Q and A

Question

What can I do about darkening of the skin and thinning of the limbs and face?

I am on Truvada and nevirapine for HIV, I am also on a preventetive antibiotic Septrin, because my CD4 count is below 200 (i.e 156). I was dignosed with TB but have since finished treatment for TB. My problem is that since I started treatment I developed changes in my body that might be noticed by those who knew me before. Changes include darkening of skin, especially face, thinning of face, arms and legs. Are these changes due to the medication I am taking? If yes, what can be done with the problem? Thank very much and keep on doing the good job you are doing for us.

Answer

Thank you for your question.

Darkening of the skin may be a result of low levels of vitamin D. I have replied to a similar question here. Hope you find the answer useful too.

As for the thinning of the face, legs, etc, this may be a condition called lipodystrophy. There is a very detailed information about it here.

Please note that taking the ARVs is still very important, as your CD4 count is still low. Your doctor may decide to make changes after you talk to him/her. It is important, however, that you do not interrupt or change medicines on your own.

94 comments

  1. Christina Antoniadi

    Hello Cynthia and many thanks for the question.

    Reydin is not linked to any skin problems or spots and rash.

    You should discuss your symptoms with your doctor.

    They might be able to help by examining the spots and deciding on further action (tests and/or treatment)

    I am sure there is no reason to worry.

    The following is advice to help with dry and itching skin but I thought you might find them useful:

    – Take a bath or shower in cool or warm water rather than hot water as this can irritate your skin

    – Avoid heavily scented or coloured soaps and shower gels. Try to use products that are marked hypoallergenic or wash with aqueous cream.
    Use liquids and not powder to wash your clothes as tiny amounts of powder can build up on your clothes. Try using non-biological makes that are designed for sensitive skin.

    – Wear cool fibres such as cotton rather than synthetic ones. When possible at home wear as few clothes as possible.

    – Try not to use too many bedclothes. Keep as cool as possible in bed as being too warm can irritate your skin. Again, use natural, cool fibres such as cotton.

    – Calamine lotion can be soothing when the skin is very irritated

  2. Cynthia

    I’m taking Reydin and I have Spots on my body it’s like pimples it leaves black spots on my thighs and bums, it’s months now I tried different creams they not working, will purbac help me to remove the spots

  3. Simon Collins

    Hi Rn, thanks. Please talk to your doctor because body changes can be caused by different things in different people. Sometimes the changes can be reduced by good advice on what you are eating and how active you are in life. Sometimes changing treatment might help, although results from studies are not so good. It also depends on how much your body changes and over how long.

  4. Rn

    The only solution to reverse your body to the normal shape is to change the treatment? Or it is non reversible?

  5. Josh Peasegood

    Hi Thembeka, Tb treatment is not associated with changes in skin colour. Please speak with your doctor about this. As with any skin change, it should be assessed by a doctor due to the number of causes and how to investigate each.

  6. Thembeka

    hi. howlong does it take for my skin colour to comeback to its normal colour after finish the course of tb treatment

  7. Josh Peasegood

    HI Tshego, as the Dermatologist has said that the skin will heal itself over time there is no reason to think otherwise. Did they say how long this can take?

    At i-base we are not doctors. I-base is a charity for HIV treatment. We can’t provide advise for managing side effects of medications and this should be an ongoing discussion with your doctor. Have you considered talking with your phamarcist to see if they recommend any creams that you can use to help improve the appearance?

  8. Tshego

    I started taking ARV with Purbac double strength in first week of November 2023, after 6 days I notice black spots all over the body,I go back to the Doctor, she told me to stop Purbac for 5 days then came back again.When I got there she replaced Purbac with Dapsone.Now I’m left with black spots on my body,I’m from Dermatologist he says there’s no thing he can do,the skin will heal itself.Please assist with any medication or cream to remove dark spots in the body.

  9. Josh Peasegood

    Hi Tasha, pregnancy does not reduce your CD4 count. There can sometimes be a small decline in actual CD4 count but this is a normal process and not significant enough to be a problem, even more so while you are taking ART.

  10. Tasha

    Hello. Does pregnancy reduce cd4 count even while on ART. And when is it safe to become pregnant.

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