Q. I was prescribed Advair for asthma. It worked well for my breathing problem but my skin became thin and I started bruising badly. Then I experienced horrible damage to my skin with deep gashes from a slight bump. One day I leaned on the bathroom counter and several inches of the skin on my arm peeled off.

My lung specialist insisted Advair was not responsible for thinning skin. One day I asked my pharmacist, “Have you ever seen anything like this?” She looked at my bruises and said, “It could be from taking steroids.”

She checked my meds and told me Advair contains a steroid. I spoke to my doctor but he still said it was not the medication. I switched to another clinic and got a different asthma medicine, Serevent. My health care provider, a nurse practitioner, told me she had seen a few others whose skin reacted as mine did. After several weeks off Advair, my skin returned to normal and I no longer have bruises or serious gashes.

A. We’re surprised the specialist you consulted was unaware that Advair can affect the skin. The official prescribing information lists bruising and wounds as potential adverse reactions.

The steroid in the asthma inhalers Advair and Flovent is fluticasone. Although not as risky as oral prednisone, there can be some systemic side effects with this drug. A higher risk of cataracts, glaucoma and pneumonia has been reported with long-term use.

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  1. Beth

    I have been using Advair for 9 years. My doc did warn me that it can make your skin thin, especially in women, and that it may not recover if you stop. So some docs do tell their patients. I do bruise more easily, but not as bad as it sounds for some. I do also get allergy shots, which has helped a lot in decreasing the amount of inhaler I have to use. I wish there was something simpler, but I’m reminded by friends who had asthma when they were young that there were scant few remedies years ago, and some where harsh. The new inhalers are an improvement, but they still need to be better.

  2. Fran

    I have been on Symbicort for 7 months and the skin on my forearms and my legs is a disaster. I asked my Doc. about these red lesions and he said nothing about Symbicort even though I asked if this could be the problem.

    Why don’t we know more about these side-effects

  3. Brenda

    I was on advair 250 for 3 yrs and my skin is awful, sometimes I bleed and don’t know it, until someone points it out. I am now on symbicort two inhales twice daily. I have asked my dermatologist about this and she said it’s just aging, what is wrong with the medical doctors that refuse to research the medicine to see if corticosteroids do indeed damage the skin, and try a more natural remedy for asthma relief. Big pharmaceutical companies put pressure on the medical professionals. Always about money!

  4. Kathy

    I was diagnosed with COPD a few years ago and given symbicort. In the last 4 years Ive noticed thinning skin, bruising and tearing etc. This thread makes me feel like I’m not alone anymore in this struggle.


    after reading all the above information on thin skin and bruising, I think my advair is causing the problem. been taking 2 puffs a day morning and night . Going to cut back to one puff at night and see what happens

  6. Cheryl
    Dayton Ohio

    I have been on symbicort for a year and began bleeding under the skin with a simple bump scratch anything that touches my arms. Asked my doctor and he saidd it was not from the symbicort. Could be aging or something else going on. I backed off for awhile and my arms did improve. I have had more asthma related issues and he increased symbocort 2 puffs in am and pm. Problem back. Weezing also. Dr. Still doesn’t thnk it’s the symbicort. Will talk to him this next visit to see an alternate medicine i can be prescribed.
    Does anyone know if a way to clear the arm up faster. It is so discusting to look at . I’d rather wear a bandage over my arm so no one has to see it.

  7. karen E.

    I have been on Symbacort now for three months and I have had the same problem with very thin skin on my forearms. I went to the doctor and got medication for psoriasis, but it didn’t help. I can’t bump my arms on anything or even scratch them with my fingernails or they start bleeding and leave a bloody welt on me. It looks really gross too and I have to put makeup on them to cover them up!

  8. Karen R.

    I was glad to read all of the comments above as I am sitting here with bruises everywhere. Prior to going on Advair, I would get bruises only on my hands maybe 3 times per year. I do have thin skin but it had not caused a problem until this past year and I have been on the Advair for about a year. The bruising, bleeding and skin tears are almost daily. I, too, will try to find other alternatives or even possibly only using a rescue inhaler as needed and see how it goes.

  9. JWR

    I was only using xopenex for my asthma but was using too much. Then my Doc recommended Symbicort 160/4.5, 2 puffs 2 x per day. Being very sensitive to drugs of any kind I asked for the lowest dose 80/4.5. I take 1 puff 2 x per day and now cutting back to 1 puff before bedtime as I don’t want to take this drug forever.
    I feel that my skin is thinner. What else can I take for asthma? It really helps me breath and I never need a rescue inhaler so that is good, but I don’t want to ruin my eyes and skin, Any suggestions on what is better? Preferably natural?

  10. Molly TM

    10-4-13 — I was put on the Qvar steroid inhaler in 1998, and was told nothing about the terrible side effects on skin which started appearing in 2010. None of my friends in their 70s and 80s have this kind of bruising and tearing skin, so I know it’s not from age. Doctors have tried to give me Advair and Flovent and Serevent and Ciprofloxacin, but they all have Black Box warnings so I refused, much to their annoyance. I always look up these drugs online now before I accept them. I stopped using Serevent, and took amoxycillin instead of cipro which worked fine. I still have to use the Qvar (the oldest and relatively safest I believe), and a nebulizer with ipratropium bromide/albuterol, and plain albuterol for a rescue inhaler. This combo gives me good asthma control and everything else seems good except for the skin problem. I suspect that older people are often used to test new drugs, but it’s shocking that steroids are also given to young children. It is sad that U.S. residents are denied the generic equivalents of medications available overseas. I am outraged by the practices of the U.S. medical and pharmaceutical organizations, as much as they are outraged when people dare to question them.

  11. B. Gaetz

    Taken Advair Inh for 8-9 years Have the unexplained bruises on arms and legs. Difficult to get rid of them. Feel like 500/50 a dose is Too High. Comments?

    • Cheryl K.

      How do you get rid of the bruising, tearing, bleeding thin skin, after you have stopped all the prescriptions for over 3 year’s? My problems just keep getting worse. Help!

      • Brenda

        I have been told that retinol helps.

    • Jenny
      Broadstairs kent uk

      Have taken the qvar since 2007 for copd. It works to.help my breathing but I have only got to knock myself and full of bruises. Half the time I don’t even know it’s happened. I am so depressed by it all. I used to have lovely skin. I know I’m an older lady of 68 but hate this. I also have lots of spider veins all over my feet and ankles. My doctor says it’s not the qvar but have had all other tests and have come back negative. I think this is something that the doctors don’t tell us. My little dog scratched me the other day and it has come up all angry and bled like mad. Fed up with it.

  12. PE

    I have been on Advair for about 7-8 years. Yesterday, my skin tore on something I rubbed it on. It kind of ripped like tissue paper and surprised me. The bruising has been going on for years since I have taken this medication. Perhaps it’s time to switch.

  13. Nak

    Does anyone know if naprosyn or ibuprofen can cause thinning skin?

  14. CF

    About 9 days ago, my doctor prescribed Advair for bronchitis. Today, my husband noticed that I had blood running down my arm, although I hadn’t realized I had even bumped it. I had a dark area of bleeding under the skin, next to a smaller area where the skin appears to have rubbed off- the latter area was bleeding externally. Since I haven’t had thinning skin and the only thing different is my using Advair, I suspected a connection. I am very glad I found this article.

  15. Trixie

    Advair is a combination of Serevent and Flovent. I’m surprised you don’t know this. It’s the Flovent that causes the thin skin and bruising. My doctor didn’t believe it either so I kept changing doctors until I found one who did agree with me. I am now on Spiriva which has far fewer side effects and my skin is beginning to go back to normal. Mouth is a little dryer but a big improvement over the lesions and bruising.

  16. MR

    I thought taking a baby aspirin each day was causing my blue bruising on my hands and arms. Is it the inhalers that are causing it instead? I have COPD and take spireva, foradil and symbicort. My dermatologist had suggested I take grapeseed extract to combat the blue bruising but that has not helped at all.

  17. Kahtleen R.

    I am making inquiries similar to those above. A friend mentioned in passing that steroids in my inhalers could be responsible for bruising and tearing on my arms and legs following the slightest knock’ even bracelets make purplish marks. I have recently been diagnosed with broncecstasis and am taking a permanent cycle of antibiotics. My consultant agreed to lower the inhaler dose and even agreed a trial stop. What experience is there of skin improvement once inhaler use is reduced? Are there any supplements to assist this, or particular foods? HELP.

  18. dencha

    I don’t know if this forum is still active, but I’d like to weigh in with my own experience. I’ve had asthma due to allergies, made worse by GERD symptoms. I’ve now had a Nissen Fundoplication to take care of the GERD, but my allergies are still creating problems for me. My skin is that of a 90 year old (I’m 57), and I have many ugly bruises. I just got off a week dose of oral prednosone due to tree pollen issues, and just that week created thinning skin, and I have two bad tears on my hand.
    I was on Flovent 220mcg 4puffs twice a day for a year (my asthma doc prescribed this–my GERD had thrown my asthma into chronic mode), and that’s when the problem occurred. My family doc reduced my dose due to symptoms of adrenal insufficiency, and my skin had gotten better. My asthma took a dive a couple weeks ago, which required antibiotic and prednosone to get back on track.
    I’m glad to find a place where others are experiencing similar problems. I’m hoping that after the allergy season, I can work my way back to Flovent 110mcg, which I was on before my asthma symptoms increased. Hopefully with the GERD under control things will improve. I hate what the steroids are doing to my outside, and am fearful of what they’re doing to my organs.
    Thanks to all.

  19. PW

    My husband has been on steroid inhalers for over 20 years, currently serevent. He has very thin skin and in the last few weeks has had two major gashes on his legs, the last requiring 8 stitches. On both occasions his trousers were intact so I think on normal skin this events would have been just a bruise. Is there anything he can do? He is a keen cyclist and I’m worried. I am seriously wondering if we should be getting him some motor bike leathers for his push bike but maybe they’ll be too heavy?

  20. mlb

    In my late 60’s, I have had problems with thin skin and severe bruising for some years. My skin is like that of a 90 yr. old. Have asked my family dr., my pulmonary dr., my dermatologist and my hemotologist (I have polycythemia) what could be the cause. Having mild asthma, I have been on a variety of inhalers over the past 10 yrs. These include Advair, Asmacort, and am now on Symbicort. The column you printed some weeks ago from the person with my same condition was the FIRST time anyone had ever told me that steroid inhalers could cause this problem. I am printing that column and taking it to my pulmonary dr. the next visit.
    Thank you so much for the awakening!

  21. te

    While uncommon, inhaled corticosteroids can cause bruising. The drug that you’ve been switched to, Serevent, should not be used alone for the treatment of asthma–it should only be used in conjunction with an inhaled corticosteroid. While Serevent will control your symptoms, it will not address the underlying inflammation in your lungs. Not knowing what dose of Advair you were on or the severity/control of your asthma, I would suggest discussing the possibility of going back onto a low dose inhaled corticosteroid.
    t.e. PharmD

  22. tom p.

    I have been taking Advair 550/50 for three plus years. I bruise very easily but never connected it to my asthma inhaler. I have asked my doctor why I bruise so easily and he told me nothing about the possibility of the steroids in my inhaler could cause them. I have an appointment tomorrow and will show him this article.

  23. j malloy

    I too have been on advair for quite some time (years) and have experienced similar problems to the point of being quite disfigured. Eventually these areas will clear up only to do it again the next time I bump my arms.

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