Medical Q&As

Steroids - side effects?

Please advise on the side effects associated with the use of steroids?

You ask a very broad question because steroids are used to treat a wide variety of medical conditions and are available in a wide variety of formulations. They are administered in various ways including orally, intravenously, intramuscularly and topically in the form of creams and ointments. They are extremely useful drugs that tend to have a slightly bad press because of reported side effects. The principal difficulties associated with their use arise when they are administered in high dosage or if they have to be given over an extended period of time. In that situation the high circulating levels of steroid circulating in the blood stream can result in suppression of the adrenal gland resulting in a Cushing’s-type syndrome. For this reason it is standard practice to use the lowest possible dose of steroid for the shortest possible period of time in order to achieve the desired therapeutic effect. Even then, as with any other drug, side effects may occur. Some people may experience nausea, vomiting or abdominal pain. It is usually recommended that steroids be taken with food or after food in order to avoid these effects. Peptic ulceration can occur particularly if higher doses of steroid are needed and in such cases the person is often prescribed a steroid tablet with a special coating that protects the stomach or alternatively an “anti ulcer” medication may be given for the duration of the steroid prescription. It is also important to urge caution in the use of steroid creams and ointments. Some people tend to be very liberal in the application of such products onto the skin. If too much is applied for too long a period of time then thinning of the skin can occur. This effect can be compared to the parchment-like skin that is often seen on the hands of older people. This thinning effect from the use of steroids can be seen in the area of skin where the treatment is applied. Once the product is applied in accordance with the medical advice and manufacturer’s instructions it can be used without fear of side effects. Most of the horror stories associated with the use of steroids date from an earlier era when they were used in very high doses for long periods of time. When they are carefully prescribed and used responsibly they are very effective and safe.