Corticosteroids

Published by Bupa’s Health Information Team, October 2011.

This factsheet is for people who are taking corticosteroids, or who would like information about them.

Corticosteroids are a type of steroid. Steroids are hormones that are made in the body. Man-made (synthetic) corticosteroids are used to treat a number of conditions and diseases. This factsheet will focus on synthetic corticosteroids. 

Why would I take corticosteroids?

Corticosteroids are usually used to treat inflammation or swelling.

Topical corticosteroids are creams or ointments that you apply to your skin. They can be used to treat skin conditions such as eczema or dermatitis.

Corticosteroids can be given through an inhaler to treat allergic conditions, such as asthma, or as eye drops or nasal sprays to treat the symptoms of hay fever.

Injections of corticosteroids can be used to treat inflammatory conditions that affect your joints, such as osteoarthritis or rheumatoid arthritis. Corticosteroids can also be injected into muscles, ligaments or around tendons to help reduce pain and inflammation. See our common questions for more information.

Other conditions that may benefit from corticosteroids include:

• inflammatory bowel disease (for example, Crohn’s disease)
• kidney disease
• systemic lupus erythematosus
• some cancers of the blood or lymphatic system (part of your body's natural defence system)

Corticosteroids can also be used to prevent your immune system from rejecting a donated organ if you have had a transplant operation.

What are the main types of corticosteroids?

There are different types of corticosteroids including:

• inhaled corticosteroids – taken as sprays or inhalers
• oral corticosteroids – swallowed as tablets
• topical corticosteroids – eye drops, or creams and ointments that you apply to your skin
• injected corticosteroids – injected directly into your bloodstream, into a joint or around a tendon

Your GP or health professional prescribing your medicine will advise you which type is best for you.

How do corticosteroids work?

Your body produces corticosteroid hormones to help maintain blood sugar levels and balance the levels of salts and water in your body. They work to control your immune system and so reduce swelling and other symptoms of inflammation.

Corticosteroid medicines are synthetic versions of these hormones. In high doses, corticosteroids block the chemicals that trigger inflammation. They also suppress your immune system.

How to take corticosteroids

There are many different ways to take corticosteroids. You can apply them as a cream or ointment, or take them as a tablet, as a nasal spray or drops, as eye drops, or as an inhaler. Alternatively, your GP may give you an injection or an enema – a liquid that you inject into your rectum (back passage).

If you have been taking corticosteroids for more than three weeks, your dose should be reduced gradually before you stop taking them. Speak to your GP for advice before you stop taking corticosteroids.

Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

Special care

Taking corticosteroid injections or tablets for a long time can make you more at risk of developing infections, particularly chickenpox, measles and shingles. Try to minimise how much close contact you have with anyone with chickenpox, measles or shingles if you're taking corticosteroids long-term.

Oral or injected corticosteroids can also reduce the effect of insulin in your body. If you have diabetes and are prescribed oral corticosteroids, speak to your GP for advice.

If you're prescribed corticosteroid tablets or injections for longer than three weeks, you will be given a steroid treatment card. This card explains that you're taking corticosteroids and that these should not be stopped abruptly. It also gives you advice about what to do if you become ill.

Side-effects of corticosteroids

Side-effects are the unwanted effects of taking a medicine. If you have side-effects, it's important to talk to your GP or the healthcare professional who prescribed your medicine before you stop taking it. This section doesn't include every possible side-effect of corticosteroids. Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

You're unlikely to get side-effects from corticosteroids if you're only taking them occasionally or if you’re using topical corticosteroids.

Side-effects from corticosteroids are less likely if they’re only used in a specific area of your body. For example, applying a cream to the area of your skin that is affected rather than taking a tablet or having an injection into a vein.

Inhaled corticosteroids can increase the risk of developing oral thrush. This can be prevented by using a spacer device and rinsing your mouth after using your inhaler.

If you have to take a high dose of oral or injected corticosteroids long-term, you may be more likely to get side-effects such as:

• changes in mood
• an increase in blood pressure
• stomach ulcers
• diabetes
• osteoporosis
• increased appetite
• weight gain
• stunted growth (in children)

Taking oral corticosteroids long-term or having numerous corticosteroid injections may also cause Cushing's syndrome. This is a condition that can cause a range of symptoms including, acne, an increase in the fat at the top of your back or stomach, muscle weakness and puffiness around your face (moon face). If you have Cushing's syndrome, you may also bruise more easily.

Using corticosteroids as a cream or ointment long-term may make your skin thinner and increase your risk of getting stretch marks.

Allergies

It's possible to have an allergic reaction to one of the ingredients in topical corticosteroids. This can cause swelling, itching and reddening of your skin. If you have an allergic reaction to a topical corticosteroid, contact your GP.

Interactions of corticosteroids with other medicines

Check with your GP or the healthcare professional who prescribed your medicine before you take any other medicine or herbal remedies at the same time as corticosteroids.

Names of common corticosteroids

The main corticosteroids are shown in the table below.

All medicines have a generic name. Many medicines also have one or more brand names. Generic names are in lower case, whereas brand names start with a capital letter.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.