People often associate steroids with abnormal muscle growth and unfair competitive advantages in sports. This image comes from anabolic steroids, which are a synthetic version of the energy-producing male hormone testosterone.
Corticosteroids are a different category of steroids used for medical purposes. These creams, pills, injections or inhalants have anti-inflammatory and immune suppression properties. They’re effective for treating the symptoms of a wide range of diseases, from asthma and eczema to lupus and arthritis.
People dealing with these conditions need to understand the benefits steroids can provide and any potential side effects they may have to deal with during treatment.
What are steroids?
Steroids are medications that affect the adrenal glands, which produce hormones for the body. Anabolic steroids bind to androgen receptors, spurring testosterone production. Corticosteroids bind to glucocorticoid receptors, which are responsible for different hormones, such as cortisol, which helps your body during times of stress.
The body naturally produces these hormones. However, medication delivers them in higher doses, producing different enhanced effects. Corticosteroids block the immune system activity that causes inflammation, reducing pain, swelling, breathing difficulties and other problems associated with inflammation.
Types of corticosteroids
Unwanted inflammation is a hallmark of many different diseases and chronic conditions. Therefore, corticosteroids have many applications. Here are the different medications and products containing steroids.
- Oral steroids come in tablet form or as a liquid. They treat a range of conditions that are too serious or widespread for topical or inhaled steroids. For example, a course of oral steroids may help control a serious asthma attack before the patient returns to their normal inhaler regimen.
- Steroid injections treat joint pain and internal inflammation. Injections may target specific areas, such as certain joints affected by arthritis. This treatment is more targeted than oral steroids. It’s also possible to get the medication intravenously.
- Inhaled steroids reduce inflammation in the lungs and airways caused by asthma or COPD. It may also help with breathing difficulties related to viruses or infections. Nasal steroids offer similar relief to inflammation of the upper airways.
- Topical steroids treat acute or chronic rashes and inflammatory skin conditions. Hydrocortisone (1% or less) creams are available over the counter for mild rashes and irritation. Stronger creams, gels or ointments require a prescription.
Corticosteroids treat inflammation, but they do not address the underlying cause of the problem. Therefore, they are often part of a large treatment plan. For instance, a doctor making an asthma treatment plan might prescribe inhaled steroids alongside bronchodilator medication for attack prevention, and a short-acting beta2-agonist (SABA) for emergencies.
Why might steroids be prescribed?
Doctors often use corticosteroids in an urgent care setting or hospital to reduce acute inflammation. Meanwhile, rheumatologists and gastroenterologists often prescribe oral steroids or provide injections for arthritis and irritable bowel syndrome (IBS), respectively.
Here are other instances when corticosteroids might be prescribed.
Respiratory conditions
Doctors use steroids like prednisone for two different respiratory treatment approaches. Firstly, higher doses can relieve acute asthma attacks or chronic obstructive pulmonary disorder (COPD) flare-ups.
Secondly, inhaled steroids can also be effective as a maintenance medication. The idea is that, with regular use, a steroid can keep inflammation in the airways at bay and avoid breathing difficulties before they occur.
Joint and muscle pain
Steroids are effective for treating joint and muscle pain due to inflammation. Because of their effectiveness, steroids are a common arthritis treatment. Rheumatoid arthritis patients respond well to steroid injections into the affected joint, or oral steroids.
Meanwhile, patients with psoriatic arthritis can use topical creams and gels on the joints in their hands and feet.
Corticosteroids also offer pain relief for muscle or soft-tissue problems, such as tendonitis or swelling after a traumatic injury. The same topical, injectable or oral options for arthritis are available for this type of swelling reduction and general pain management.
Gastrointestinal issues
Irritable bowel syndrome (IBS) is a chronic gastrointestinal condition with no known cause. It can produce stomach cramps, bowel control issues, diarrhea and constipation.
Poor gut health can lead to other issues such as inflammatory bowel disease because your gastrointestinal system is responsible for removing waste and absorbing nutrients from the foods you consume. Failure to perform these functions can affect your energy level, ability to fight off other diseases, and level of comfort.
Because of the unpredictable bowel movements and cramping, many gastrointestinal conditions can also affect mental health and the ability to perform normal daily activities.
Oral corticosteroids may be effective for treating IBS and related gastrointestinal conditions because they address the inflammation that perpetuates the symptoms of IBS.
Skin conditions
Steroids like hydrocortisone are an effective treatment option for both acute and chronic skin problems. Dermatologists prescribe topical steroid creams, gels or ointments for rashes caused by plants like poison ivy, insect bites, stings or allergic rashes.
Chronic conditions like contact dermatitis, psoriasis and eczema may also respond to topical or oral steroids. Meanwhile, conditions causing problems like severe dandruff and scalp inflammation sometimes call for medicated foam containing corticosteroids.
Autoimmune diseases
Steroids surprise the immune system, so they are often a part of the treatment regimen for diseases like lupus and multiple sclerosis, which are caused by overactive immune systems.
These conditions typically require oral or injectable corticosteroids. The goal is not to cure the disease, but to induce remission or lessen the severity of the disease. Doctors may try high doses of steroids for a short period to deal with severe or late-stage illnesses where there is a danger of death or organ failure.
These doses are not sustainable in the long term, so treatment of less severe cases requires finding the right dosage for long-term use.
Side effects of steroids
In the correct dosages, steroids are safe. With short-term use for acute symptoms, patients may not have any side effects. However, others will experience some of the following side effects with long-term or high-dose use.
- Stomach irritation, nausea and loss of appetite;
- Weight gain;
- Nervousness and insomnia;
- Eye problems, such as cataracts or glaucoma;
- Increased infections (due to immune system suppression);
- Mood swings or feelings of restlessness.
Long-term use can also cause the development of osteoporosis, hypertension or other chronic conditions.
Consulting a doctor can help you decide if steroids are a good treatment option for your condition. Dosage and directions for use are important for limiting the side effects and ensuring you get potent anti-inflammatory benefits.