a "rebound effect"--worse KP than ever. If this happens, I'll certainly report on it.

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Originally posted by Twinspeak

Hey Debra, I'm so glad you have found something that works. Like I mentioned, I too have had success with steroid creams. If I recall correctly I think that the Diprovelene is the strongest potency you can get(Class 1) while Diprosalic is a Class 2. They range from Class 1 to 4. And you are right, if someone out there has a less severe case of KP then an over the counter anti-inflammatory might do the trick. Unfortunately I have it on my arms and legs so it wasn't strong enough for me. I now use the Diprosalic around 3 times a week, sometimes 4 if it is needed. When I first started I was using it twice a day for around 4 or 5 days. It starts to work right away. I have not yet started treating my legs mainly because the ointment is sooooo gooey(sp?) that it would take hours to dry. I may get a tube of Diprovelene for the initial treatment of my legs(they are worse than my arms) and then switch back to the Diprosalic. Perhaps if I were using the Diprovelene on my arms they would be around 95% clear as opposed to the 80-85% they are now but I am satisfied with the results so far. For the first time in my entire life(31 years)I am wearing tank tops and my arms are much smoother. A few bumps remain on the most affectd areas, which is for me the first half of my forearm, and there is a little redness but it is so much better than it was. Like Karen reiterated, these types of ointments are not meant for long term use but if you try it there is no reason why you should have to use it everyday for the rest of your life. My KP is(was) very severe and like I mentioned within a week I had cut down from twice a day to 4 times a week max. I use this ointment plus a few different creams for the roughness. And just as a
sidenote, when I orininally went to a dermatologist and asked about Diprosalic he looked at me like I was an alien and asked me why I wanted that, it was a steroid cream. I will admit that when I first asked for it I had no idea what it was and what it did. I thought it was just another cream. He told me that redness would never go away and that there was nothing to treat it. Excuse my language but F**k them if they won't help, I'll do it on my own. And I did. Every single piece of information on this condition and possbible treatments I found through the web and through friends that I have met on the web. No doctor I have ever gone to has ever prescribed anything more than a cream to moisten my skin. If your regular doctor won't give you a prescription then go to a free clinic and get one there. That's what I did. It costs around 50$(CAN) for a 50mg tube. Again, for the millionth time, do your research and decided for yourself but I can guarantee you that it is working wonders for me. Take care.

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Originally posted by I meant Diprolene not Diprovelene, whoops!

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Originally posted by Debra

In case this is helpful: the www.pharm-international.com site sells Diprosone (same as Diprolene) in both cream and ointment formulations. They sell Diprosalic in ointment and a "topical solution" that comes in a bottle. Maybe using a cream or topical solution (whatever that is) would be easier to spread on your legs. I like using the ointment (plus Keralyt gel)--the gel really does make it easier to spread, and the ointment formulation keeps me aware of how much I'm using (I might slather a cream on more generously). Hopefully the Diprosalic topical solution is available in Canada. (BTW--I'm Canadian but live in the States. Where do you live?)

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Originally posted by Debra

Hi Debra. Yes, the Diprosalic lotion is available in Canada but I think it is used more for scalp irritations and the like. It is literally a liquid lotion that you squirt on so I opted to go with the ointment. Diprosalic does not come in a cream form. Besides, the ointment is stronger than the lotion so I decided I wouldn't even bother wasting my money on something that might not work as well. I first heard of Diprolene on this very site but I have never tried to get any so I have no idea if it is available in Canada. I don't see why it wouldn't be. The only reason I hesitate to use it is because it is the strongest class cream you can buy and I have noticed that it also carries some warnings that the Diprosalic does not. I put some ointment on my legs for the first time last night and it actually spread easily enough(or maybe I'm just getting better at mastering the technique) but it was the drying time that was tedious. I put it on around 8pm and it still wasn't dry when I went to bed at 1am. I'm not working right now so I have the time to let it dry but it takes forever. A lot of it ends up rubbing off on clothes or furniture or whatever. But I'm going to keep applying it and see what happens. To answer your question, I am in Ottawa right now but I will be moving to Mexico to teach in a couple of months or so. Luckily for me you can find virtually every ointment, cream, whatever there and you don't need a prescription. That's a nice bonus. Anyway, we'll see what happens with my legs and if they don't respond I'll probably look into the Diprolene. It's funny, the weather today was quite a bit cooler than it has been recently and I was actually bummed because I wouldn't be able to wear a tank top. Huh?! Who knows, maybe one day I'll be complaining because it's too cold and I can't wear my shorts. Some day. Take care.

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Originally posted by Twinspeak

Debra, as you can see, for some unknown reason I decided to masquerade as you under my last post. Ya, I'm pretty sure my KP has something to do with it. It's probably affecting my mental capacity by now. Sorry.