Potential Side Effects of Corticosteroids

With all their promise, topical, oral, and systemic GCSs have drawbacks. The literature reflects more than 50 years of studies noting a variety of adverse reactions to corticosteroids - ranging from mild to life-threatening and life-altering. The research has looked at side effects related to the dose and potency of the medications. Some side effects also are related to the drug’s method of administration - whether it is given orally or applied to the skin; length of therapy; patient’s age; and site of topical application.

GCS therapy’s side effects have been shown to include:

Cataracts, or a clouding of the eyes, is a known side effect of high GCS dosages and long-term topical therapy applied around the eyes.

Glaucoma, an eye disease, can result when GCS treatment is applied topically around the eyes or administered systemically, especially when patients are already at high risk for glaucoma.

Gastrointestinal effects, such as nausea and vomiting, can occur with oral GCS therapy. Patients can minimize these effects by taking their medication with food. Peptic ulcers also have been shown to occur in patients taking non-steroidal anti-inflammatory medications along with corticosteroids, as well as those with past histories of peptic ulcer disease, smoking, or alcohol use.

Growth retardation is a side effect that occurs especially with long-term, systemic (oral or injected) administration of GCS before age two or at puberty. Experts say that children usually resume growing once GCS therapy is discontinued.

Hypertension, or high blood pressure, is most common in patients with preexisting hypertension who are on long-term, therapeutic doses of corticosteroids.

Osteoporosis, a loss of bone density or bone thinning, can occur especially in women who take daily long-term prednisone therapy.

Skin effects, including stretch marks and spider veins, occur not only with systemic GCS, but also with long-term use of potent topical agents. Sometimes, acne appears on the trunks of patients going through puberty, who also are on corticosteroids. Acne around the mouth has also been shown to occur with corticosteroid use when potent forms of the therapy are applied to the face.

Tachyphylaxis, or a decreasing response to corticosteroids, can occur with long-term use of the medications. This can be detected with careful monitoring of medication use.

Weight gain may occur because of increased appetite and fluid retention, which can begin after one month of taking larger doses of corticosteroids.

Infection; skin rashes and irritation; skin thinning; and formation of dilated blood vessels are other side effects that are often associated with the use of topical corticosteroids.

Source: EczemaNet