A patch FAQ?

[Hazumu]

Are there other patch users here?  Currently my therapist has me using transdermal patches and, although they're pretty convenient (slap 'em on yer bum,) they're not without their problems.

Me?  The little buggers don't always stay stuck for the entire period.  Sometimes as early as the second day they start coming unstuck.  Why? I don't know, yet.  I do take care to shave the area before applying, and use soap that doesn't leave any sort of residue on the area.  I do have eczema that acts up in the late winter/early spring (this year it flared up pretty good -- not the worst, but pretty good,) so my skin may not be ideal for the patches to stick to.

I consulted with Kimberly when I got my first supply and she provided a few tips--

-If the patch starts coming unstuck, try peeling it partly up and then smooth it back down and re-stick it (good one for the middle of the day where you can re-seat them during a quick trip to the stall.)

-If they won't stay stuck in that location, try moving them to another location.

-Location is important.  Like, right where your waistband/belt sits is not a good idea -- the mechanical rubbing will lift the dang things.

I've come up with another technique, as it seems mine always start to unstick in the shower.  After the shower I carefully unstick the thing and use a blow-dryer to carefully dry the skin and the sticky side of the patch, then re-seat it.  It seems to last longer that way.

Do you have any other tips on patch use?  Please post 'em here.  I'm hoping we may be able to put together a patch FAQ of sorts. 

Karen

[AmyNYC]

Hi Karen,

I'm afraid I don't really have any tips to help patches from coming off, but I can tell you that the girl I was dating immediately preceding the start of my transition was on them for quite a while (birth control).  They would never stay in place either.  She started using tape to keep them down, but she eventually changed birth control methods, specifically because she was tired of worrying about whether her patch had come off.

Good Luck!

Amy

[DawnL]

I'm a patch user.  I've found the name brand (Climara) stays put better than the generics.  My doctor wrote a script that called for brand name only but they're expensive unless you have insurance.  Mine generally stay put if I put them on clean dry skin.  If they start to peal, I hit the detached area with a hair dryer and it will usually lay back down.  Sometimes, I remove the entire patch, dry it, and reapply.  Wearing snug panties and keeping the patch somewhere underneath them helps keep them in place as well.  They tend to hold the best right in front just below the belt line, though with low-rise jeans, there isn't often much room there.

Dawn

[stacey]

Try cleaning the skin with alcohol pads prior to placing the patch on the skin.  Natural oils in the skin will make adherence tough, if not impossible.  The alcohol cuts the oil and allows the adhesive to bond much better. 

I have also found that if you cut the patch in half (depending on the type you may not be able to do this) and space the halves out on the skin, it has less stress transmitted to the adhesive during normal movements.  The patch is non-stretchy and your skin is very stretchy, so when the surrounding skin stretches it places a stress concentration at the edge of the patch.  The stress concentration causes loadings too high for the adhesive to take and the edge of the patch will start to lift.  Once the edge starts to lift, its all down hill from there.  Smaller patch sizes decrease the amount of loading.  The stress concentration will still be there, but the magnitude of stress will be much less.


Hope this helps.

Stacey

[Sheila]

I use the patch and have for the last year and a half. I have not had any problems with it. I use Viville, I think that is how you spell it. I make sure that I clean all the old residue off my butt and then I shower. I also make sure I don't have any residue from soap or gels or anything like that. When I get out of the shower I dry the area that I'm going to place the patch really good. Before I do anything I place the patch on and hold it there for about 15 seconds. I place it on my butt, where my panties will cover it, not on any seam or where my clothes will rub on it. I change sides everytime I put a new one on. I have got into a habit that everytime I use the restroom I rub it to make sure it is there. That is just a habit cause I'm afraid it might fall off, but it hasn't, not one. I do know that some people can't have the patch as it won't stick. I have a friend who has tried and she can't keep it on. She went back to oral.
Karen, I know all about the eczema. I fought with that most of my life. You probably won't be able to keep the patch on with eczema. I had it so bad as a kid that it killed all my hairs on my legs. I don't have to shave at all down there. I had it all over my body at one time. I feel for you as I know the pain that you go through when it flares up.
Sheila

[Kendall]

Yes mine start to peel off and bunch up too. Putting it on my bum seems to cause less stress to it or on side of hip like the instruction diagram showed. It does feel a little awkward at first for me.

I personally take it off during showers and baths, clean up then reapply once totally dry. Instructions say leave it on, but it ends up falling off anyway for the amount of time I spend in it.

[Hazumu]

Hmn -- take it off in the shower -- Interesting.  I used to spend a long, hot, Japanese-style soak at least once a week, but cut it out since starting the patch.  I'll have to give that trick a try...

I recently started using the StefiGaff™®© and it tends to hold the little buggers down and smooth under a wide range of conditions.  There's a lot less migration, too.

Kendra, thanks for the tip!  And Tinkerbell, I'm firin' up Google as I type 

Karen

[angelsgirl]

I'm on ortho-evra patches.  I (usually) take a shower before I put it on and then wipe down the area with rubbing alcohol, let it air dry and then apply the patch.  It stays on without much ado for a whole week and then when I have to take it off, I (usually) take a shower and then rip if off like a band-aid (it still usually feels like I'm waxing it!)  I noticed that it stays on better if I remember to use the rubbing alcohol and it also seems to keep me from getting any of those gross little pimple things underneath the patch, too.  I'm surprised that the pharmaceutical companies aren't using the same adhesive for all the patches when some clearly stick better than others. It's probably something to do with patents, I'm guessing.

[Melissa]

Alcohol dries skin and gets rid of moisture, which is why it works that way.

Melissa

[Hazumu]

Because of my eczema, and because it seems to be a little more -persistent- than normal this year, I've been using OTC Hydrocortizone 1% cream on my skin -- especially the 'patch farm' area of my buttocks.  I found I need the alcohol wipe to clean up the cream residue and help the patch stick.

My electro mentioned something last night -- that spironolactone dries out your skin.  If that's true, then that would explain why my eczema's being so persistent this season.

^{>'...food for thought...'muses to herself<}

Karen

[Julie Marie]

I've been on the patch for about a year. I have realized if you place it anywhere your skin has excessive movements, such as at joints, it will loosen. I remove mine before showering and replace them, but in a different location, afterwards so I lose some of the adhesive. But if I take the time to put them somewhere they won't be subjected to a lot of movement I find they remain pretty much in full contact with my skin.

[Buffy]

I used patches for a long time pre-op, but post op I have switched back to oral tablets, as I have restarted my spotring career and found that they caused me problems, they kept coming off.

I was using Climaval and tried everything to keep them on, but it wasn't to be.

Buffy