Weight gain is usually the most dreaded side—effects of steroid use, incurred to some degree by nearly all patients who take them. The amount of weight gain varies from individual to individual. In addition to causing weight gain, prednisone leads to a redistribution of body fat to places that are undesirable, particularly the face, back of the neck, and abdomen. Pictured below is a example of redistribution of body fat to the back of the neck. High blood sugar, or steroid—induced diabetes.
This usually resolves when the steroids are decreased or discontinued. The higher the steroid dose and the longer the duration of therapy, the greater the risk of infection. The risk is also increased when patients receive combinations of immunosuppressive medications, such as cyclophosphamide cytoxan and prednisone.
The risk of some infections can be greatly reduced by taking specific types of antibiotics prophylactically. Pictured below is woman under treatment with prednisone and methotrexate for vasculitis and a concurrent neurologic condition myasthenia gravis developed painful vesicles in her mouth.
The vesicles were confirmed by culture to be caused by re—activation of a Herpes simplex infection, and responded to treatment with acyclovir. Prednisone may cause thinning of the bones even in people who are not usually at high risk for osteoporosis for example: males, young people. In people susceptible to osteoporosis, prednisone may accelerate the process of bone loss. Fortunately, in the past few years, excellent treatments and preventive measures have become available for osteoporosis.
All patients on prednisone for prolonged periods are candidates for these medicines. Patients on moderate to high doses of prednisone often notice that they bruise easily, even with only slight trauma. Pictured below is a patient with giant cell arteritis who suffered a skin laceration after she struck her leg against a chair.
Many patients find it difficult to sleep when taking high doses of steroids. Many also find that they are more irritable than usual. Steroids sometimes even induce depression, which improves when the drug is decreased or discontinued. A number of studies 2 , 3 confirm that inhaled corticosteroids, even at low doses, 4 can cause skin atrophy i. The mechanism appears to involve a reduction in collagen synthesis. The meta-analysis showed fluticasone had a significantly greater effect on adrenal suppression compared to inhaled beclomethasone or budesonide.
The potential for corticosteroid-induced adrenal suppression was found to correlate with the likelihood of skin bruising. The Centre for Adverse Reactions Monitoring CARM has received a report suggestive of sun exposure aggravating the skin atrophic effects of inhaled corticosteroids.
There is one published case report 7 of the association between topical corticosteroids, sun exposure and skin atrophy. The pathogenesis of skin atrophy from photoaging i. The risk of systemic side effects, including skin atrophy, with inhaled corticosteroids can be minimised by using the lowest possible maintenance dose that provides best asthma control. Reviewing the patient's inhalation technique may also be useful.
Be aware of other dose formulations of corticosteroids i.
Most people only need to use the medicine once or twice a day for 1 to 2 weeks. Occasionally a doctor may suggest using it less frequently over a longer period of time. The medicine should only be applied to affected areas of skin. Gently smooth a thin layer onto your skin in the direction the hair grows. If you're using both topical corticosteroids and emollients , you should apply the emollient first. Then wait about 30 minutes before applying the topical corticosteroid.
Sometimes, the amount of medicine you're advised to use will be given in fingertip units FTUs. A FTU about mg is the amount needed to squeeze a line from the tip of an adult finger to the first crease of the finger. It should be enough to treat an area of skin double the size of the flat of your hand with your fingers together. The recommended dosage will depend on what part of the body is being treated.
This is because the skin is thinner in certain parts of the body and more sensitive to the effects of corticosteroids. The most common side effect of topical corticosteroids is a burning or stinging sensation when the medicine is applied. However, this usually improves as your skin gets used to the treatment.
If potent or very potent topical corticosteroids are used for a long time or over a large area, there's a risk of the medicine being absorbed into the bloodstream and causing internal side effects, such as:. This is not a full list of all the possible side effects. For more information on side effects, see the leaflet that comes with the medicine.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you're taking. Page last reviewed: 15 January Next review due: 15 January Topical corticosteroids. Topical corticosteroids are available in several different forms, including: creams lotions gels mousses ointments tapes and bandages solutions They're available in 4 different strengths potencies : mild moderate potent very potent Mild corticosteroids, such as hydrocortisone , can often be bought over the counter from pharmacies.
Conditions treated with topical corticosteroids Conditions widely treated with topical corticosteroids include: eczema — such as atopic eczema contact dermatitis — which causes symptoms such as dandruff and scaly patches on the skin psoriasis Topical corticosteroids cannot cure these conditions, but can help relieve the symptoms. Who can use topical corticosteroids Most adults and children can use topical corticosteroids safely, but there are situations when they are not recommended.
Generally a milder topical steroid or non-steroid treatment is used on the in-between days. Strong steroids should be avoided on sensitive sites such as the face, groin and armpits. Even the application of weaker or safer steroids should be limited to less than two weeks on those sites. The obvious priority is immediate discontinuation of any further topical corticosteroid use. Protection and support of the impaired skin barrier is another priority. Eliminating harsh skin regimens or products will be necessary to minimize potential for further purpura or trauma, skin sensitivity, and potential infection.
Steroid-induced skin atrophy   is often permanent, though if caught soon enough and the topical corticosteroid discontinued in time, the degree of damage may be arrested or slightly improve. However, while the accompanying telangiectasias may improve marginally, the stretch marks are permanent and irreversible. From Wikipedia, the free encyclopedia.
Medical condition. Journal of the European Academy of Dermatology and Venereology. PMID Indian Journal of Dermatology. PMC American Family Physician. Tokyo, Japan: Ishiyaku Publishers, Inc.
The study showed that mean age of patients who experienced side effects was 7. In many of these cases, the topical steroid was applied to the face and neck. In general, most side effects were described as local irritation, skin discoloration, and scarring.
However, there were reports of severe side effects were also observed. In order to limit and prevent side effects associated with topical steroids, here are 5 useful tips you should follow , 25 , :. Overall, it is important to pay attention to where the topical steroid is being applied and how frequently the application is being used. With careful application, side effects may be reduced. Before we conclude, it is important to know that topical steroids are not just one drug.
Instead, there are over 50 different types of medications. Aside from the type of forms e. Vasoconstriction test: this test examines the efficacy of steroids in inducing blood vessels to close and narrow Ultraviolet erythema test: a topical steroid is applied 24 hours prior to the exposure of ultraviolet rays.
Just seven hours into the exposure, redness is examined and treated sites are compared to untreated ones 5. Skin atrophy test: this exam looks for areas where the skin seems to be wasting away. The topical steroid gets applied to a specific area on the skin for 3 weeks and is given a score to rank the intensity of the side effect 7. Depending on the location, the severity of rash and age of the patients, your doctor may prescribe different types of steroids.
In general, for severe and extensive skin diseases, more potent steroids will be prescribed. This is a double-edged sword, meaning that stronger steroids are more effective in treating skin diseases. However, it also means that you will more likely to get the side effects. When topical steroids are used properly they can work wonders and have little side effects Unfortunately, like all drugs, steroids have many side effects.
So, have you ever used topical steroids? What were your results? Do you know anyone who is currently using steroids for long period of time? If so, please share this article and let them know about the potential harms associated with this class of drugs.
When I have significant flare-ups of Erythema multiforme minor on my hands, I apply Triamcinolone Acetonide Ointment 0. Could this exacerbate sleeping problems? I also take simvastatin and venlaxafine. Can you recommend an alternative to the topical corticosteroid?
I have been taking steroid based oral ointment to treat my oral ulcer. Is there any connections? Should I stop the ointment? I m a hypothyroidism thyroid age 47, patient my skin is very dry and my city climate is also dry. I have malasama on cheeks and nose as i was using a cream which had steroids which cause redness and spider veins as i stoped my face skin has become very dark plz advice me so that my complexion gets fair as it was plz plzplz reply.
Thanks dear for sharing such beautiful information with us. But here I have a very quick question that How we can realize our types of skin? Hope soon you will write a detailed article to give a complete info about my question. Share this post. Subscribe Sign up to receive news, updates and product discounts. You are correct! Most importantly, we want to share 5 easy ways to prevent and limit these side effects. Atrophy: Skin atrophy is defined as thinning of the skin, and this is by far the most common side effect.
It is generally accepted that all topical steroids can cause atrophy after prolonged use. Clinically, the atrophic skin tends to be more transparent, thinned, and fragile. It is believed that steroids suppress the cell growth and inhibit collagen production, which leads to the thinning of the skin. Telangiectasia is defined as an increase in number and size of small blood vessels on the skin. Typically, blood vessels are not easily seen on the skin. Because of thinning of the skin, the blood vessels become more visible.
In addition, steroids stimulate the growth of endothelial cells cells that create the lumens of the blood vessels , which lead to increased proliferation of blood vessels. Epidermal barrier disturbance: The skin provides a protective barrier between our body and environment. Our skin not only prevents bacteria and allergens from entering our body, but it also regulates temperature and water content.
Steroids can damage the skin barrier resulting in an increased penetration of allergens and bacteria into the deeper layers of skin and body resulting rash and infection, respectively. Also, damage to the skin barrier can make skin disease such as eczema worse. Steroid rosacea is defined as redness on the nose, cheeks, forehead, and chin. This symptom occurs when the steroid is used over a very long course period.
Usually, middle-aged women experience this side effect. As mentioned before, topical steroids can thin the skin and increase in number and size of blood vessels. The end result is an increased redness on the face. Acne is a well-known side effect of topical steroid use. Steroids, at first, suppress inflammation of papules small or raise pimples. Shower gel is just liquid soap. They still strip the natural oils from the skin and the external humidity doesn't really make much difference to that!
I can't really tell you much about the Doublebase - I use it about once a year and in small quantities! You use it after a shower while the skin is still damp to keep the moisture in - everyone I know who uses it swears by it. Age 79 and counting A short time spent on a vasculitis or lupus forum makes you realise that PMR is really not the end of the world for most people. It doesn't kill. I also do have to say - 13 years of PMR is a bit of a pain!!!!!
Yes, 13 years would be bit much. I am also on another site via Facebook for the eye disease that I have. The one thing I find on there, is that everyone is cheefrul. I checked it out everyday and comment freuqently. Basically we joke about how many times we have fallen over the dishwasher door when it is down. We don't see things that eveyrone else does.
Basically we are all going blind, however at different rates. I have had this eye disease for 46 years, so I have been quite blessed that I still have a little bit of central vision. We are all very different, but I have learned in my long battle with this declining vision that the sun still comes up each day, I still have family and friends who love me, life is still pretty darned good.
I am happy each day that I am still on the top side of the grass. I do not like PMR, but there are many things that are much worse. I would like to get off of prednsone for sure. I am down to 5 mg from 20 mg beginning a bit over a year ago. We all just need to put one foot in front of the other.
Well, for me, I need to remind myself to look before I put that one foot in front of the other. For those of us who are going blind, we still have that HOPE for a cure. In the meantime I shall take good care of it. Oh, no. So weight on or weight off it's there. I could wrap presents in it but it's not very colourful. Join this discussion or start a new one? We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters.
Yes, the skin on my arms is so thin. All I need to do is barely scrape it on a door jamb or something and I am bleeding. I use lotion. My dermatologist said it is all caused by the prednisone, but he did not give me a remedy, so I will be standing by to see if anyone responds. I hope we get some help. It is bad enough having PMR without having this to contend with. Babazaga ptolemy. Anhaga Babazaga. Anhaga ptolemy. It has all sorts of medicinal possibilities going back to the Greeks and Romans.
It is supposed to prevent some kinds of cancer , help hair care, cure diabetes, help fluid retention, and a host of other things. Babazaga amkoffee. Meant to add, if you do use DoubleBase Gel or similar in the shower, be sure to use a rubber mat as the shower base will be very slippery. I blame my wife EileenH Babazaga. EileenH donna I remember now that you are not in the UK. I have always heard that putting any moisturizer on the skin should be done while it is still damp. The main reason I switched to shower get forty years ago was that it leaves no soap film on the shower, thus the shower is easier to clean.
Ha Ha I was not thinking of my skin back then. Well, I think that a lot of this is trial and error for all of us, and I stand by the part that I said about the age of our skin. Mine is much older than a lot of you. And one of the downsides of pred is that it does speed the aging process Double Base Gel, disappears as you put in on. I think a lot of this depends upon the person. I think a very positive attitude has a lot fo do with gettting through all of this. I refuse to just buy into all of it.
I still walk 5 miels a day, I eat right, keep very active, and just try to look at the glass as half full, not half empty. I thimk that hope is what keeps us all going. Without hope, we tend to fall into a trap. There are many who say that prednisone causes weight gain.
I have a friend who did gain weight on prednisone, but she laughed and said it made her hungry all the time, thus she put more gas in her tank than she could use in a day - result, weight gain. I am just going to keep pouring on moisturizers. I do know that our skin cells, and all of our body cells are always regenerating. That is one of the miracles of the human body. I think the person who posted on here that he was told by his doctor that once off prednisone that the skin would get better.
I do think this is possible. I think we need to do all that we can to combat what prednisone does to us, but we also need to go on with our lives without always thinking that PMR has doomed us forever. I just refuse to think that way. That is one reason I am not on here a lot. Oh, I just looked up the ingredients in the shower gel that I use and feel pretty good about it.