Misconceptions About Steroids

In my practice, whenever I mention the word “steroid,” I can practically see parents getting agitated and apprehensive. It is not surprising since everyone knows that steroid is bad for the body. In today’s topic, I hope to break some taboos concerning steroids.

Steroids are anti-inflammatory medicines that are used to treat various illnesses. Inflammation is a process whereby the immune system releases chemicals in response to injury, infection, and toxins. Steroids should not be confused with anabolic steroids used illegally to boost muscle power.

Steroids are human-made versions of hormones naturally produced by our body, specifically by the adrenal glands. Natural steroids (hormones) are needed in various bodily functions. However, when taken in higher doses than what is produced by the body, it reduces inflammation, thereby helps in conditions like eczema and asthma.

Steroids come in many different preparations.

Tablets, syrups, and liquids – prednisolone

Inhalers and nasal sprays – beclomethasone or fluticasone

Injections – methylprednisolone

Creams, lotions, and gel – hydrocortisone

There are various other steroids available with different chemical names.

The side effects of steroids depend on the type of steroids used.

Tablets – taking steroid tablets for < 3 weeks is generally harmless. Consumption beyond that may suppress the immune system, cause weight gain, high blood pressure, high blood sugar, weakening bones (osteoporosis), and many more.

Steroid inhalers – if misused, can cause sore mouth, cough, rough voice, nosebleeds, or fungal infection of the mouth (thrush).

Steroid nasal sprays – dryness or nose, irritated throat, stinging or itchiness of the nose, and nosebleeds may occur if used continuously for > 1 month.

Steroid creams – depending on the strength of the steroid and duration, typical side effects include thinning of the skin, easy bruising, stretch marks, and excessive hair growth. The growth of a child can be affected and should be monitored closely.

Thankfully, these side effects are reversible once steroid usage is stopped.

The need for steroids would depend on the severity of the disease and overall condition following a doctor’s assessment. For example, Child A with infrequent asthmatic attacks would not need steroid inhalers compared to Child B with frequent wheezing, daily cough, or frequent breathlessness.

Barely 3 years ago, an “all-natural” baby skin cream was found to contain a potent steroid in Canada. The labeled ingredients include shea butter, argan oil, aloe vera, and claimed to be “steroid-free.” A similar incident also occurred in the UK where parents were not aware that certain baby skin products were contaminated with steroids. Hence be extra cautious when products give ‘miraculous’ or ‘too good to be true’ results or claims.

The key point that I wish to stress here is that steroids do not cause significant side effects when taken for short periods or at a low dose. However, anyone who is on steroids should be monitored by a doctor for early identification of its harmful side effects.

1. Steroids www.nhs.uk

2. Herbal creams used for atopic eczema in Birmingham UK illegally contained potent corticosteroids Archives of Disease in Childhood BMJ Journals Volume 88, Issue 12

3. Recall of ‘natural’ cream for kids’ skin problems a cautionary tale for parents:MD https://nationalpost.com/…/health-canada-issues-warning…