Steroids are used to suppress inflammation and come in many forms, including topical steroids, inhaled steroids, oral steroids, injectable steroids, and IV (intravenous) steroids. Oral steroids, also called systemic steroids, systemic corticosteroids, or glucocorticoids, are a class of steroids taken by mouth and used for many human diseases, including various skin conditions. They are synthetic forms of the natural hormone cortisol, which is produced by the adrenal gland.
Below are oral steroids commonly used for skin conditions, including brand names and a comparison of their potencies:
Oral steroids mimic the steroid hormones that are naturally produced by our adrenal glands and act on various receptors throughout the body to exert their anti-inflammatory effects. Steroids bind to glucocorticoid receptors in almost every cell of the body. These steroid/receptor pairs then bind to specific sequences of DNA to decrease the production of many different types of inflammatory molecules.
Through various mechanisms, most oral steroids decrease inflammation and work to:
Prevent migration of immune cells called neutrophils into tissue
Decrease the production of pro-inflammatory chemicals and molecules
Reverse increased blood capillary permeability
Suppress the normal immune system response
What Conditions Do Oral Steroids Treat?
FDA approved uses of oral steroids for the skin:
Oral steroids are used in both short-term “bursts” (four weeks or less) and for long-term (over four weeks) management of chronic skin diseases.
Often oral steroids are initially given in a higher dose (such as 60 mg per day) to help get the disease under control, and then they are tapered to a lower dose a few weeks later. Without proper tapering, there is risk for steroid withdrawal symptoms including body aches, mood changes, headache, fatigue, and abdominal pain.
Steroid dosage is often categorized as: (1) low dose: < 10 mg/day, (2) medium dose: 10-20 mg/day, or (3) high dose: >20 mg/day.
What Are Common Side Effects and Risks of Oral Steroids?
Treatment with oral steroids can involve a wide range of risks and side effects. Some patients have a much higher risk of side effects than others. For example, women and the elderly are at greater risk for osteoporosis caused by steroid treatment.
Groups with Increased Risk for Steroid Induced Side Effects:
People with liver disease and alcoholics – difficulty metabolizing exogenous steroids
Children and adolescents – higher risk for osteoporosis and delayed growth
Females, especially postmenopausal females – slower clearance of steroids and lower bone density increase risk for toxicity
Elderly – higher risk for osteoporosis and complications due to physical inactivity
Additionally, there are different side effects that commonly occur with short-term versus long-term treatment with oral steroids.
Side Effects of Short-Term Oral Steroid Treatment:
Fluid retention and/or swelling
Mood changes and difficulty sleeping
High blood sugar (hyperglycemia)
Higher risk for infections
Slow wound healing
Loss of menstruation
Acne-like skin rashes when the steroids are stopped
Table 2. Side Effects of Long-Term Oral Steroid Treatment
* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.
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