Corticosteroid therapy refers to the medical use of varying forms of corticosteroids to treat a variety of conditions. Therapy might be undertaken for short periods of time to address something like contact dermatitis, or some people will take one of the steroids most of the time for chronic inflammatory conditions or to dull immune response. There are many ways steroids can be delivered, and these include orally, topically, or via nasal or bronchial inhalation. Different types of steroids can be used, and delivery and type may change common side effects.
People undergoing oral corticosteroid therapy frequently take medications like prednisone. Use could be short or long-term. People who have transplants might be on steroids most of the time, and those with autoimmune disorders or conditions like Crohn’s disease could take prednisone or other drugs daily. These may reduce side effects of health conditions, though they also come with their own set of side effects, which can be onerous.
Side effects of oral corticosteroid therapy include rounding of the face, stomach upset, mood changes, excess hair growth, failure to grow or achieve normal development in children, water retention, weight gain, predilection toward fungal infections, poor bone development, and greater risk of diabetes. Most of these side effects will not bother people on a short-term regimen. Longer-term use is associated with greater side effects risk. Doctors must carefully weigh the benefits of longer therapy and the risks of treatment.
Other forms of therapy tend to be site specific. When a person is given a corticosteroid cream or ointment to apply on the skin, the degree to which it might cause effects like those listed above has to do with type and strength of cream and length of use. Medicine can enter bloodstream via skin. Short-term use on a small area of skin is unlikely to create much of an issue, and doctors will typically suggest the weakest steroid strength possible for the shortest period possible. This isn’t always the right choice, and the risk of using stronger creams for longer periods may be higher than benefits accrued.
Associated with even fewer side effects are inhaled, through mouth or nose, steroids, often taken for things like asthma, allergy, or chronic obstructive pulmonary disorder (COPD). Corticosteroid therapy of these types tends to be well tolerated, though some people get irritations from the inhalation process. There are some higher risks of developing glaucoma, particularly if medicine gets in the eyes, but this can be assessed with regular eye examinations to evaluate intraocular pressure.
Ultimately corticosteroid therapy is of extraordinary use in medicine, despite some side effects that can be undesirable. It is an essential part of treatment for many conditions, and there is more than one steroid that might be tried. For instance, some people who take prednisone orally find they have fewer side effects with medicines like oral budesonide (Entocort®). Establishing working relationships with an understanding doctor is the best way to find the most effective therapy with fewest side effects.