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Steroids: a comprehensive guide to anti-inflammatory medication

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read
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Steroids, known as corticosteroids, are potent anti-inflammatory medicines widely used to treat a diverse range of medical conditions. They're a man-made version of hormones typically produced by the body. Steroids are available in various formulations, including tablets, liquids, inhalers, nasal sprays, creams, injections, and eye/ear drops. Most of these are available through a doctor's prescription, although some over-the-counter options exist for specific conditions.

Who can benefit from steroids?

Steroids offer therapeutic benefits for a wide range of medical conditions. Inhalers containing steroids can be prescribed to help manage asthma symptoms by reducing airway inflammation. Tablets and injections are used to treat systemic conditions characterized by immune system-related inflammation like arthritis. Nasal sprays, which can be bought over the counter, provide relief from nasal congestion associated with sinusitis and hay fever. Topical creams are commonly used to alleviate inflammation in various skin conditions, including eczema. In fact, they are so commonly prescribed that there are guidelines for a steroid ladder in eczema.

Mechanism of action

Steroids are synthetic versions of hormones normally produced by the body. These hormones play a crucial role in regulating inflammation levels. Therefore, increasing the amount of steroids will reduce inflammation caused by these hormones. Steroids also reduce the activity of the immune system, which is the body's natural defense against illness and infection.

Who should avoid steroids?

Precautions and contraindications may vary depending on the specific formulation of steroids:

  • Individuals with a weakened immune system should exercise caution and seek advice from a healthcare professional before starting steroid therapy.
  • Steroids should be used for short periods or sparingly under the supervision of a doctor.
  • It is advisable to avoid using steroid creams on the face.
  • Diabetic individuals should be cautious as steroids can affect blood sugar levels.
  • Similarly, nasal sprays can impact blood pressure, so they should be avoided by individuals with uncontrolled high blood pressure.
  • Steroids can have adverse effects on fetal development - avoid in pregnancy unless directed by a doctor
  • Children - has a potential impact on growth and development.
  • Individuals with glaucoma - increases intraocular pressure.
  • Patients with osteoporosis - can lead to bone density loss.
  • People with peptic ulcers - may exacerbate gastric issues.

Are there any side effects?

Some side effects associated with steroids depend on the dosage and duration of use. Taking tablets for a long period of time can cause weight gain, affect blood pressure, lead to indigestion, affect blood sugar levels, impact bone density, cause sleep problems (avoided if taken in the morning), and increase sweating. Using a nasal spray can increase the risk of nosebleeds and affect blood pressure.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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