Corticosteroids

Inhaled Corticosteroids

Inhaled steroids are absorbed primarily through lung tissue, and very little enters the blood circulation — therefore there is little risk of systemic steroid side effects from inhaled steroids. The most common side effects include hoarseness of the voice, coughing, and thrush (yeast infection in the mouth). The use of a spacer device with the inhaled steroid lessens irritation in the mouth and throat and reduces the risk of these side effects. We also recommend routine rinsing of the mouth with water after using an inhaled steroid.

Inhaled corticosteroids have been available for many years and have been used safely in both adults and children with asthma. Many times, inhaled corticosteroids dramatically lessen the need for oral corticosteroids and offer much better day-to-day control of asthma.

Growth can be difficult to evaluate in children with asthma because many children — even those not on steroid therapy — may have a delayed growth spurt, but typically asthmatic children do reach normal adult height. Many studies have shown normal growth in children treated with low to moderate amounts of corticosteroids. Some recent studies have shown there may be a growth delay with higher doses of inhaled corticosteroids in children, or cataracts and possibly glaucoma in adults after high dosage and prolonged use.

Inhaled Nasal Steroids

Inhaled nasal steroids are often used to help control allergies and have proven to be very safe and effective with minimal side effects. They should be aimed away from the nasal septum (the middle part of the nose), as nasal bleeding and — rarely — a perforation or hole may develop in the nasal septum when the spray is aimed incorrectly.

Topical Corticosteroids

Topical creams and ointments are another form of steroids often used to treat rashes. These are extremely safe but should be used only under the direction of your doctor. The use of steroid creams around the eyes or in the facial and groin area is not recommended on a routine basis, because the skin in these areas is thin and the steroid may be absorbed more easily.

Oral Corticosteroids

Oral corticosteroids are often prescribed in liquid or pill form to treat exacerbations of asthma or other allergic reactions. When used for short periods of time, oral corticosteroids are very safe. The most common side effects of short-term use are an alteration in mood (either depression or euphoria) and increased appetite. There can also be some stomach upset, so these medications should be taken with food. Elevation in blood pressure and blood sugar may also be seen with short-term use.

Some individuals with difficult-to-control allergies or asthma may require oral corticosteroids long-term. Side effects of long-term use can include loss of calcium and bone density, muscle weakness, weight gain, easy bruising, high blood pressure, cataracts, high blood sugar, and possible loss of blood supply and injury to joints (avascular necrosis). Every attempt is made to wean the amount of oral corticosteroids whenever possible. This should only be done under your doctor's direction, as oral corticosteroids can decrease the body's own production of corticosteroids and must therefore be withdrawn slowly.

In general, steroids are a very safe and effective form of treatment for allergy and asthma and offer many potential benefits. Most of the time, the benefits of corticosteroids outweigh any adverse effects.

If you have any questions about the use of these medications, please contact our office: Omaha: 402-391-1800 Lincoln: 402-464-5969