Corticosteroid Side Effects
Interview with Dr. Dennis Lee, and Dr. William C. Shiel Jr.
Dr. Lee: We have several viewer questions regarding
side effects of corticosteroids. Let me just introduce the topic by saying that
corticosteroids are potent medications that have been used in medicine to treat
many conditions that involve inflammation. For instance, they have been used to
treat
rheumatoid arthritis, and other
arthritis that is caused by inflammation
in the joints. They are also used to treat liver inflammation (hepatitis),
ulcerative colitis, and
Crohn's colitis (which involve inflammation of the inner
lining of the intestines). Corticosteroids are used by pulmonologists to treat
asthma. So, they are very important medications. However, they have serious potential side effects. Some of them involve thinning of the bones,
avascular necrosis of
bones, thinning of the skin and also swelling of the face, among many other
possible
side effects.
Here is a question for Dr. Shiel; one viewer wants to know whether
long-term steroids can cause thinning of the skin.
Dr. Shiel: Yes, Dr. Lee without question long-term use of
cortisone-related medications such as prednisone or prednisolone is
commonly associated with skin thinning.
Dr. Lee: Long term, you mean several months, I presume.
Dr. Shiel: Typically, for thinning of the skin to occur, several
months use is required. Often times it does not show up for a year after
initially starting treatment.
Dr. Lee: Another viewer wants to know whether this skin thinning is
reversible after the corticosteroids are stopped.
Dr. Shiel: In my experience,
significant thinning of the skin and other skin changes that occur because of
steroids or cortisone-related medication, generally does not reverse significantly after these
medications are discontinued.
Dr. Lee: Is it fair to say that if the skin is thinned by
corticosteroids it is more prone to lacerations or injury?
Dr. Shiel:
Absolutely. Not only is the skin more fragile as a result of cortisone, but the tiny
blood vessels in the skin called capillaries are
particularly sensitive to injury and can rupture more easily after taking cortisone
medications.
Dr. Lee: Another viewer wants to know about the corticosteroids-induced rounding of the face. Is that temporary or is that irreversible after stopping the steroids?
Dr. Shiel: Fortunately, the
rounding of the face, which occurs because of cortisone medications, is often
times reversible. This usually occurs because of a re-distribution of fatty
tissue and enlargement of fat in and
around the face so that what is commonly referred to as a "moon
face" can occur with prolonged cortisone use. This often times is a
temporary phenomenon. There are a limited number of patients who
unfortunately, this is not reverse in, but most often does reverse over
time after the medicines are discontinued.
Dr. Lee: Thank you Dr.
Shiel. Let me add that corticosteroids have many more significant side effects
when used on a long-term, high-dose basis. Viewers are encouraged to see
MedicineNet.com's Prednisone
and Prednisolone articles.
Last Editorial Review: 12/26/2006
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