Dry skin, nail problems, hair loss, frozen shoulder

Dry skin
Hair loss
Frozen shoulder (capsulitis)
Nail problems

Dry skin

Associated drugs: indinavir (Crixivan), 3TC (Epivir) and hydroxyurea (Hydrea), AZT (nails discolouration)

Dry skin, chapped lips and nail problems are a problem for HIV-positive people but this is often more related to HIV than HIV drugs.

Indinavir was particularly linked to skin, nail and hair problems. As this drug is now used so rarely, switching to an alternative is the first option.

All the measures listed on rashes are helpful where dry skin is a problem, along with the use of emollients (moisturisers) such as aqueous cream, diprobase, oilatum, and balneum. Try to drink plenty of fluids as well.

Vitamins and a healthy diet are also important for better skin health.

Where rashes and dry skin are unmanageable with medications or simple interventions then ask your doctor to change the medication that is responsible.

You can also ask to be referred to a specialist dermatologist.

Chapped lips have been linked to indinavir in a similar way to dry skin. Regularly using a lip balm and checking indinavir blood levels are both recommended.

Hair loss

Associated drugs: indinavir (Crixivan), 3TC (Epivir) and hydroxyurea (Hydrea)

Upset bald man People have reported that the thickness and quality of their hair changed while using indinavir – usually becoming thinner – and that this has been reported for both head and body hair.

Usually this is reported as being mild and reversing when indinavir is switched to another drug.

Balding patches of head hair, called alopecia, has also been reported, though rarely, with 3TC.

Frozen shoulder (capsulitis)

Associated drugs: indinavir (Crixivan)

Frozen shoulder (also called adhesive capsulitis) is a painful disorder that reduces movement of this joint. It has been associated with indinavir.

Conservative therapies include rest, painkillers and range-of-motion exercises and the shoulder can return to normal over 1-2 years although persistant pain can remain in 5-10% cases. More active treatments include more active exercise, oral corticosteroids, corticosteroid injection and manipulation under anesthesia.

Nail problems

Associated drugs: indinavir (Crixivan), 3TC (Epivir) and hydroxyurea (Hydrea)

Bad big toe Paronychia (inflammation around the finger nails) and ingrown toe nails have both been reported as rare side effects with indinavir and 3TC.

Many of the people using indinavir are likely to have also used 3TC - so the cause and contribution of each drug is uncertain.

If you are using indinavir consider switching to another drug.

Hydroxyurea and AZT have been associated with nail changes and skin pigment changes in African people.